SIU Investigator, Auto Claims

Openkrill; United States; Remote; USD 65,000 - 73,000; Full time

Benefits offered by this job

Equity in company

Comprehensive benefits package

401(k) with employer match

20 paid vacation days

Parental leave

Health & wellness coverage

Job summary

Lemonade is seeking an experienced SIU Investigator to lead end-to-end investigations of complex auto claims, including BI and PIP, with a focus on Florida-specific fraud trends. You will work with data science and product teams to refine predictive models, and you’ll counter evolving digital fraud risks while supporting EUOs and referrals.

The role requires 5+ years in SIU or auto claims, deep Florida PIP/BI knowledge, and comfort working in a remote environment. A college degree is preferred.

Qualifications

• 5+ years in SIU or auto claims investigations.
• Deep Florida PIP and BI expertise.
• Experience with intelligence platforms (ISO ClaimSearch, Accurint, TLOxp, LexisNexis).
• Proven ability to investigate large-scale multi-jurisdictional fraud rings.

Responsibilities

• Lead end-to-end SIU investigations on complex auto claims — ownership from referral to resolution.
• Identify and dismantle fraud networks, staged rings, and billing schemes.
• Apply Florida PIP statutes, treatment windows, and 14-day rule to fight fraud
• Collaborate with Data Science and Product to test and refine predictive models.
• Investigate AI-manipulated damages, synthetic media, and altered records.
• Support EUOs, state fraud referrals, and case strategy with claims and legal.

Skills

SIU investigations

Auto claims experience

Fraud pattern recognition

AI curiosity in investigations

Remote work readiness

Education

College degree in criminal justice/insurance/related field

Tools

ISO ClaimSearch

Accurint

TLOxp

LexisNexis

Job description

What you're applying for

We're looking for an experienced SIU Investigator to help protect honest policyholders and keep sophisticated fraud networks from gaming the system — while making sure legitimate claims move fast. You'll join our Claims team at a pivotal moment, bringing specialized investigative expertise to high-risk files as we expand into key markets like Florida and keep pushing the boundaries of what modern fraud detection looks like.

We believe three things matter for every role at Lemonade: drive to push through challenges, efficiency that keeps standards high while moving fast, and adaptability that lets you pivot with data and AI insights. These aren't buzzwords, they're how we actually work.

Our AI-first approach isn't just a tagline either. We're building the future of insurance with AI at the center, and we need people who are genuinely excited to learn and grow alongside these tools.

In this role you'll

• - Lead end-to-end SIU investigations on complex auto claims — Physical Damage, Bodily Injury, and PIP/Medical Payments — with full ownership from referral to resolution
• - Identify and dismantle multi-claim fraud networks, staged accident rings, and coordinated medical billing schemes using link analysis and pattern-recognition techniques
• - Apply deep working knowledge of Florida PIP statutes, medical fee schedules, and the 14-day treatment rule to counter state-specific fraud trends
• - Partner directly with our Data Science and Product teams to test and refine predictive fraud models, feeding real-world case intelligence back into automated detection
• - Investigate emerging digital fraud risks — AI-manipulated damage photos, synthetic media, and altered records — using the latest AI tools and digital research platforms
• - Support EUOs, state fraud bureau referrals, and case strategy alongside claims adjusters and legal counsel

What you'll need

• - 5+ years of dedicated SIU or auto claims investigative experience, with a track record on complex, high-stakes cases
• - Deep Florida PIP and BI expertise — statutes, treatment windows, billing mill fraud, and EUO dynamics
• - Hands-on experience with intelligence platforms like ISO ClaimSearch, Accurint, TLOxp, or LexisNexis
• - Proven ability to investigate large-scale, multi-jurisdictional organized fraud rings and billing syndicates
• - Genuine curiosity about AI — both as an investigative asset and as a fraud threat vector you'll need to stay ahead of
• - A college degree, preferably in criminal justice, insurance, or a related field
• - Ability to work in a remote environment

Please note that we are unable to sponsor applicants for work visas.

Unfortunately, we cannot consider applicants from these states: Alaska, California, Colorado, Montana, Hawaii, New Mexico and Puerto Rico.

Lemonade's US base salary range for this full-time position is $65,000 - $72,500 plus equity + benefits. Our salary ranges are determined by role, level, and location. Within the range, individual pay is determined by work location and additional factors, including job-related skills, experience, and relevant education or training. Our competitive total rewards package includes comprehensive health & wellness coverage, equity, a 401(k) plan with employer match, 20 paid vacation days, and parental leave.