SIU Investigator

CITON Claims Solutions•Atlanta, GA

2d•Onsite

About The Position

CITON is seeking an experienced SIU Investigator to conduct comprehensive investigations into suspicious or potentially fraudulent insurance claims. This role requires strong field investigative experience, analytical skills, and the ability to independently manage complex case assignments across multiple jurisdictions. The ideal candidate will play a critical role in protecting the integrity of the claims process through detailed investigations, accurate reporting, and collaboration with internal teams, law enforcement, and regulatory agencies.

Requirements

Bachelor’s degree preferred or equivalent professional experience
Minimum 4+ years of SIU, fraud investigation, or investigative law enforcement experience
Experience handling complex, high-volume investigative caseloads
Strong investigative and analytical skillset
Ability to work independently with minimal direction
Excellent written and verbal communication skills
Sound judgment and decision-making ability
Knowledge of medical terminology and claims-related documentation
Proficiency with Microsoft Office, investigative tools, open-source intelligence, and Verisk platforms
Strong relationship-building skills with internal and external stakeholder

Nice To Haves

Prior military or law enforcement investigative experience considered a strong plus
CIFI (Certified Insurance Fraud Investigator)
CFE (Certified Fraud Examiner)
FCLS, FCLA or other relevant industry designations

Responsibilities

Conduct detailed, timely, and thorough investigations utilizing established SIU investigative principles
Perform field and scene investigations, including inspections and evidence documentation
Obtain recorded statements from insureds, claimants, and witnesses
Analyze claims, documentation, and data to identify fraud indicators and inconsistencies
Prepare comprehensive investigative reports and summaries supporting findings
Conduct or support Examinations Under Oath (EUO) as required
Ensure compliance with Department of Insurance reporting requirements and anti-fraud regulations
Collaborate with claims teams, legal counsel, and SIU leadership on complex investigations
Coordinate with external partners including NICB, law enforcement, IASIU, and investigative vendors
Provide deposition and courtroom testimony when required
Maintain accurate documentation and case management tracking
Participate in fraud awareness training and internal education initiatives
Attend industry meetings and maintain required anti-fraud continuing education