Analyst, Special Investigations
About The Position
The SIU Analyst supports the Special Investigations Unit by overseeing its vendor and ensuring investigations are properly managed, documented, and aligned with regulatory and internal standards. The role partners with the vendor, Claims leadership, and internal teams to promote high-quality investigations, support SIU training and engagement, and maintain compliance across SIU functions. The Analyst interprets investigative data, identifies trends, and helps strengthen fraud mitigation strategies within the Claims Department. The position also supports high-level investigations, audits, regulatory reviews, special investigative projects, and fraud-prevention initiatives. Duties listed are representative of the general nature and level of the work and are not exhaustive.
Requirements
- Bachelor’s degree or equivalent professional experience.
- At least 3–7+ years in P&C claims, SIU, or investigations.
- Strong fraud-identification and analytical capability.
- Effective communication and documentation skills.
- Experience working cross-functionally.
- Strong analytical ability to interpret investigative data and identify meaningful patterns.
- Clear, professional communication when presenting investigative findings or vendor performance updates.
- High attention to detail when reviewing reports, documentation, and compliance requirements.
- Ability to build effective working relationships with vendors, Claims teams, and leadership.
- Sound judgment and investigative reasoning to support case evaluation and escalation decisions.
- Ability to manage multiple cases, deadlines, and priorities with disciplined organization.
- Ability to adapt to evolving investigative needs, regulatory changes, and departmental priorities.
- Proficiency using reporting tools, SIU systems, and Microsoft Office.
Nice To Haves
- Industry designations such as AIC, CIFI, CFE, or CPCU are beneficial but not required.
Responsibilities
- Provide day-to-day oversight of the SIU vendor to ensure timely, thorough, and compliant investigative activity.
- Review investigative reports, findings, and recommendations for accuracy, completeness, and alignment with departmental expectations.
- Partner with the vendor and internal teams to support SIU-related training, including fraud awareness and investigative best practices.
- Work with the SIU vendor, compliance, and legal teams to maintain SIU compliance functions, including documentation standards, regulatory requirements, and reporting obligations.
- Analyze investigative data, identify trends, and translate insights into actionable recommendations for Claims leadership.
- Collaborate with Claims staff to support high-level investigations and ensure proper escalation and case handling.
- Assist in developing and refining SIU processes, workflows, and performance metrics.
- Participate in audits, regulatory reviews, or special investigative projects as needed.
- Assist with updates to SIU policies, procedures, and training materials as needed.
- Support fraud-prevention initiatives or cross-departmental improvement efforts as needed.
Benefits
- Medical, dental, life, and vision benefits.
- Company-paid short- and long-term disability.
- 401(k).
- Tuition assistance.
- Additional benefits.
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
