Special Investigations Unit Investigator (Remote)

Davies • Home, WV

21h • $65,000 - $82,000 • Remote

About The Position

Davies North America is seeking an experienced Special Investigations Unit (SIU) Investigator to conduct comprehensive investigations involving suspected fraud, misrepresentation, claim irregularities, and other potentially questionable activity. The role investigates insurance claims across multiple lines, including Workers’ Compensation, General Liability, Auto, and Property; prior Workers’ Compensation investigative experience is required.

This is a remote position. Candidates located in Southern California or Central Florida are strongly preferred based on business needs and investigative coverage requirements. The role may require local travel for investigative assignments, along with a valid driver’s license, reliable transportation, and the ability to obtain and maintain any investigator license or registration required in the relevant jurisdiction.

The investigator reviews claim materials and evidence, researches records and claimant activity, develops investigative strategies, conducts interviews, coordinates with stakeholders, and prepares detailed reports. They manage assigned cases in accordance with regulations, client requirements, and internal procedures while maintaining confidentiality and meeting quality, deadline, and service expectations.

Requirements

• Workers’ Compensation investigative experience.
• Prior experience conducting SIU, insurance fraud, claims, law enforcement, corporate, or related investigations.
• Demonstrated experience conducting background investigations and researching public records and investigative databases.
• Strong interviewing, investigative research, analytical, and report-writing skills.
• Ability to analyze claim documentation and recognize inconsistencies, suspicious activity, and potential fraud indicators.
• Strong organizational and time-management skills, including the ability to manage multiple investigations simultaneously.
• Excellent written and verbal communication skills.
• Ability to work independently in a remote environment and collaborate effectively with internal teams and clients.
• Proficiency with Microsoft Office and familiarity with claims management, investigative research, or case management systems.

Nice To Haves

• Investigative experience across multiple insurance lines, particularly Workers’ Compensation, General Liability, Auto, and Property.
• Previous experience in an insurance carrier, third-party administrator (TPA), SIU, investigative firm, or law enforcement environment.
• Experience conducting field investigations, interviews, statements, background investigations, and social media or open-source research.
• Experience with Premium Fraud investigations.
• Familiarity with insurance fraud regulations and SIU compliance requirements.
• Located in Southern California or Central Florida.
• Ability and willingness to travel locally for investigative assignments as business needs require.
• Valid driver’s license and reliable transportation.
• Ability to obtain and maintain any investigator license or registration required by the state or jurisdiction where assignments are performed.

Responsibilities

• Conduct comprehensive SIU investigations involving suspected fraud, misrepresentation, claim irregularities, and other potentially questionable activity.
• Research claimant activity, employment history, business interests, prior claims, relationships, and other relevant areas of inquiry.
• Conduct background investigations using public records, proprietary databases, court records, business records, social media, and other approved resources.
• Investigate matters across Workers’ Compensation, General Liability, Auto, Property, and other insurance lines.
• Review claim files, SIU referrals, supporting documentation, and available evidence to develop investigative strategies and next steps.
• Identify investigative leads, inconsistencies, fraud indicators, and opportunities for additional investigative activity.
• Conduct interviews and obtain recorded or written statements as appropriate.
• Coordinate investigative activities with claims professionals, SIU leadership, clients, attorneys, and other stakeholders.
• Prepare clear, accurate, timely, and professional investigative reports documenting findings, evidence, activities, and recommended next steps.
• Maintain accurate case documentation and complete investigations in accordance with applicable regulations, client requirements, and internal procedures.
• Manage assigned caseload while meeting established quality standards, deadlines, and service expectations.
• Maintain confidentiality and appropriately handle sensitive claim and investigative information.
• Maintain regular and dependable attendance and be available to perform job responsibilities during established work hours.

Benefits

• Medical, dental, and vision plans.
• 401(k) plan with employer matching.
• Discretionary Time Off (DTO) for exempt employees and Paid Time Off (PTO) for non-exempt employees.
• Paid holidays.
• Life insurance.
• Short-term and long-term disability coverage.
• Paid sick leave, paid family and parental leave, and other mandated benefits where required by applicable state and local laws.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: No Education Listed