SIU Major Case Investigator, Commercial Claims - Remote

<p style="text-align:left">External candidates: In order for your application to be correctly processed please sign-in before you apply</p><p style="text-align:inherit"></p><p style="text-align:left">Internal candidates: Please go to Workday and click "Find Jobs" link under Career</p><p style="text-align:inherit"></p><p style="text-align:left">Thank you for considering opportunities with us!</p><p style="text-align:inherit"></p><p style="text-align:left"><u><b><span style="font-size:14px">Job Title</span></b></u></p>SIU Major Case Investigator, Commercial Claims - Remote<p style="text-align:inherit"></p><p style="text-align:left"><u><b><span style="font-size:14px">Requisition Number</span></b></u></p>R7624 SIU Major Case Investigator, Commercial Claims - Remote (Open)<p style="text-align:inherit"></p><p style="text-align:left"><span style="font-size:14px"><u><b>Location</b></u></span></p>Colorado - Home Teleworkers<p style="text-align:inherit"></p><p style="text-align:left"><u><b><span style="font-size:14px">Additional Locations</span></b></u></p>Alabama - Home Teleworkers, Alabama - Home Teleworkers, Arizona - Home Teleworkers, Arkansas - Home Teleworkers, California - Home Teleworkers, Connecticut - Home Teleworkers, Delaware - Home Teleworker, District of Columbia - Home Teleworkers, Florida - Home Teleworkers, Georgia - Home Teleworkers, Idaho - Home Teleworkers, Illinois - Home Teleworkers, Indiana - Home Teleworkers, Iowa - Home Teleworkers, Kansas - Home Teleworker, Kentucky - Home Teleworkers, Louisiana - Home Teleworkers, Maine Home Teleworkers, Maryland - Home Teleworkers, Massachusetts - Home Teleworkers, Michigan - Home Teleworkers, Minnesota - Home Teleworkers, Mississippi - Home Teleworker, Missouri - Home Teleworker, Montana - Home Teleworkers {+ 20 more}<p style="text-align:inherit"></p><p style="text-align:left"><u><b><span style="font-size:14px">Job Information</span></b></u></p><p>We're Mobilitas, a commercial insurance company created by CSAA Insurance Group. Our mission is to reinvent commercial insurance in the mobility space to offer our partners innovative solutions for today’s way of doing business. At Mobilitas, we believe in what's possible and we use our inventive skills to meet the demands of modern mobility with exceptional service. We’re looking for motivated, innovative individuals who think big, move fast and are dedicated to creating a company from the ground up, without the constraints of a traditional insurance company. We’re excited to push the boundaries of commercial insurance and are looking for enthusiastic team members to help us reimagine insurance.</p><p></p><p>We are actively hiring for an SIU Major Case Investigator, Commercial Claims - Remote</p><p></p><p><b>Your Role:</b> 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.</p><p></p><h2><b>Your Work: </b></h2><ul><li>Focusing on organized fraud rings, develops and implements strategies to detect and prevent fraud activities, focusing on attorney-provider networks.</li><li>Collaborate with internal technology teams to design and refine fraud detection tools and methodology.</li><li>Conduct detailed investigations into suspected fraud cases and compile findings into reports for further action within Mobilitas and external agencies.</li><li>Makes key decisions regarding the structuring and conduction of major case investigations involving multiple claims and/or organized fraud ring activity.</li><li>Stay updated with the latest trends in fraud schemes and countermeasures.</li><li>Provide training and guidance to other team members on best practices for fraud detection.</li><li>Work closely with regulatory and law enforcement agencies to stay up to date on all fraud detection measures.</li><li>Complies with local, state, and federal statutes regarding proper, timely, and ethical insurance investigations.</li><li>Acts as a liaison with local/state/federal law enforcement personnel, industry advocates and other companies.</li><li>Serves as the subject matter expert (liaison) on fraud to business and industry partners.</li><li>Applies rules of evidence; recognizes evidence and determines its value to specific claim, evidence collection and interpretation.</li><li>At times may also handle non-ring investigations as needed.</li></ul><p></p><h2><b>Required Experience, Education and Skills</b></h2><ul><li>7-10 years of experience handling complex claims, preferably in the commercial auto environment.</li><li>High School Diploma/GED or 7 years of relevant work experience in claims and fraud investigation</li><li>Depending on assignment, may be required to obtain and maintain Adjuster's license (state-specific).</li><li>Strong analytical and problem-solving skills.</li><li>Proficient in using advanced data analytics tools and software with industry specific technology (i.e. Lexis Nexus, ISO Claims Search, Network Analytics).</li><li>Advanced Excel skills (pivot tables, formulas).</li><li>Excellent attention to detail and the ability to manage multiple investigations simultaneously.</li></ul><p></p><p><b>What would make us excited about you?</b></p><ul><li>BA/BS in finance, criminal justice or another related field.</li><li>Industry certifications, such as the CIFI, CIFA, CFE, or FCLS.</li><li>Criminal investigation or fraud detection experience.</li><li>Experience in building out data sets in anticipation of/preparation for RICO filings, to include medical and billing information.</li><li>Experience in <span style="overflow-wrap: break-word; display: inline; text-decoration: inherit; hyphens: auto;">constructing/maintaining</span> a fraud identification model.</li><li>5+ years of advanced data analysis.</li><li>Knowledge of available resources (internal and external) to assist in investigations.</li><li>Time management skills.</li><li>Proficiencies in accurate reporting, presentation, and training.</li><li>Understanding of claim best practices.</li><li>Actively shapes our company culture (e.g., participating in employee resource groups, volunteering, etc.).</li><li>Fulfills business needs, which may include investing extra time, helping other teams, etc.</li></ul><p></p><p>Please note we are hiring for this role remote anywhere in the United States with the following exceptions: Hawaii and Alaska.</p><p></p><p><b>Why Choose a Career at Mobilitas?</b></p><p></p><p>At Mobilitas, we are a mission-driven organization proudly committed to empowering our members, our employees, and our communities to thrive<b>. </b></p><p></p><p><b>Recognition: </b>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 <span style="overflow-wrap: break-word; display: inline; text-decoration: inherit; hyphens: auto;">careers.mobilitasinsurance.com.</span></p><p></p><p><b>Career Growth: </b>We believe in growth for everyone. Here at Mobilitas, leaders and mentors partner with employees to align interests, unlock development opportunities, and support long‑term success.</p><p></p><p><b>Flexible Workplace: </b>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 in‑person moments that deepen connection and collaboration.</p><p></p><p><b>Inclusion and Belonging: </b>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.</p><p></p><p><b>Sustainability: </b>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.</p><p></p><p>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.</p><p></p><p>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 <a href="mailto:jobs@mobilitasinsurance.com" target="_blank" rel="noopener noreferrer"><span style="overflow-wrap: break-word; display: inline; text-decoration: inherit; hyphens: auto;">jobs@mobilitasinsurance.com</span></a></p><p></p><p>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.</p><p></p><p>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.).</p><p></p><p>Mobilitas Insurance Group is an equal opportunity employer.</p><p></p><p>#LI-CH1</p><p>.</p>

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