Special Investigations Unit Investigator ; Mid-Level – Medicare Supplement Fraud Waste
Listed on 2026-01-12
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Law/Legal
Financial Crime
Life Special Investigations Unit Investigator I (Mid-Level) – Medicare Supplement Fraud Waste & Abuse
Join to apply for the Life Special Investigations Unit Investigator I (Mid-Level) – Medicare Supplement Fraud Waste & Abuse role at USAA
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Join to apply for the Life Special Investigations Unit Investigator I (Mid-Level) – Medicare Supplement Fraud Waste & Abuse role at USAA
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Why USAA?
At USAA, our mission is to empower our members to achieve financial security through highly competitive products, exceptional service and trusted advice. We seek to be the #1 choice for the military community and their families.
Why USAA?
At USAA, our mission is to empower our members to achieve financial security through highly competitive products, exceptional service and trusted advice. We seek to be the #1 choice for the military community and their families.
Embrace a fulfilling career at USAA, where our core values – honesty, integrity, loyalty and service – define how we treat each other and our members. Be part of what truly makes us special and impactful.
The Opportunity
USAA Life Company’s SIU Life & Health is seeking a talented Life Special Investigations Unit Investigator I (Mid-Level) to review, analyze, and investigate life, health, and annuity claims to ensure claim validity and to protect the association from potentially fraudulent activity. This role will provide investigative support and recommendations on claim settlements and assists with fraud detection and deterrence, as well as, investigate fraud investigations that may have significant financial impact to Life Company and/or the association.
Consult and involve Legal Counsel, Underwriting, law enforcement, and other agencies as appropriate.
As a Mid-Level Life SIU Investigator for Medicare Supplement Fraud, Waste, and Abuse you will support the Life Special Investigations team that is responsible for increasing fraud awareness throughout USAA and its membership, developing innovative fraud detection and prevention programs, and investigating cases of suspected fraud for Life Company.
We offer a flexible work environment that requires an individual to be in the office 4 days per week. This position can be based in one of the following locations:
San Antonio, TX, Phoenix, AZ, Colorado Springs, CO, Tampa, FL, or Plano, TX. Relocation assistance is not available for this position.
What You'll Do
- Conducts moderately complex investigations for life, health, and annuity products for potential claims fraud.
- Gathers evidence through interviews, searches of investigative databases, internal resources, internet resources, medical records, law enforcement records, and/or public records to support conclusions while adjusting investigative strategies as necessary.
- Prepares detailed and comprehensive investigative reports to summarize and substantiate the results/outcome of the investigation.
- Applies proficient knowledge of state/federal laws and regulations and legal concepts, including contract and case law, to ensure investigations are conducted within regulatory requirements.
- Applies proficient product and system knowledge to ensure appropriate investigation and/or claim settlement.
- Proactively manages the life of an investigation and acts as the liaison between the member, legal counsel, law enforcement, and other related agencies, as appropriate.
- Submits Department of Insurance fraud reports in compliance with established regulatory guidelines and time frames.
- Uses evidence of investigation and supporting documentation to make claim settlement determinations and recommendation for claim payments.
- Represents USAA at mediations and/or trial as required.
- Ensures risks associated with business activities are effectively identified, measured, monitored, and controlled in accordance with risk and compliance policies and procedures.
- High School Diploma or General Equivalency Diploma required.
- 2 years of life insurance claims and/or investigation experience.
- Profic…
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