Special Claims Desk Investigator

This position is listed on behalf of a partner company, who manages all applications and next steps. Our partner is looking for a Special Claims Desk Investigator based in the United States.

This role sits within a specialized insurance investigation function focused on identifying, analyzing, and preventing complex fraud schemes within claims operations.
You will investigate suspected fraudulent activity, including organized or ring-based claim behavior, and develop actionable insights that support fair and accurate claims handling.
The position requires strong analytical thinking, investigative rigor, and the ability to coordinate across multiple internal and external stakeholders.
You will work closely with claims teams, law enforcement, and external partners to ensure potential fraud is thoroughly assessed and appropriately escalated.
A key part of the role involves identifying patterns, trends, and anomalies across claims data to strengthen fraud detection efforts.
You will also contribute to investigative reporting, case documentation, and, when necessary, support legal proceedings.
This is a high-impact, detail-oriented role within a collaborative and mission-driven insurance environment.

You will be responsible for conducting detailed fraud investigations, analyzing claims activity, and supporting the organization’s efforts to detect, deter, and prevent insurance fraud.

• Investigate suspected fraudulent claims, including referrals and complex or organized fraud (“ring activity”) cases.
• Collect and analyze supporting documentation such as reports, policies, statements, appraisals, and other relevant evidence.
• Identify trends, patterns, and anomalies in claims data that may indicate fraudulent behavior.
• Coordinate investigative efforts with law enforcement, regulatory agencies, legal counsel, and internal claims teams.
• Prepare clear, detailed investigative reports and recommend appropriate courses of action to management.
• Conduct or coordinate field investigations, including surveillance or third-party investigative services when needed.
• Support fraud awareness initiatives, training activities, and best practice sharing across teams.
• Assist in evaluating and improving investigative tools, databases, and technology used in fraud detection.

Requirements

The ideal candidate brings hands-on investigative experience, strong analytical skills, and familiarity with fraud detection or insurance claims environments.

• Bachelor’s degree in Criminal Justice, Law Enforcement, Business, Liberal Arts, Computer Science, or related field; or equivalent experience.
• 3–6 years of experience in investigations, fraud detection, insurance claims, or related fields.
• Strong understanding of investigative methodologies, evidence gathering, and case documentation.
• Experience analyzing complex cases and identifying patterns of suspicious or fraudulent activity.
• Ability to collaborate with law enforcement, regulatory bodies, and internal stakeholders.
• Strong written communication skills, particularly in preparing structured investigative reports.
• Professional certifications (e.g., CFE, private investigator license) are a strong plus.
• Comfortable working independently and managing multiple active investigations simultaneously.

Benefits

• Competitive salary range: $70,000 – $80,000 annually
• Medical, dental, and vision insurance coverage (full-time employees)
• Paid time off and paid company holidays
• 401(k) retirement plan with company match
• Employee stock purchase plan
• Wellness programs and parental leave support
• Tuition reimbursement and professional development support
• Adoption assistance and commuter benefits
• Flexible benefits depending on role eligibility and employment type