SIU – Complex Major Case Investigator

AmTrust Financial Services, Inc.

114d

About The Position

The SIU – Complex Major Case Investigator is a cornerstone of our fraud defense strategy. This role moves beyond traditional case investigation to proactively identify, analyze, and dismantle complex fraudulent networks targeting the organization. By leveraging all-source data, advanced analytics, and collaborative partnerships, this position provides actionable intelligence that protects company assets, ensures regulatory compliance, and supports high-stakes legal proceedings. The ideal candidate is an expert in both investigative techniques and data interpretation, capable of turning raw information into strategic insight.

Requirements

• Bachelor’s degree in criminal justice, data analytics, intelligence studies, or a related field.
• Minimum of 5-7 years of professional experience in complex insurance fraud investigations (Commercial, P&C, Workers' Compensation), law enforcement, or intelligence analysis.
• Demonstrated expertise in conducting all-source intelligence gathering and applying analytical techniques to complex investigations.
• Strong analytical and quantitative skills with a proven ability to interpret large datasets, identify patterns, and make data-driven decisions.
• Proficiency with investigative databases, social media analysis, and data visualization tools is highly preferred.
• Exceptional written and verbal communication skills, with the ability to present complex information clearly to diverse audiences.
• Proven ability to operate with a high degree of autonomy, initiative, and discretion.
• A strong understanding of insurance principles, fraud statutes, and privacy regulations.

Responsibilities

• Conduct complex investigations into suspected fraudulent claims and schemes involving claimants, providers, policyholders, and internal parties.
• Gather, preserve, and analyze critical evidence from a wide array of sources, including financial records, digital forensics, surveillance, social media, and public/private databases.
• Prepare detailed, clear, and concise investigative reports suitable for internal claims decisions, law enforcement referrals, and courtroom testimony.
• Manage a dynamic caseload efficiently, working both independently and as a collaborative team member to meet deadlines and objectives.
• Proactively monitor fraud activity across all products and channels, applying statistical analysis to identify emerging patterns, trends, and systemic vulnerabilities before they escalate.
• Apply all-source research, collection, and analysis techniques to illuminate fraudulent networks, their key players, and methodologies.
• Continuously evaluate new data sources and vendor tools to uncover novel fraud patterns and enhance the evolution of our predictive models and fraud detection strategies.
• Provide timely and actionable intelligence briefings to leadership on fraud trends, tool effectiveness, and the overall threat landscape.
• Collaborate closely with Claims, Underwriting, and Audit departments to provide investigative expertise and ensure a cohesive strategy.
• Serve as a key liaison with external partners, including law enforcement, regulatory agencies (NICB, state fraud bureaus), and legal counsel, to disrupt and dismantle fraudulent networks.
• Partner with vendors, product managers, and digital teams to refine and improve the accuracy of fraud detection rules, alerts, and analytical models.
• Ensure all investigative and analytical activities are conducted in strict compliance with relevant fraud statutes, privacy laws (e.g., GLBA), and regulatory reporting requirements.
• Uphold the highest ethical standards, maintaining absolute confidentiality and integrity in all matters.

Benefits

• Medical & Dental Plans
• Life Insurance, including eligible spouses & children
• Health Care Flexible Spending
• Dependent Care
• 401k Savings Plans
• Paid Time Off

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: Bachelor's degree