Senior Special Investigator

Job not on LinkedIn

🕒 July 3

🌽 Illinois – Remote

🌽 Illinois – Remote

💵 $91.5k - $118.5k / year

⏰ Full Time

🟠 Senior

✨ Investigator

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eFinancial

WebsiteLinkedInAll Job Openings

201 - 500 employees

Founded 2001

💸 Finance

🏪 Marketplace

Finance • Marketplace

<eFinancial> is an online life insurance quote comparison and brokerage platform that helps consumers compare and purchase term, permanent, and final expense life insurance from top-rated carriers. The site offers quick online quotes, a 10-question term calculator, educational resources, and access to licensed agents who can provide personalized guidance and same-day coverage in many cases. eFinancial aggregates carrier options, highlights plan differences (coverage lengths, premiums, medical exam requirements, cash value), and emphasizes customer support and easy application processes.

📋 Description

• Review alerts, referrals, and claims for indicators of fraud or suspicious activity, including misrepresentation, forgery, beneficiary fraud, and agent/distributor misconduct. • Independently prioritize and triage the SIU’s cases based on risk, severity, exposure, regulatory deadlines and reputational risk. • Establish and maintain accurate, audit-ready case logs and documentation standards in accordance with internal procedures and regulatory guidelines. • Manage a concurrent caseload of complex, high-value investigations from intake through resolution. • Lead and independently manage end-to-end fraud investigations involving life insurance claims, policy procurement, and distribution channel activity. • Plan and conduct structured interviews of claimants, agents, witnesses, and other relevant parties. • Gather, organize, and critically analyze evidence sets including claim records and policy files. • Draft clear, concise, and well-supported fraud case summaries and investigative reports for SIU leadership and legal counsel.

🎯 Requirements

• Bachelor’s degree in Criminal Justice, Business, Insurance, or a related field. • 5-8 years of experience in insurance claims, fraud investigations, insurance audit or compliance (life insurance experience strongly preferred), minimum 5 years investigative experience. • Demonstrated expertise in life insurance products, policy structures, claims adjudication processes, fraud typologies, and investigative methods specific to life insurance. • Proven ability to independently plan and conduct structured investigative interviews, including complex or adversarial interviews, with strong written communication skills and a demonstrated track record of producing investigative reports and case summaries used in regulatory or legal proceedings. • Demonstrated ability to manage concurrent investigative caseload of complex investigations with minimal oversight. • Ability to interpret life insurance policy documentation and analyze policy lifecycle activity, transactions, and claim information across multiple systems to identify inconsistencies, anomalies, or indicators of fraud.

🏖️ Benefits

• Medical Insurance: Choose from a variety of plans to fit your healthcare needs. • Dental Insurance: Coverage for preventive, basic, and major dental services. • Employer-Paid Vision: Comprehensive eye care coverage at no cost to you. • Employer-Paid Basic Life and AD&D Insurance: Peace of mind and additional protection. • Employer-Paid Short-Term and Long-Term Disability Insurance: Financial support in case of illness or injury. • 401(k) Plan: Save for your future with a company match to help you grow your retirement savings. • PTO and Sick Time accrue each pay period: Take time off when you need it. • Annual Bonus Program: Performance-based bonus to reward your hard work.