Senior Complex Insurance Fraud Investigator

Jobgether; Oregon; Hybrid; USD 105,000 - 110,000; Full time

Benefits offered by this job

Medical and dental insurance

Life insurance

Healthcare FSA

Dependent Care FSA

401(k) savings plan

Paid time off

Career advancement

Diversity and inclusion

Job summary

Jobgether is seeking a SIU, Complex Major Case Investigator in the United States to lead investigations into sophisticated insurance fraud schemes. You will analyze data from multiple sources, prepare concise reports, and collaborate with Claims, Underwriting, Audit, and external partners to disrupt fraudulent activity.

Role requires 5–7 years in complex fraud investigations, a strong analytical mindset, and deep knowledge of privacy regulations such as GLBA.

Qualifications

• Extensive experience in complex insurance fraud investigations.
• Bachelor's degree in Criminal Justice, Data Analytics, Intelligence Studies, or related field.
• 5–7 years of professional experience in complex insurance fraud investigations.
• Experience in all-source intelligence gathering and analytical techniques.
• Strong analytical and quantitative skills for interpreting large datasets.
• Proficiency with investigative databases, social media analysis, and data visualization.
• Excellent written and verbal communication; able to present findings clearly.
• Ability to work autonomously with sound judgment and discretion.
• Solid understanding of insurance principles, fraud statutes, and privacy regulations.

Responsibilities

• Lead complex investigations into suspected fraudulent claims.
• Collect, preserve, and analyze evidence from multiple sources.
• Prepare detailed reports to support decisions and legal proceedings.
• Manage an active caseload independently.
• Monitor fraud activity and identify emerging patterns.
• Collaborate with Claims, Underwriting, Audit, and external partners.
• Ensure compliance with GLBA and privacy regulations.

Job description

Jobgether is seeking a SIU, Complex Major Case Investigator in the United States to lead investigations into sophisticated insurance fraud schemes. You will analyze data from multiple sources, prepare concise reports, and collaborate with Claims, Underwriting, Audit, and external partners to disrupt fraudulent activity.

Role requires 5–7 years in complex fraud investigations, a strong analytical mindset, and deep knowledge of privacy regulations such as GLBA.