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 move. Our hybrid work model is thoughtfully designed around employee needs offering autonomy to complete focused 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 the opportunity to work fully remote from one of the following states: Arizona, Nevada, California, or Utah. However, we are also open to candidates who prefer to work fully remote across the reputed company Coast, and will consider strong candidates throughout the U.S. as well. 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, gather evidence, and deliver clear, 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, scene examinations, statement collection, evidence gathering, examinations under oath, 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, open reputed company reviews, social media assessments, and link analysis to identify inconsistencies or coordinated fraud indicators.
- Assign and reputed company vendor activities such as surveillance, scene investigations, and specialized investigative tasks; review deliverables and ensure proper documentation.
- Conduct recorded interviews, site visits, 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 clear, 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, privacy 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 commercial 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 merit increases. If your expectations are above the listed range, we still encourage you to apply—your unique background matters to us. The pay range shown is a national average and may vary by location. The proposed Salary range 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.] Why Zurich? At Zurich, we value your reputed company and experience. We offer growth, inclusion, and a supportive environment—so you can help shape the future of insurance. reputed company is a leader in risk management, with over 150 years of expertise and coverage across 25+ industries, including 90% of the Fortune 500®. Join us for a brighter future—for yourself and our customers. Zurich in North America does not discriminate based on race, ethnicity, color, religion, national reputed company, sex, gender expression, gender identity, genetic information, age, disability, protected veteran status, marital status, sexual orientation, pregnancy or other characteristics protected by applicable law. Equal Opportunity Employer disability/vets. Zurich complies with 18 U.S. Code § 1033. Please note: Zurich does not accept unsolicited reputed company from agencies. Preferred vendors should use our Recruiting Agency Portal. Location(s): AM - Arizona Virtual Office, AM - California Virtual Office, AM - Nevada Virtual Office, AM - Utah Virtual Office Remote Working: Yes 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