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Davies

Special Investigations Unit Investigator (Remote)

Posted 5 days ago
$65000 - $82000 per year
2-5 years experience
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AI Summary

The investigator will conduct comprehensive investigations into suspected insurance fraud, misrepresentation, and claim irregularities across multiple lines of business. They are responsible for gathering evidence, conducting interviews, and preparing professional reports to support claims professionals and stakeholders.

Special Investigations Unit Investigator (Remote)

Department: Risk Management and Loss Control

Employment Type: Permanent - Full Time

Location: Home United States

Reporting To: Director of SIU

Compensation: $65,000 - $82,000 / year



Description

Our Story
Imagine being part of a team that’s not just shaping the future but actively driving it. At Davies North America, we’re at the forefront of innovation and excellence, blending cutting-edge technology with top-tier professional services. As a vital part of the global Davies Group, we help businesses navigate risk, optimize operations, and spearhead transformation in the insurance and regulated sectors.

What's in Store
We are on the lookout for an experienced Special Investigations Unit (SIU) Investigator to join our team! You will be responsible for conducting comprehensive investigations involving suspected fraud, misrepresentation, claim irregularities, and other potentially questionable activity.

The ideal candidate will have investigative experience across multiple lines of insurance, including Workers’ Compensation, General Liability, Auto, and Property claims. Prior Workers’ Compensation investigative experience is required.

This is a remote position; however, candidates located in Southern California or Central Florida are strongly preferred based on business needs and investigative coverage requirements. In addition, it is highly preferred that the candidate has the ability and willingness to travel locally to conduct investigative assignments as business needs require, have a valid driver’s license and reliable transportation, and possess the ability to obtain and maintain any investigator license or registration required by the state or jurisdiction in which assignments are performed.



Key Responsibilities

  • Conduct comprehensive SIU investigations involving suspected fraud, misrepresentation, claim irregularities, and other potentially questionable activity.
  • Investigate insurance claims by researching claimant activity, employment history, business interests, prior claims, relationships, and other relevant areas of inquiry.
  • Conduct detailed background investigations using public records, proprietary databases, court records, business records, social media, and other approved investigative resources.
  • Handle investigations across multiple lines of business, including Workers’ Compensation, General Liability, Auto, Property, and other insurance-related matters.
  • Review claim files, SIU referrals, supporting documentation, and available evidence to develop effective investigative strategies and appropriate next steps.
  • Identify investigative leads, inconsistencies, fraud indicators, and opportunities for additional investigative activity.
  • Conduct interviews and obtain recorded or written statements, as appropriate.
  • Coordinate investigative activities with claims professionals, SIU leadership, clients, attorneys, and other stakeholders as needed.
  • Prepare clear, accurate, timely, and professional investigative reports documenting findings, evidence, activities performed, and recommended next steps.
  • Maintain accurate case documentation and ensure investigations are completed in accordance with applicable regulations, client requirements, and internal procedures.
  • Manage assigned caseload effectively while meeting established quality standards, deadlines, and service expectations.
  • Maintain confidentiality and appropriately handle sensitive claim and investigative information.



Skills, knowledge & expertise

Required:
  • Workers’ Compensation investigative experience is required.
  • Prior experience conducting SIU, insurance fraud, claims, law enforcement, corporate, or related investigations.
  • Demonstrated experience conducting background investigations and researching public records and investigative databases.
  • Strong interviewing, investigative research, analytical, and report-writing skills.
  • Ability to analyze claim documentation and recognize inconsistencies, suspicious activity, and potential fraud indicators.
  • Strong organizational and time-management skills with the ability to manage multiple investigations simultaneously.
  • Excellent written and verbal communication skills.
  • Ability to work independently in a remote environment while collaborating effectively with internal teams and clients.
  • Proficiency with Microsoft Office and familiarity with claims management, investigative research, or case management systems.
Preferred:
  • Investigative experience across multiple insurance lines, particularly Workers’ Compensation, General Liability, Auto, and Property.
  • Previous experience working within an insurance carrier, third-party administrator (TPA), SIU, investigative firm, or law enforcement environment.
  • Experience conducting field investigations, interviews, statements, background investigations, and social media or open-source research.
  • Experience with Premium Fraud investigations. 
  • Familiarity with insurance fraud regulations and SIU compliance requirements.
  • Candidates located in Southern California or Central Florida are strongly preferred.



Equal Employment Opportunity & Legal Notices

Benefits
At Davies North America, we are dedicated to supporting the well‑being and future of our qualifying employees. Our comprehensive benefits package includes:
  • Medical, dental, and vision plans to support your health and that of your family
  • A 401(k) plan with employer matching
  • Time‑off policies, including Discretionary Time Off (DTO) for exempt employees and Paid Time Off (PTO) for non‑exempt employees
  • Paid holidays
  • Life insurance and short‑term and long‑term disability coverage
Benefit offerings, eligibility, and required employer contributions may vary based on role, classification, and applicable federal, state, and local laws, including those tied to an employee’s primary work location.

Where required by law, the Company provides paid sick leave, paid family and parental leave, and other mandated benefits in accordance with applicable state and local requirements.

Diversity and Inclusion
Davies is dedicated to fostering a diverse and inclusive workplace that embraces a wide range of perspectives and experiences. We believe that diversity of thought is essential for innovation and creativity, and we actively promote an environment where all voices are valued and heard.

Compensation Transparency:
The salary range listed reflects the full compensation band for this role across all locations. Actual compensation will be based on factors such as skills, experience, qualifications, and geographic location, which may impact the final offer. We share ranges to remain transparent and consistent with pay equity practices.

Essential Functions
The following responsibilities and expectations are considered essential to the successful performance of this role. Reasonable accommodations may be made to enable qualified individuals with disabilities to perform these essential functions.
  • Maintain regular and dependable attendance.
  • Be available and able to perform job responsibilities during established work hours.
Background Check & Fair Chance Compliance 
Any background check or review of criminal history, if applicable to the role, will be conducted only after a conditional offer of employment and in compliance with applicable federal, state, and local laws, including fair‑chance hiring requirements.

Massachusetts Notice
It is unlawful in Massachusetts to require or administer a lie detector test as a condition of employment or continued employment. An employer who violates this law shall be subject to criminal penalties and civil liability.

AI Policy
At Davies, we value authentic conversations and a fair candidate experience. While candidates may use AI and technology tools to prepare for interviews, we expect interview responses and assessments to reflect each individual's own experience, knowledge, and professional judgment. 

We do not use sites like Facebook, Craigslist, or Telegram to recruit or interview potential employees or contractors. If you have been asked to provide any information through any method other than our career portal, please email us at recruitment@davies-group.com

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