For Employers
Apply Now

Please mention DailyRemote when applying

?
Resume Match Score

See how much of this job your resume covers, and what’s missing.

Want a recruiter to go through it line by line?

Get professional review

Create a cover letter for this job

Upload your resume and we draft a letter for this exact role, tailored to what it asks for.

  • Tailored to this role
  • Based on your resume
  • Fully editable
AI Summary

The Senior Investigator will conduct complex fraud investigations, including organized ring activity, by gathering evidence and interviewing relevant parties. They will also provide anti-fraud training and develop marketing strategies for SIU services while maintaining compliance with reporting requirements.

At EMC, we’re all about working together to make an impact. As part of our team, you’ll have the opportunity to grow, contribute, and gain experience that matters. We strive to be caring leaders, close partners, and responsive experts—always supporting each other to do our best work. Join us, and let’s improve lives together.

  

**This position is eligible to work from home anywhere in the United States**

Essential Functions:

  • Promptly investigates and evaluates SIU referrals of moderate to high complexity, including organized ring activity
  • Reviews claim, underwriting and premium audit files pertinent to the referral
  • Initiates contact with other departments, insureds, claimants, witnesses, vendors, other carriers, attorneys, law enforcement or any others to obtain information
  • Researches background information, including public records, claims history and social media sites
  • Takes statements from insureds, claimants, witnesses and other pertinent parties.
  • Documents all special investigative handling and activity
  • Reviews the facts of an investigation and completes field investigations
  • Attends examinations under oath (EUOs) and depositions for assigned cases
  • Secures and reviews bills, invoices, receipts and other documentation for legitimacy and accuracy
  • Tracks trends and patterns of investigations regarding organized ring activity
  • Provides status updates on special investigations to branch or corporate office team members, agents, defense counsel and law enforcement entities
  • Identifies, investigates and pursues opportunities for recovery or restitution
  • Develops and evaluates investigative data and evidence to formulate recommendations
  • Conducts analysis of all investigative materials to formulate a recommendation for further handling, including payment, compromise or denial of a claim or rescission of a policy
  • Prepares a special report with written summaries of all investigative data
  • Communicates with branch and corporate office departments, as well as other impacted entities, regarding investigative activities and evidence to support or exonerate potential fraud
  • Prepares documentation in compliance with a state’s anti-fraud reporting requirements on each investigation
  • Prepares evidence packets related to civil litigation or criminal prosecution for submission to defense counsel, National Insurance Crime Bureau (NICB), State Fraud Bureaus and/or Attorney General’s offices or other law enforcement entities
  • Develops assigned internal and external anti-fraud training and marketing of SIU services
  • Develops assigned internal and external anti-fraud training
  • Provides anti-fraud training to internal and external customers through investigative discussions and dissemination of educational materials
  • Collaborates with team members in developing marketing strategies for the SIU department and its services
  • Implements assigned marketing strategies
  • Participates in the establishment of effective policy standards, practices, techniques and procedures for the investigation, evaluation and disposition of the SIU referral. Maintains active involvement in professional associations within the industry.

Education & Experience:

  • Bachelor’s degree in business, insurance, criminal justice or related field or equivalent relevant experience
  • Five years of claims adjusting, investigation or insurance experience or related experience
  • Prior property and casualty experience preferred
  • Fraud Claim Law Specialist (FCLS) designation within the first year of hire
  • Insurance designations, such as INS or AIC, preferred

Knowledge, Skills & Abilities:

  • Strong knowledge of the investigative process, including proper identification and collection of physical evidence
  • Strong knowledge of civil and criminal investigative procedures and the legal system
  • Strong knowledge of various statement taking techniques, collection and analysis of public and private records
  • Good knowledge of property and casualty insurance industry and fraud awareness preferred
  • Strong investigative skills and ability to make sound decisions
  • Good conflict resolution, negotiation and facilitation abilities
  • Ability to work independently and as part of a team
  • Strong verbal and written communication skills, including file documentation and report writing
  • Good knowledge of computers and Microsoft Office Suite 
  • Attendance of the National Insurance Crime Bureau SIU Academy within the first two years of hire
  • Occasional travel; a valid driver’s license with an acceptable motor vehicle report per company standards required if driving

Per the Colorado Equal Pay for Equal Work Act, the hiring range for this position for Colorado-based team members is $75,910.79 - $97,485.70. The hiring range for other locations may vary.

The hiring salary range for this position will vary based on geographic location, falling within either of the following:

$78,726 - $108,771 or $87,008 - $119,646

A hiring range represents a subset of the full salary range. The actual salary will depend on several factors, including relevant education, skills, and experience of an applicant, geographic location, and business needs.

 

 

For information relating to the benefits EMC Team Members receive as part of a comprehensive rewards package, please visit www.emcins.com/careers.

Our employment practices are in accordance with the laws that prohibit discrimination due to race, color, creed, sex, sexual orientation, gender identity, genetic information, religion, age, national origin or ancestry, physical or mental disability, medical condition, veteran status, active military status, citizenship status, marital status or any other consideration made unlawful by federal, state, or local laws.

All of our locations are tobacco free including in company vehicles.

Automatically Apply to the Best Remote Jobs

Stop the endless job search. Our AI finds and applies to the best jobs for you.

Try it Now
Keep looking

Similar Jobs

See all Remote Others jobs →

AI Trainer

Freelance United Arab Emirates, Argentina, Austria +43 more $60K – $70K Others

Enterprise Account Executive - Life Sciences

Full Time United States Others

Process Modeller - Biologics

Full Time Canada Others

Product Manager - LED Lighting - Remote Latin America

Full Time Mexico Others

Healthcare Concierge. Care Partner

Full Time Egypt Others

Remote Protection Services Advisor

Full Time United States $90000 - $119K per year Others
Apply Now

Personalize your Remote Job Search in 3 Easy Steps!

Featuring 221,974+ Jobs in Others

Answer easy questions

Answer easy questions

221,974+ jobs across 15+ categories

Get your best job matches

Get your best job matches

Only hand-screened, legit jobs

Find a remote job faster

Find a remote job faster

No ads, scams, or junk

“I was the first applicant for a remote marketing position that got listed on the company website the same day I applied. Had an interview within 48 hours!”

Sarah J. — Sarah J. · Marketing Manager ★★★★★ Verified