Senior Special Investigator

The Senior Special Investigator protects the assets of the organization by avoiding the payment of fraudulent claims in accordance with the applicable law and policy provisions. SIU gathers facts of the loss without exposing the company to bad faith damages.

What will be my duties and responsibilities in this job?

• Conducts timely investigations of suspected fraudulent claims to ensure a prompt and accurate claims decision.
• Conducts complex recorded interviews and investigations in an effort to validate a claim or identify persons or organizations that are involved in suspicious related activities.

• Leads high exposure, high profile and sensitive work assignments, and special investigations involving complex specialized fraud referrals, (examples: organized provider rings, staged accidents, large losses of significant exposure and broad scale P&C schemes) across multiple entities or functions-Major Cases.
• Applies advanced knowledge of P&C insurance industry products, services, and processes in investigating claims. This includes P&C insurance policy contracts and coverages and claims handling process and procedures.
• Applies advanced knowledge of state laws and regulations pertaining to insurance fraud in investigating claims.
• Processes large quantities of unstructured detailed information with high levels of accuracy by collecting evidence of potential fraud through field or remote interviews and thorough searches of investigative databases, internal resources, Internet resources, public records, and forensic tools, in order to validate the company’s exposure.

• Maintains assigned claims files in confidential manner and ensures that all relevant facts pertaining to the files are documented in the appropriate claims handling system.
• Initiates referrals to State Insurance Department, Fraud bureaus and NICB when a suspicious or fraudulent activity has been identified.
• Initiates civil/criminal actions based on investigative outcomes.
• Maintains investigative databases.
• Assist all Assurant subsidiaries and accounts with investigations.
• Conducts Fraud Training for new hires, clients and company staff as needed.
• Assist SIU Manager with Claims Assignment as needed.
• ·Requests, prepares, documents, and may conduct Examinations under Oath and/or sworn statements including those involving attorney representation.
• Conducts thorough searches using investigative databases, internal resources, internet resources, and public records to locate parties and collect evidence to determine if potential fraud exists.
• Obtains, evaluates and summarizes law enforcement reports, credit reports, medical documentation and affidavits in relation to loss including documentation from required parties in accordance to state and federal regulations.
• Reviews and interprets medical records, reports, and billing in relation to injury loss investigations.
• Testifies at depositions, hearings, and trials.
• Develops and maintains a rapport with local information networks to include law enforcement, vendors, and industry experts.
• Handles budgeting and directs outsourced investigations to vendor partners.
• Acts as a resource to other Special Investigators. 

What are the requirements needed for this position?

• 10+ years of P&C SIU/Fraud investigation experience or relevant fraud industry investigation experience, or at least 10 years prior law enforcement investigative experience/detective rank. 
• Knowledge of Florida Property Fraud preferred. 
• Bachelor’s Degree in Criminal Justice or relevant work experience desired.
• CFE/CIFI/FCLS designations a plus.
• Field Investigation experience.

• Detail-oriented with strong organizational skills, able to work well under deadlines in a changing environment and perform multiple tasks effectively and concurrently.
• Demonstrated ability to manage relationships with both internal and external customers.
• Demonstrated ability to work effectively independently and within a collaborative team-oriented environment using sound judgment in decision-making.
• Excellent communication skills both oral and written skills with strong analytical skills.
• Demonstrated proficiency with Microsoft Office products (Excel, PowerPoint, and Word) and claims related software programs.
• Must be a results-oriented, skilled investigator with experience taking complex statements from multiple parties to an event.
• Ability to gather broad range of evidence and draw conclusions based on the objective details related to the applicability of fraud.
• Proven ability to organize and prioritize workload, performing multiple tasks and devising solutions to problems.

• Must be able to handle high volume of investigations and remain timely on status reports.
• Ideal candidate will reside in Florida.

Job Grade

Pay Range:

Any posted pay range considers a wide range of compensation factors, including candidate background, experience and work location, while also allowing for salary growth within the position.

If there is no posting end date then this is a pipeline requisition, and we will continue to collect applications on an ongoing basis.

AI and Biometric Usage

Assurant supports the responsible use of Artificial Intelligence (AI), but we want to know the real you. Visit our AI Usage Guidelines page to understand what we expect from applicants regarding their use of AI during the application process. Since we would like to know the real you, we require that all of our virtual interviews be conducted on video.

Employment is contingent upon completion of a required identity verification process, which may include biometric technology, where permitted by applicable law and subject to applicable notice and consent requirements. See our Privacy Notice to learn about Assurant’s privacy practices, including our use of AI-enabled technology, automated decision making, and biometric information.

Equal Opportunity Statement
Assurant is an Equal Employment Opportunity employer and does not use or consider race, color, religion, sex, national origin, age, disability, veteran status, sexual orientation, gender identity, or any other characteristic protected by federal, state, or local law in employment decisions.

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