SIU Claims Fraud Investigator - Auto Insurance - Virginia

SIU Claims Fraud Investigator - Auto Insurance - Virginia

We are a company of driven, enthusiastic, and determined people. We celebrate achievement and success. We foster innovation, determination, and recognition. Because of that, our employees feel recognized and rewarded for the contributions they make on a daily basis. At GAINSCO, it is our people that set us apart.

If you are looking for a place where you can make a difference, perceive how your work impacts the company, and be recognized for your efforts and passion, then GAINSCO is the company for you.

We are seeking a skilled and detail-oriented SIU Claims Fraud Investigator to join our team. As a SIU Claims Fraud Investigator, you will work in the field and will play a crucial role in identifying and preventing fraudulent claims by applying your technical knowledge and human relations skills. If you have a background in claims and investigative experience and are dedicated to maintaining the highest standards of integrity, we invite you to apply for this exciting opportunity.

What does a SIU CLAIMS FRAUD INVESTIGATOR do?

• Conduct thorough investigations of suspicious claims, including background checks, public record searches, and field interviews.
• Personally inspect vehicles, medical clinics, and accident scenes; collect evidence and take recorded statements.
• Perform Examinations Under Oath (EUO) and canvass neighborhoods for additional information.
• Use antifraud technology and investigative strategies to proactively identify questionable claims and initiate SIU referrals.
• Work closely with adjusters and internal departments to share findings and coordinate investigative efforts.
• Communicate with law enforcement, the National Insurance Crime Bureau (NICB), and regulatory agencies.
• Provide training and guidance to claims staff on fraud indicators and investigative best practices.
• Deliver timely updates and maintain detailed documentation in compliance with company and regulatory standards.
• Ensure investigations are conducted within legal and regulatory timelines.
• Stay current on industry trends, fraud schemes, and state-specific regulations.
• Report systemic issues or process gaps that impact the customer experience or claim outcomes.

What is required?

Education:

• High School Diploma or Equivalent.

Certifications:

• To perform the essential functions of this job an active Texas or Florida Adjuster License will be preferred to comply with state and GAINSCO requirements.
• Upon hire, additional license(s) may be required. If that is the case, license(s) must be obtained.
• All licenses must be maintained in accordance with state requirements.
• CFE (Certified Fraud Examiner) or CIFI (Certified Insurance Fraud Investigator) certification is a plus.

Experience:

• Minimum of 4 years of auto insurance claims experience required.
• Minimum 3 years of investigative experience required.
• Preferred insurance handling experience for the states of: VA, MD, PA, NJ, OH, IL, FL, TX, UT, AL.

Other skills and abilities:

• Excellent verbal and written communications skills
• Ability to manage your own time while prioritizing multiple tasks
• Ability to remain calm when dealing with difficult customers
• Effective negotiating skills
• Ability to gather and analyze information in order to evaluate results and choose the best solution to the problem
• Bilingual (English/Spanish) preferred
• Occasional weekend work may be required

What else do you need to know?

• Field-based role with travel required. Required candidate location is Virginia to be considered for the position.
• Excellent benefits package: medical & dental, vision insurance, life insurance, short term and long term disability insurance.
• Parental Leave Policy.
• 401K + Company Match.
• PTO + Paid Company determined Holidays.

Applicants are required to be eligible to lawfully work in the U.S. immediately; employer will not sponsor applicants for U.S. work authorization (e.g. H-1B visa) for this opportunity

All offers are contingent upon a successful background investigation (including employment, education, criminal and DMV verification- when applicable) and a pre-employment drug test with results satisfactory to GAINSCO.

GAINSCO is an Equal Employment Opportunity Employer

Equal Opportunity Employer This employer is required to notify all applicants of their rights pursuant to federal employment laws. For further information, please review the Know Your Rights notice from the Department of Labor.