Job Description
About our Special Investigations Unit (SIU)
At Citizens, financial stewardship drives our Special Investigations Unit’s (SIU) mission to detect and deter insurance fraud with speed and precision. We are committed to continuous improvement—leveraging advanced analytics, investigative expertise, and innovative strategies to stay ahead of emerging fraud trends.
Building a best-in-class SIU requires more than tools and technology—it requires exceptional people. We seek high-performing professionals who thrive in an environment that values accountability, respect, growth, and ownership. Our culture encourages fresh thinking, where the best ideas—even if new and untried—rise to the top and help shape our success.
As part of Citizens’ SIU team, your contributions will be recognized and rewarded. We value dedication, performance, and integrity, and we are committed to supporting your professional development while empowering you to make a meaningful impact in the fight against insurance fraud.
Job Summary
This position’s primary purpose is leveraging robust analytic systems, and knowledge of insurance fraud, assist with the design, implementation, monitoring and performance tracking of Fraud detection models helpful in detecting fraud that impacts the insurance operation and provide technical guidance on suspicious policies and claims investigated within the Special Investigations Unit (SIU).
Job Duties
- Models’ ethical behavior and executes job responsibilities in accordance with Citizens core values, ethics, and information protection policies.
- Uses independent judgement to plan, prioritize, respond to high-risk alerts, and determine the need for additional fact gathering. Provides consultative guidance on investigative strategies to individual contributors and managers within the insurance enterprise to resolve high-risk exposures.
- Creates and designs innovative and cutting-edge predictive models consisting of business rules, third party sources, and the critical components key to the business unit’s mission to expose suspect patterns and associations; monitors model performance and adjusts models.
- Assist with the implementation of new processes and software solutions, identify system improvements to prevent fraudulent activities and maintain fraud analysis models to improve efficiency and effectiveness of the predictive systems.
- Coaches, advises, counsels, and trains insurance staff; may also direct the work activities of others, provide input in the Performance Management goal setting and review process.
REQUIRED EDUCATION And EXPERIENCE
- High School Diploma | GED X
- Associate/Technical Degree OR 2 years relevant experience, OR a combination of both college and experience equivalent to 2 years
OR
- Bachelor’s Degree OR 3 years relevant experience, OR a combination of college education and relevant experience equivalent to 3 years
PREFERRED EXPERIENCE And EDUCATION
- Criminal Justice/Corrections, Business Administration or related field.
- 4 or more years of combined SIU/investigative experience and/or property/casualty experience.
- 5 or more years of investigations / SIU experience in the P&C Insurance industry.
- Investigation experience with established workflows and hands-on reviewing the claims files.
- Knowledge of Fraud Analytics Software and/or Fraud detection methodologies.
- Demonstrated broad problem-solving skills.
Knowledge, Skills, & Abilities
- High degree of knowledge and skills related to the investigation and defense of property claims.
- Demonstrated knowledge of the SIU investigation processes and methodologies.
- Ability to communicate effectively verbally and in writing with a wide range of staff and management.
- Proficiency with fraud detection software and tools.
- Ability to work independently with minimal supervision and manage a high volume of assignments.
- Ability to resolve conflicts and create rapport with business partners.
- Identify and resolve issues and identify solutions, utilizing comprehensive analytical skills and demonstrating attention to detail.
- Prior experience with risk analysis, risk management.
- Strong organizational and time management skills / Self Motivated.
- Strong customer Service skills and ability to build relationships and collaborate with internal and external stakeholders.
- Strong Microsoft Office Suite skills.
- Analytical skills and ability to make decisions; logical and sequential thinker.
Citizens is proud to be an Equal Opportunity Employer.
Visa sponsorship is not available for this position.