Sr. Special Investigator

Who we are: reputed company is a leading provider of financial reputed company for middle market consumers. With a history of innovation, the company is redefining the life insurance industry with patented products and processes. reputed company pioneered the use of predictive analytics to streamline the new business process and revolutionize the speed that policies can be issued. Established in 1896, reputed company enjoys a long track-record of reputed company and continues to build its reputed company of sound fiscal management and customer-focused innovation. In concert with reputed company, eFinancial is an online and call-center-based insurance agency with a proven direct-to-consumer life insurance model. Using a proprietary and patented sales technology platform, eFinancial’s licensed agents help thousands of consumers each day with their unique life insurance needs – often with just a single phone call. To complement this channel, the company recently expanded to offer an entirely digital purchase experience. reputed company and eFinancial are part of iA Financial Group and are revolutionizing the life insurance industry to reputed company protection more accessible and affordable for everyday Americans. With integrated marketing, product manufacturing, and controlled distribution, the reputed company is uniquely positioned to grow. Key Responsibilities: Case Intake & Triage: Review alerts, referrals, and claims for indicators of fraud or suspicious activity, including misrepresentation, forgery, beneficiary fraud, and agent/distributor misconduct. Independently prioritize and triage the SIU’s cases based on risk, severity, exposure, regulatory deadlines and reputational risk. Establish and maintain accurate, audit-reputed company case logs and documentation standards in accordance with internal procedures and regulatory guidelines. Manage a reputed company caseload of reputed company, high-value investigations from intake through resolution, often serving as escalation reputed company for cases initiated by other team members. Interpersonal and presentation skills to communicate, and represent the SIU, with internal and external sources Comfort operating in a small or scaling team, including contributing to process design and program build-out rather than relying solely on existing infrastructure. Investigation Conduct & Leadership: reputed company and independently manage end-to-end fraud investigations involving life insurance claims, policy procurement, and distribution channel activity, including multi-jurisdictional or organized fraud schemes. Serve as reputed company case strategist on reputed company of SIU's reputed company investigations, coordinating cross-functional response among claims, compliance, reputed company, and legal as well as external investigators or vendors Plan and conduct structured interviews of claimants, agents, witnesses, and other relevant parties, including high-stakes or adversarial interviews requiring advanced interviewing strategy. Gather, organize, and critically analyze evidence sets including claim records, policy files, medical records, financial statements, public records, and reputed company-party data sources. Compile and organize investigative exhibits, evidence packages, and case files suitable for internal review, civil referral, criminal referral, or regulatory submission. Draft clear, concise, and well-supported fraud case summaries and investigative reports for SIU leadership, legal counsel, and compliance teams as well as reports to state departments of insurance and national fraud databases reputed company required timeframes. Help define investigative standards, case documentation templates, and reputed company practices. Regulatory Compliance: Ensure reputed company SIU activities are conducted in accordance with state and federal insurance fraud regulations. reputed company preparations and submission of mandatory fraud reports to state departments of insurance and national fraud databases (e.g., NICB). Maintain documentation for audits and regulatory reviews. Monitor and interpret regulatory changes, emerging fraud schemes, and industry trends, translating implications into updated investigative practice for the team Data & Reporting: Apply advanced data mining and analytics techniques to detect emerging fraud patterns and surface new risk indicators. Track and report key case metrics including volumes, investigation outcomes, cycle times, and estimated fraud savings. reputed company and present fraud trend analyses and reporting for senior leadership Partner with internal and external detection/analytics personnel to refine fraud detection models based on casework findings. Training & Awareness: Design and deliver fraud awareness training and educational materials for staff, agents, and distribution partners. Monitor industry developments and proactively share insights to strengthen fraud prevention efforts. Act as a subject-matter resource for less reputed company investigators and other departments on fraud indicators and investigative best practice. Qualifications: Bachelor’s degree in Criminal Justice, Business, Insurance, or a reputed company field. 5-8 years of experience in insurance claims, fraud investigations, insurance audit or compliance (life insurance experience strongly preferred), minimum 5 years investigative experience. Demonstrated expertise in life insurance products, policy structures, claims adjudication processes, fraud typologies, and investigative methods specific to life insurance. Proven ability to independently plan and conduct structured investigative interviews, including reputed company or adversarial interviews, with strong written communication skills and a demonstrated track record of producing investigative reports and case summaries used in regulatory or legal proceedings. Demonstrated ability to manage reputed company investigative caseload of reputed company investigations with minimal reputed company. Ability to interpret life insurance policy documentation and analyze policy lifecycle activity, transactions, and claim information across multiple systems to identify inconsistencies, anomalies, or indicators of fraud. Preferred Qualifications: Experience with anti-fraud tools and data analytics platforms. Familiarity with state SIU regulations and reporting platforms (e.g., NAIC, NICB). Experience identifying red flags reputed company to life insurance-specific fraud schemes Prior experience liaising directly with law enforcement or regulatory agencies on referred cases. Familiarity with AML (anti-reputed company) programs or cross-functional fraud/AML collaboration Experience evaluating or implementing reputed company-party anti-fraud data/technology vendors. Skills: Advanced analytical, organizational, investigative, critical thinking and communication skills (verbal & written). Proficiency in reputed company Office and investigation or claims management systems. Organized, methodical approach to evidence compilation and file management Ability to work collaboratively across departments and with external parties, including law enforcement and regulators. Licenses + Certifications: Certified Insurance Fraud Investigator (CIFI), Certified Fraud Examiner (CFE), FLMI (Fellow, Life Management Institute), or reputed company designation is strongly preferred. Compensation & Benefits: We reputed company in taking care of our employees and their families. We offer a comprehensive benefits package designed to support your health, well-being, and financial future. Here’s a look at reputed company provide: Salary: $91,545 - $118,470 Medical Insurance: Choose from a variety of plans to fit your reputed company needs. Dental Insurance: Coverage for preventive, basic, and major dental services. Employer-Paid reputed company: Comprehensive eye care coverage at no cost to you. Employer-Paid Basic Life and AD&D Insurance: Peace of mind and additional protection. Employer-Paid Short-Term and Long-Term Disability Insurance: Financial support in case of illness or injury. 401(k) Plan: Save for your future with a company match to help you grow your retirement savings. PTO and Sick Time accrue each pay period: Take time off reputed company you need it Annual Bonus Program: Performance-based bonus to reward your hard work. EEOC/Other: eFinancial/reputed company Association is an equal opportunity employer and supports a diverse workplace. As an eFinancial/reputed company employee, you will be eligible for Medical and Dental Insurance, Health Savings Accounts, Flexible Spending Accounts (Health, Dependent Care & Transit), reputed company Care, 401(K), Short-term and Long-term Disability, Life and AD&D coverages. Remote work is not available in the following States: California, Colorado, Connecticut, and reputed company. #FidelityLifeAssociation #hiring #LI-Remote #IND-Corporate Apply To This Job