SIU Sr. Investigator

Berkley•Overland Park, KS

29d•Onsite

About The Position

The SIU Senior Investigator leads and executes thorough, multifaceted, and highly complex investigations involving suspected insurance fraud, particularly within commercial lines. This role manages major case-level files, develops tailored investigative strategies, and ensures all investigations meet regulatory and evidentiary standards.

Requirements

7 or more years of prior SIU experience handling multi-line claims with a focus on commercial lines.
Knowledge of basic insurance principles pertaining to claims processes and procedures.
Knowledge of good faith claims practices.
Demonstrated knowledge of investigative methods and applicable laws, rules, and regulations involving insurance fraud.
Knowledge of privacy regulations and compliance requirements.
Proficiency with MS Office products.
Ability to easily adapt to new or changing situations and priorities.
Ability to be flexible and multi-task.
Dedication to meeting the expectations of internal and external customers.
Strong organizational and prioritization skills.
Ability to properly handle sensitive and confidential information.
Ability to work both independently and in a team environment.
Strong work ethic with a positive attitude.
Excellent verbal and written communication skills.

Nice To Haves

Bachelor’s Degree preferred.
Completion of one or more of the following designations: CIFI, FCLS, FCLA, and/or CFE.

Responsibilities

Evaluate sophisticated commercial and personal lines claim scenarios to identify patterns, inconsistencies, and emerging fraud trends requiring major case handling.
Conduct comprehensive interviews and gather, examine, and interpret evidence from multiple internal and external sources, with emphasis on commercial property, casualty, auto, and liability exposures.
Utilize advanced analytical reasoning to assess the extent and financial impact of suspected fraudulent activity, including complex commercial claim structures, multi‑party losses, and layered coverages.
Coordinate with specialized vendors, forensic experts, and intelligence resources to support complex investigative needs, particularly those involving commercial risk profiles and higher‑severity losses.
Serve as the primary liaison with state fraud bureaus, NICB, law enforcement, and prosecutors when cases present indicators of criminal activity or organized fraud schemes affecting commercial policyholders or business operations.
Prepare investigative summaries and present findings suitable for regulatory referral, legal review, and support of civil or criminal proceedings involving commercial claim fraud.
Identify systemic vulnerabilities and fraud trends impacting commercial lines portfolios and communicate insights to SIU and claims leadership.
Mentor claims personnel on fraud indicators, investigative best practices, and nuances specific to commercial lines underwriting, coverages, and loss patterns.
Participate in the development and delivery of anti‑fraud training, including curriculum tailored to commercial lines exposures, fraud schemes, and industry‑specific risks.
Participate in decision-making discussions with Company personnel on cases worked and resolution of investigative results.
Provide effective technical advice on SIU-related investigative issues and communicate industry data, trends, government, and legal updates.