Claims Fraud Investigator- SIU
GAINSCO, Virginia, MN, United States
Overview
We are a company of driven, enthusiastic, and determined people. We celebrate achievement and success. We foster innovation, determination, and recognition. Because of that, our employees feel recognized and rewarded for the contributions they make on a daily basis. At GAINSCO, it is our people that set us apart.
We are seeking a skilled and detail‑oriented SIU Field Investigator to join our team. As an SIU Field Investigator, you will play a crucial role in identifying and preventing fraudulent claims by applying your technical knowledge and human relations skills. If you have a background in claims and investigative experience and are dedicated to maintaining the highest standards of integrity, we invite you to apply for this exciting opportunity.
Responsibilities
Conduct thorough investigations of suspicious claims, including background checks, public record searches, and field interviews.
Personally inspect vehicles, medical clinics, and accident scenes; collect evidence and take recorded statements.
Perform Examinations Under Oath (EUO) and canvass neighborhoods for additional information.
Use antifraud technology and investigative strategies to proactively identify questionable claims and initiate SIU referrals.
Work closely with adjusters and internal departments to share findings and coordinate investigative efforts.
Communicate with law enforcement, the National Insurance Crime Bureau (NICB), and regulatory agencies.
Provide training and guidance to claims staff on fraud indicators and investigative best practices.
Deliver timely updates and maintain detailed documentation in compliance with company and regulatory standards.
Ensure investigations are conducted within legal and regulatory timelines.
Stay current on industry trends, fraud schemes, and state‑specific regulations.
Report systemic issues or process gaps that impact the customer experience or claim outcomes.
Qualifications
Education:
High School Diploma or Equivalent.
Certifications:
Active Texas or Florida Adjuster License preferred; upon hire additional license(s) may be required and must be maintained in accordance with state requirements. CFE (Certified Fraud Examiner) or CIFI (Certified Insurance Fraud Investigator) certification is a plus.
Experience:
Minimum of 4 years of auto insurance claims experience. Minimum 3 years of investigative experience. Preferred insurance handling experience for the states of VA, MD, PA, NJ, OH, IL, FL, TX, UT, AL.
Other Skills and Abilities:
Excellent verbal and written communications skills. Ability to manage your own time while prioritizing multiple tasks. Ability to remain calm when dealing with difficult customers. Effective negotiating skills. Ability to gather and analyze information to evaluate results and choose the best solution to problems. Bilingual (English/Spanish) preferred. Occasional weekend work may be required.
Benefits
Field‑based role with travel required; candidate location required: Virginia.
Excellent benefits package: medical & dental, vision insurance, life insurance, short‑term and long‑term disability insurance.
Parental Leave Policy.
401(k) + company match.
PTO + paid company‑determined holidays.
Applicants must be eligible to lawfully work in the U.S. immediately; the employer will not sponsor U.S. work authorization.
All offers are contingent upon a successful background investigation (employment, education, criminal and DMV verification) and a satisfactory pre‑employment drug test.
Equal Employment Opportunity
GAINSCO is an Equal Employment Opportunity Employer.
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We are a company of driven, enthusiastic, and determined people. We celebrate achievement and success. We foster innovation, determination, and recognition. Because of that, our employees feel recognized and rewarded for the contributions they make on a daily basis. At GAINSCO, it is our people that set us apart.
We are seeking a skilled and detail‑oriented SIU Field Investigator to join our team. As an SIU Field Investigator, you will play a crucial role in identifying and preventing fraudulent claims by applying your technical knowledge and human relations skills. If you have a background in claims and investigative experience and are dedicated to maintaining the highest standards of integrity, we invite you to apply for this exciting opportunity.
Responsibilities
Conduct thorough investigations of suspicious claims, including background checks, public record searches, and field interviews.
Personally inspect vehicles, medical clinics, and accident scenes; collect evidence and take recorded statements.
Perform Examinations Under Oath (EUO) and canvass neighborhoods for additional information.
Use antifraud technology and investigative strategies to proactively identify questionable claims and initiate SIU referrals.
Work closely with adjusters and internal departments to share findings and coordinate investigative efforts.
Communicate with law enforcement, the National Insurance Crime Bureau (NICB), and regulatory agencies.
Provide training and guidance to claims staff on fraud indicators and investigative best practices.
Deliver timely updates and maintain detailed documentation in compliance with company and regulatory standards.
Ensure investigations are conducted within legal and regulatory timelines.
Stay current on industry trends, fraud schemes, and state‑specific regulations.
Report systemic issues or process gaps that impact the customer experience or claim outcomes.
Qualifications
Education:
High School Diploma or Equivalent.
Certifications:
Active Texas or Florida Adjuster License preferred; upon hire additional license(s) may be required and must be maintained in accordance with state requirements. CFE (Certified Fraud Examiner) or CIFI (Certified Insurance Fraud Investigator) certification is a plus.
Experience:
Minimum of 4 years of auto insurance claims experience. Minimum 3 years of investigative experience. Preferred insurance handling experience for the states of VA, MD, PA, NJ, OH, IL, FL, TX, UT, AL.
Other Skills and Abilities:
Excellent verbal and written communications skills. Ability to manage your own time while prioritizing multiple tasks. Ability to remain calm when dealing with difficult customers. Effective negotiating skills. Ability to gather and analyze information to evaluate results and choose the best solution to problems. Bilingual (English/Spanish) preferred. Occasional weekend work may be required.
Benefits
Field‑based role with travel required; candidate location required: Virginia.
Excellent benefits package: medical & dental, vision insurance, life insurance, short‑term and long‑term disability insurance.
Parental Leave Policy.
401(k) + company match.
PTO + paid company‑determined holidays.
Applicants must be eligible to lawfully work in the U.S. immediately; the employer will not sponsor U.S. work authorization.
All offers are contingent upon a successful background investigation (employment, education, criminal and DMV verification) and a satisfactory pre‑employment drug test.
Equal Employment Opportunity
GAINSCO is an Equal Employment Opportunity Employer.
#J-18808-Ljbffr