Senior Special Investigator

Overview We’re hiring a Senior Special Investigator to lead fraud prevention and investigative operations at SageSure, a profitable, growth‑driven property insurance company with an entrepreneurial spirit. Responsibilities Lead the development and execution of comprehensive fraud prevention strategies and investigative operations, reviewing referrals for red flags and assigning work to investigators. Conduct high‑profile and sensitive special investigations involving complex fraud referrals. Apply advanced knowledge of state laws and regulations related to the P&C insurance industry, its products, services, and processes. Prepare and deliver detailed investigative reports, both written and verbal, and analyze patterns related to fraud, process gaps, strengths, and weaknesses. Serve as a subject‑matter expert within the SIU, providing guidance, training, and program ownership for fraud investigators, claims, and underwriting personnel. Maintain external relationships with key stakeholders, industry experts, and law‑enforcement authorities to strengthen fraud prevention efforts. Take charge of CAT duty responsibilities as needed during extraordinary events or emergencies. Support regulatory compliance activities, including reporting, research, training, and education. Leverage third‑party vendors and specialized tools for effective claim investigations. Present actionable findings and recommendations on fraud trends and risk mitigation to leadership. Qualifications Bachelor’s degree in a related field or equivalent education plus 10 years’ experience conducting fraud investigations. At least 7 years of experience in P&C SIU/Fraud investigations or 9 years in a related investigation role. Exceptional expertise in fraud investigations, case law, state laws, and regulations. Results‑driven, seasoned investigator with experience in complex multi‑party statements. Proficiency in gathering evidence and arriving at conclusions based on objective fraud details. Strong organizational and prioritization skills for handling multiple tasks and complex problem‑solving. Computer proficiency and experience with data analysis tools. Comprehensive knowledge of city, state, and local regulations, legal principles, contract understanding, case law, medical treatment, and terminology. Proven ability to manage specialty/complex/litigated claims and cases concurrently. California Applicants View SageSure’s Workforce Members’ Privacy Notice – CA Privacy Policy & Notice of Collection. Equal Opportunity Employer SageSure is a proud Equal Opportunity Employer committed to building a workforce that reflects a spectrum of perspectives, experiences, and abilities. We actively seek diverse candidates and champion belonging and inclusion for all identities, including race, ethnicity, religion, sexual orientation, age, veteran status, ability status, gender, and country of origin. #J-18808-Ljbffr