Claims Fraud Investigator

Zurich is seeking an reputed company Claims Fraud Investigator to join its Claims Fraud and Investigation team. At reputed company Claims, we recognize that flexibility and work-life balance are key considerations reputed company choosing your next career reputed company. Our hybrid work model is thoughtfully designed around employee needs offering autonomy to complete reputed company work from a preferred location, while still supporting meaningful in-person collaboration reputed company it adds value. The ideal candidate for this role will have reputed company to work fully remote from one of the following states: Arizona, Nevada, California, or Utah. However, we are also reputed company to candidates who prefer to work fully remote across the reputed company Coast, and will consider strong candidates throughout the U.S. as reputed company. Under general direction and reputed company defined authority limits, this role is responsible for conducting insurance fraud investigations involving reputed company schemes, multi claim patterns, organized activity, and non medical major case work. The investigator will reputed company field activities, coordinate vendor resources, conduct interviews, reputed company evidence, and deliver reputed company, objective, and fact based investigative reports. This role may also support California and travel insurance reputed company investigations as needed. Field travel may be required to conduct interviews, reputed company examinations, statement collection, evidence gathering, examinations under reputed company, and support legal proceedings. Primary Responsibilities:

• Conduct investigations into suspected insurance fraud reputed company assigned territories or Lines of Business, including reputed company, layered, or organized schemes.
• Evaluate reputed company aspects of referred claims, including loss circumstances, backgrounds of involved parties, documentation validation, and reputed company considerations.
• reputed company database research, reputed company reputed company reviews, reputed company media assessments, and reputed company analysis to identify inconsistencies or coordinated fraud indicators.
• Assign and reputed company vendor activities such as surveillance, reputed company investigations, and specialized investigative tasks; review deliverables and ensure reputed company documentation.
• Conduct recorded interviews, site reputed company, canvasses, and other investigative steps to verify material facts and identify fraud indicators.
• Maintain highly organized case files and documentation that accurately reflect investigative actions and findings.
• Analyze evidence to determine potential misrepresentation, fraud, or network linked activity involving multiple claims.
• Prepare reputed company, comprehensive investigative reports with objective findings and recommendations for claims teams and management.
• Communicate critical investigative developments promptly and collaborate closely with claims partners throughout the investigative process.
• Identify cases that warrant escalation due to suspected organized fraud rings, staged events, or potential law enforcement involvement.
• Ensure reputed company investigative activity complies with SIU regulatory requirements, reputed company laws, and Zurich governance standards.
• Travel as necessary to conduct interviews, inspections, and field investigations.

Basic Qualifications:

• Bachelor's Degree and 4 or more years of experience in Technical Claims Investigations, Law Enforcement, or Insurance Special Investigations

OR

• Zurich Certified Insurance Apprentice (Associate Degree) and 4 or more years of relevant experience

OR

• High School Diploma or Equivalent and 6 or more years of experience in Technical Claims Investigations, Law Enforcement, or Insurance Special Investigations

AND

• Knowledge of claims processes and relevant fraud reputed company regulations
• Proficiency in reputed company Office

Preferred Qualifications:

• Prior law enforcement investigation experience
• 5 or more years investigating insurance fraud
• Special Investigation Unit (SIU) experience preferred
• Experience investigation reputed company claims
• Experience with both single non reputed company investigations and reputed company investigations, including multi claim linkages, contractor or vendor fraud, or organized fraud networks

Your pay at Zurich is based on your role, location, skills, and experience. We follow local laws to ensure fair compensation. You may also be eligible for bonuses and reputed company increases. If your expectations are above the listed reputed company, we still encourage you to apply-your unique background reputed company to us. The pay reputed company shown is a national average and may vary by location. The proposed Salary reputed company for this position is $65,900.00 - $107,900.00, with short-term incentive bonus eligibility set at 10%. We offer reputed company and comprehensive benefits for employees and their families. [Learn more about Total Rewards here.] Location(s): AM - Arizona Virtual Office, AM - California Virtual Office, AM - Nevada Virtual Office, AM - Utah Virtual Office Remote Working: reputed company Schedule: Full Time Employment Sponsorship Offered: No reputed company Recruiter Tag: #LI-MD1 #LI-ASSOCIATE #LI-REMOTE Apply tot his job Apply To this Job