Claims Investigation Specialist

Role Description

We are excited to bring on a Specialist, Claims Investigator to our Group Protection Special Investigations Team in Charlotte, NC; Omaha, NE; or remote.

• Proactively identify red flags and support referrals for SIU engagement.
• Provide claims investigative support and information to assigned claims area(s), Corporate Compliance, and Legal.
• Attend claims consults/huddles, review, report on, and audit open inventory items and referrals.
• Address questions from internal/external stakeholders.
• Assist management with prioritizing work, developing team initiatives, and contributing to training.
• Provide support in the manager’s absence.

What you'll be doing:

• Maintain knowledge on current and emerging developments/trends related to insurance fraud.
• Complete assigned proactive reviews weekly to support the claims operation in identifying potential fraud and opportunities for SIU resource utilization.
• Review assigned surveillance and field investigator referrals from claims team to ensure investigative resources are used appropriately.
• Complete assigned quality audits per referral type (field investigation, database, surveillance) per vendor each month.
• File Suspicious Incident Reports in accordance with state requirements.
• Address questions and requests for documentation from state departments of insurance.
• Deliver New Hire and ad hoc training on various topics such as ISO, social media/database research, and system(s) used.
• Stay informed on state and federal regulations and guidelines and perform duties in compliance with all state and federal regulations and guidelines.
• Remain current in profession and industry trends.

Qualifications

• 4 Year/bachelor's degree or equivalent work experience (4 years of experience in lieu of Bachelor's) (Minimum Required).
• An associate or bachelor’s degree in criminal justice or a related field; or
• 5+ Years experience in claims investigation experience or professional investigation experience with law enforcement agencies; or
• 7+ years of professional investigation experience involving economic or insurance related matters.
• Investigative background such as law enforcement or private investigator (Nice-to-haves).

Requirements

• Applications for this position will be accepted through May 7, 2026, subject to earlier closure due to applicant volume.

Benefits

• Clearly defined career tracks and job levels, along with associated behaviors for each of Lincoln's core values and leadership attributes.
• Leadership development and virtual training opportunities.
• PTO/parental leave.
• Competitive 401K and employee benefits.
• Free financial counseling, health coaching and employee assistance program.
• Tuition assistance program.
• Work arrangements that work for you.
• Effective productivity/technology tools and training.
• The pay range for this position is $55,700 - $100,200 with anticipated pay for new hires between the minimum and midpoint of the range.
• Role may be eligible for the Annual Incentive Program, which is discretionary and based on performance.