Encova Insurance

SIU Investigative Analyst

Encova Insurance

full-time

Posted on:

Origin:  • 🇺🇸 United States

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Salary

💰 $61,742 - $98,788 per year

Job Level

Mid-LevelSenior

About the role

  • JOB OBJECTIVE : The SIU Investigative Analyst is responsible for identifying , analyzing, and investigating potentially fraudulent insurance claims or suspicious activities across various lines of business. This role investigates potentially fraudulent insurance claims by triaging SIU referrals, conducting research (including OSINT and social media), occasional recorded statements, and collaborating with investigators, claims professionals, legal and law enforcement. This role ensures regulatory compliance and supports effective fraud resolution. Strong analytical skills and fraud detection expertise are essential.
  • ESSENTIAL FUNCTIONS : Review insurance claims, applications and other documentation for potential fraud indicators or misrepresentation using internal and external systems and databases. Identify emerging fraud trends and contribute to the development of predictive analytics or fraud detection strategies. Review referred SIU claims and identify the scope of investigation needed. Conduct detailed investigations by analyzing data, obtaining statements, and working with field investigators. This role is primarily desk based with limited travel or fieldwork. Investigations requiring fieldwork should be assigned to a field SIU Investigator. Assist SIU investigators in compiling case documentation and evidence. Compile and document case files with findings, evidence, and recommendations. Prepare reports and referrals to management, law enforcement, regulatory bodies, or state fraud bureaus, as required. Monitor industry alerts and trends related to fraud schemes and tactics including relevant laws, regulations, and procedures governing insurance fraud. Coordinate with internal departments (e.g., Claims, Legal, Compliance) and external entities as necessary. Maintain detailed case records and ensure all information is logged accurately.
  • OTHER FUNCTIONS : Complete various special projects and investigations as assigned. Network with industry personnel, law enforcement, legal counsel and others to develop information for investigative analysis and leads. Act as a subject matter resource providing fraud awareness, investigative consultation and mentorship to company associates. Perform other duties as assigned.
  • KNOWLEDGE, SKILLS AND ABILITIES : Bachelor's degree in criminal justice, business, insurance, or a related field or equivalent experience is preferred. Experience in claims processes, investigation, fraud detection, or a related field is desired. Strong analytical, research, and problem-solving skills. Knowledge of fraud schemes and regulatory requirements (e.g., NICB, SIU compliance) is strongly preferred. Proficiency with investigative tools, databases, and reporting systems. Excellent written and verbal communication skills. Multi-line insurance background is a plus. Continuing insurance education is desired and may be obtained through designation training offered by industrial organizations such as IASIU. This position has been evaluated in accordance with the Americans with Disabilities Act . Encova Insurance makes every effort to reasonably accommodate disabilities to permit performance of the essential functions and candidates who need such accommodation are encouraged to seek it . This description reflects the nature and level of work performed by associates in this position . It is not an all-inclusive inventory of duties, responsibilities and qualifications required . It provides an accurate overview of the work and skills needed to perform this position. Because job content may change from time to time, Encova Insurance reserves the right to add and/or delete functions from this job as it deems necessary for business reasons. Ready to join our team? At Encova Insurance, we firmly believe that our associates drive our company’s success by delivering unrivaled service to our customers. With success in mind, we make an ongoing effort to provide an environment that offers challenging, stimulating and financially rewarding opportunities. Join us to discover a work experience where your diverse ideas will be met with enthusiasm – where you can learn and grow to your fullest potential. What you can expect from us Join our family of industry leaders, and let us reward you with a competitive salary, bonus and benefits package that includes but is not limited to: a 401(k), wellness programs, bonus incentive plans and flexible schedules and a early close of the office every Friday. Additionally, Encova aspires to be an outstanding corporate citizen in all the markets we serve; we encourage and support associate participation in community initiatives through our foundations. Encova Insurance is an EOE/E-Verify employer. Life at Encova At Encova our associates are the heart of our business. Our exceptional culture makes it a special place to work and gives us a unique advantage. Building and sustaining this culture requires intentional effort from everyone in the company. We believe that achieving results and building trust are interrelated. Through connection, character and competence, we build trusting relationships with associates, agents and policyholders to achieve excellent results. Through our collaborative team structure we find professional and personal growth. We never stop learning and always seek to improve ourselves. At Encova, we know that inclusion and belonging foster our competitive edge by giving voice to every individual’s unique talent and perspective; and we believe that when a condition of equity exists, all associates can contribute to the fullest extent of their knowledge, skills and ability. Read More Job Alerts Don't see the dream job you are looking for? Click Sign In at the top right corner of the screen to access Job Alerts . Here you can select your job search criteria using filters. You will be notified via email if a new position becomes available that matches your requirements. Read More Are you a Referral? If you know a current Encova Insurance associate and would like to apply as a referral, please encourage them to submit your referral information before you submit your application. You will receive an email with a direct URL link to the Job Posting of interest. Applying through this URL link will create your referral relationship for our Talent Acquisition Team. Read More Discover Encova in our Community Encova Internship Experience Follow Us Privacy Policy © 2025 Workday, Inc. All rights reserved.

Requirements

  • Bachelor's degree in criminal justice, business, insurance, or a related field or equivalent experience is preferred.\n
  • Experience in claims processes, investigation, fraud detection, or a related field is desired.\n
  • Strong analytical, research, and problem-solving skills.\n
  • Knowledge of fraud schemes and regulatory requirements (e.g., NICB, SIU compliance) is strongly preferred.\n
  • Proficiency with investigative tools, databases, and reporting systems.\n
  • Excellent written and verbal communication skills.\n
  • Multi-line insurance background is a plus.\n
  • Continuing insurance education is desired and may be obtained through designation training offered by industrial organizations such as IASIU.