SIU, Complex Major Case Investigator

AmTrust Financial Services, Inc.•,

11d•$105,000 - $110,000•Remote

About The Position

The SIU – Complex Major Case Investigator advances the company’s fraud defense strategy by investigating complex fraudulent networks and schemes. The role uses all-source data, advanced analytics, and collaborative partnerships to develop actionable intelligence that protects company assets, supports regulatory compliance, and contributes to high-stakes legal proceedings. The investigator conducts complex insurance fraud investigations, gathers and analyzes evidence, identifies fraud patterns and vulnerabilities, and prepares reports and intelligence briefings. The role works with internal departments and external partners to support investigations and disrupt fraudulent activity, while ensuring compliance with applicable laws and maintaining confidentiality and integrity.

Requirements

Bachelor’s degree in criminal justice, data analytics, intelligence studies, or a related field.
5–7 years of professional experience in complex insurance fraud investigations, law enforcement, or intelligence analysis.
Expertise in all-source intelligence gathering and analytical techniques for complex investigations.
Strong analytical and quantitative skills, including interpreting large datasets, identifying patterns, and making data-driven decisions.
Exceptional written and verbal communication skills, including the ability to present complex information clearly to diverse audiences.
Ability to work with a high degree of autonomy, initiative, and discretion.
Strong understanding of insurance principles, fraud statutes, and privacy regulations.

Nice To Haves

Proficiency with investigative databases, social media analysis, and data visualization tools is highly preferred.

Responsibilities

Conduct complex investigations into suspected fraudulent claims and schemes involving claimants, providers, policyholders, and internal parties.
Gather, preserve, and analyze evidence from financial records, digital forensics, surveillance, social media, and public and private databases.
Prepare investigative reports for internal claims decisions, law enforcement referrals, and courtroom testimony.
Manage a dynamic caseload independently and collaboratively to meet deadlines and objectives.
Monitor fraud activity across products and channels and apply statistical analysis to identify patterns, trends, and systemic vulnerabilities.
Use all-source research, collection, and analysis techniques to identify fraudulent networks, key players, and methodologies.
Evaluate new data sources and vendor tools to uncover fraud patterns and improve predictive models and fraud detection strategies.
Provide leadership with intelligence briefings on fraud trends, tool effectiveness, and the threat landscape.
Collaborate with Claims, Underwriting, and Audit to provide investigative expertise and coordinate strategy.
Liaise with law enforcement, regulatory agencies, and legal counsel to disrupt fraudulent networks.
Partner with vendors, product managers, and digital teams to improve fraud detection rules, alerts, and analytical models.
Ensure investigative and analytical work complies with applicable fraud statutes, privacy laws, and regulatory reporting requirements.
Maintain confidentiality and uphold high ethical standards.