SIU Major Case Investigator, Commercial Claims - Remote
Job Description
We are actively hiring for an SIU Major Case Investigator, Commercial Claims - Remote
Your Role: The SIU Major Case Investigator is accountable for identifying, investigating, and mitigating sophisticated fraud schemes, particularly those involving fraud rings in the TNC space. Leveraging a deep understanding of emerging technologies and analytical techniques, the role will work to combat fraud effectively within the Mobilitas ecosystem.
Your Work:
• Focusing on organized fraud rings, develops and implements strategies to detect and prevent fraud activities, focusing on attorney-provider networks.
• Collaborate with internal technology teams to design and refine fraud detection tools and methodology.
• Conduct detailed investigations into suspected fraud cases and compile findings into reports for further action within Mobilitas and external agencies.
• Makes key decisions regarding the structuring and conduction of major case investigations involving multiple claims and/or organized fraud ring activity.
• Stay updated with the latest trends in fraud schemes and countermeasures.
• Provide training and guidance to other team members on best practices for fraud detection.
• Work closely with regulatory and law enforcement agencies to stay up to date on all fraud detection measures.
• Complies with local, state, and federal statutes regarding proper, timely, and ethical insurance investigations.
• Acts as a liaison with local/state/federal law enforcement personnel, industry advocates and other companies.
• Serves as the subject matter expert (liaison) on fraud to business and industry partners.
• Applies rules of evidence; recognizes evidence and determines its value to specific claim, evidence collection and interpretation.
• At times may also handle non-ring investigations as needed.
Required Experience, Education and Skills
• 7-10 years of experience handling complex claims, preferably in the commercial auto environment.
• High School Diploma/GED or 7 years of relevant work experience in claims and fraud investigation
• Depending on assignment, may be required to obtain and maintain Adjuster's license (state-specific).
• Strong analytical and problem-solving skills.
• Proficient in using advanced data analytics tools and software with industry specific technology (i.e. Lexis Nexus, ISO Claims Search, Network Analytics).
• Advanced Excel skills (pivot tables, formulas).
• Excellent attention to detail and the ability to manage multiple investigations simultaneously.
What would make us excited about you?
• BA/BS in finance, criminal justice or another related field.
• Industry certifications, such as the CIFI, CIFA, CFE, or FCLS.
• Criminal investigation or fraud detection experience.
• Experience in building out data sets in anticipation of/preparation for RICO filings, to include medical and billing information.
• Experience in constructing/maintaining a fraud identification model.
• 5+ years of advanced data analysis.
• Knowledge of available resources (internal and external) to assist in investigations.
• Time management skills.
• Proficiencies in accurate reporting, presentation, and training.
• Understanding of claim best practices.
• Actively shapes our company culture (e.g., participating in employee resource groups, volunteering, etc.).
• Fulfills business needs, which may include investing extra time, helping other teams, etc.
Please note we are hiring for this role remote anywhere in the United States with the following exceptions: Hawaii and Alaska.
Why Choose a Career at Mobilitas?
At Mobilitas, we are a mission-driven organization proudly committed to empowering our members, our employees, and our communities to thrive.
Recognition: We offer a total compensation package, annual bonus eligibility for most roles, 401(k) with a company match, and so much more! Read more about what we offer and what it is like to be a part of our dynamic team at careers.mobilitasinsurance.com.
Career Growth: We believe in growth for everyone. Here at Mobilitas, leaders and mentors partner with employees to align interests, unlock development opportunities, and support longterm success.
Flexible Workplace: We embrace a remote-first culture through our Flexible Workplace. Most employees hold Home-Flex roles, working primarily from home, often with the flexibility to work from various locations including Mobilitas offices. Our flexible workplace empowers you to balance remote work with intentional inperson moments that deepen connection and collaboration.
Inclusion and Belonging: An inclusive and welcoming workplace is the cornerstone of our success. By fostering an environment where people feel valued and heard, we deepen our ability to understand and meet the unique needs of our members. This strengthens innovation and enhances our products and services, giving us a competitive edge in the market.
Sustainability: As climate change leads to more frequent and severe weather events, we are taking bold action to build more resilient communities and reduce our environmental impact.
Submit your application to be considered. We communicate via email, so check your inbox and/or your spam folder to ensure you don't miss important updates from us.
CSAA is committed to providing reasonable accommodations to qualified applicants and employees with disabilities or other limitations. If you would like to request an accommodation to participate in the job application or interview process, please contact [jobs@mobilitasinsurance.com](mailto:jobs@mobilitasinsurance.com)
If you apply and are selected to continue in the recruiting process, we will schedule a preliminary call with you to discuss the role and will disclose during that call the available salary/hourly rate range based on your location. Factors used to determine the actual salary offered may include location, experience, or education.
Mobilitas does not provide visa sponsorship for this role. Applicants must have authorization to work indefinitely in the US. Please do not apply for this role if at any time (now or in the future) you will need immigration support (i.e., H-1B, TN, STEM OPT Training Plans, etc.).
Mobilitas Insurance Group is an equal opportunity employer.
#LI-CH1
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We are actively hiring for an SIU Major Case Investigator, Commercial Claims - Remote
Your Role: The SIU Major Case Investigator is accountable for identifying, investigating, and mitigating sophisticated fraud schemes, particularly those involving fraud rings in the TNC space. Leveraging a deep understanding of emerging technologies and analytical techniques, the role will work to combat fraud effectively within the Mobilitas ecosystem.
Your Work:
• Focusing on organized fraud rings, develops and implements strategies to detect and prevent fraud activities, focusing on attorney-provider networks.
• Collaborate with internal technology teams to design and refine fraud detection tools and methodology.
• Conduct detailed investigations into suspected fraud cases and compile findings into reports for further action within Mobilitas and external agencies.
• Makes key decisions regarding the structuring and conduction of major case investigations involving multiple claims and/or organized fraud ring activity.
• Stay updated with the latest trends in fraud schemes and countermeasures.
• Provide training and guidance to other team members on best practices for fraud detection.
• Work closely with regulatory and law enforcement agencies to stay up to date on all fraud detection measures.
• Complies with local, state, and federal statutes regarding proper, timely, and ethical insurance investigations.
• Acts as a liaison with local/state/federal law enforcement personnel, industry advocates and other companies.
• Serves as the subject matter expert (liaison) on fraud to business and industry partners.
• Applies rules of evidence; recognizes evidence and determines its value to specific claim, evidence collection and interpretation.
• At times may also handle non-ring investigations as needed.
Required Experience, Education and Skills
• 7-10 years of experience handling complex claims, preferably in the commercial auto environment.
• High School Diploma/GED or 7 years of relevant work experience in claims and fraud investigation
• Depending on assignment, may be required to obtain and maintain Adjuster's license (state-specific).
• Strong analytical and problem-solving skills.
• Proficient in using advanced data analytics tools and software with industry specific technology (i.e. Lexis Nexus, ISO Claims Search, Network Analytics).
• Advanced Excel skills (pivot tables, formulas).
• Excellent attention to detail and the ability to manage multiple investigations simultaneously.
What would make us excited about you?
• BA/BS in finance, criminal justice or another related field.
• Industry certifications, such as the CIFI, CIFA, CFE, or FCLS.
• Criminal investigation or fraud detection experience.
• Experience in building out data sets in anticipation of/preparation for RICO filings, to include medical and billing information.
• Experience in constructing/maintaining a fraud identification model.
• 5+ years of advanced data analysis.
• Knowledge of available resources (internal and external) to assist in investigations.
• Time management skills.
• Proficiencies in accurate reporting, presentation, and training.
• Understanding of claim best practices.
• Actively shapes our company culture (e.g., participating in employee resource groups, volunteering, etc.).
• Fulfills business needs, which may include investing extra time, helping other teams, etc.
Please note we are hiring for this role remote anywhere in the United States with the following exceptions: Hawaii and Alaska.
Why Choose a Career at Mobilitas?
At Mobilitas, we are a mission-driven organization proudly committed to empowering our members, our employees, and our communities to thrive.
Recognition: We offer a total compensation package, annual bonus eligibility for most roles, 401(k) with a company match, and so much more! Read more about what we offer and what it is like to be a part of our dynamic team at careers.mobilitasinsurance.com.
Career Growth: We believe in growth for everyone. Here at Mobilitas, leaders and mentors partner with employees to align interests, unlock development opportunities, and support longterm success.
Flexible Workplace: We embrace a remote-first culture through our Flexible Workplace. Most employees hold Home-Flex roles, working primarily from home, often with the flexibility to work from various locations including Mobilitas offices. Our flexible workplace empowers you to balance remote work with intentional inperson moments that deepen connection and collaboration.
Inclusion and Belonging: An inclusive and welcoming workplace is the cornerstone of our success. By fostering an environment where people feel valued and heard, we deepen our ability to understand and meet the unique needs of our members. This strengthens innovation and enhances our products and services, giving us a competitive edge in the market.
Sustainability: As climate change leads to more frequent and severe weather events, we are taking bold action to build more resilient communities and reduce our environmental impact.
Submit your application to be considered. We communicate via email, so check your inbox and/or your spam folder to ensure you don't miss important updates from us.
CSAA is committed to providing reasonable accommodations to qualified applicants and employees with disabilities or other limitations. If you would like to request an accommodation to participate in the job application or interview process, please contact [jobs@mobilitasinsurance.com](mailto:jobs@mobilitasinsurance.com)
If you apply and are selected to continue in the recruiting process, we will schedule a preliminary call with you to discuss the role and will disclose during that call the available salary/hourly rate range based on your location. Factors used to determine the actual salary offered may include location, experience, or education.
Mobilitas does not provide visa sponsorship for this role. Applicants must have authorization to work indefinitely in the US. Please do not apply for this role if at any time (now or in the future) you will need immigration support (i.e., H-1B, TN, STEM OPT Training Plans, etc.).
Mobilitas Insurance Group is an equal opportunity employer.
#LI-CH1
00
About CSAA Insurance Group
Why we're forever forward -- At CSAA IG, one thing will always endure: our commitment to excellence in everything we do for our members, employees and communities. As insurance industry leaders, we know things can change in an instant. It’s why we’re here.
We’re not afraid of change. We welcome it and use it to advance the cause. For employees, our cause is to become ever more inclusive and supportive of their goals and contributions. For our AAA Members, it’s finding new ways to help them prevent, prepare for and recover from whatever comes. For our communities, it’s exploring new ways of helping them meet evolving challenges.
Whatever may happen, change becomes progress at CSAA IG.
Benefits for today and for your future -- Benefits at CSAA IG represent our commitment to protect our employees by providing for their needs today and helping them prepare for a more secure future. Our suite of benefits is designed to provide for your physical, mental, social and financial health.
Our sense of belonging keeps us together -- Belonging is the feeling of being welcomed and accepted for who you are and the qualities you bring. It’s knowing you’re heard and valued as an individual and employee.
At CSAA IG, we share a strong sense of purpose and a hunger for adventure.
Change should always be expected, but can’t always be predicted. Whatever happens, we remain true to our beliefs and clear on our purpose. We meet change head on and grow from each experience.
A promise to act -- Life is uncertain, but we are not. When our AAA Members need us, we know how to move with the speed, expertise and confidence they rely on.