Director, Special Investigations Unit

MDD Forensic Accountants

Director of Special Investigations Unit overseeing fraud detection and prevention at Davies North America. Collaborating with teams to mitigate insurance fraud and ensure compliance.

Posted 5/7/2026full-timeRemote • Alabama • 🇺🇸 United StatesLead💰 $90,000 - $125,000 per yearWebsite

About the role

Key responsibilities & impact

Develop and execute enterprise SIU strategy to detect, investigate, and prevent insurance fraud.
Monitor emerging fraud schemes and industry trends to proactively strengthen detection capabilities.
Lead and manage SIU investigators, SIU 1099s, Field Investigators, and vendors while establishing performance expectations and KPIs.
Conduct regular performance reviews of the SIU staff ensuring quality service standards are being met.
Direct investigations into suspected fraud across workers’ compensation, liability, property, casualty, and disability claims.
Ensure investigations meet company quality standards, regulatory standards, and evidentiary requirements.
Review investigation findings, reports, and approve referrals to law enforcement or regulatory bodies.
Collaborate with legal teams on litigation support, depositions, and fraud prosecution efforts.
Ensure compliance with state insurance fraud regulations, reporting requirements, and anti-fraud plans.
Maintain policies, SOPs, and training programs aligned with regulatory guidelines and industry standards.
Utilize predictive analytics, claims data mining, and external fraud databases (e.g., ISO, NICB).
Identify high-risk claims trends and coordinate fraud prevention initiatives with claims leadership.
Assist leadership as needed with implementing technology and automation to improve investigation efficiency and case outcomes.
Partner with claims, underwriting, legal, compliance, and audit teams to identify fraud indicators.
Maintain relationships with law enforcement, regulatory bodies, and industry fraud networks as needed.
Represent the organization in fraud task forces, industry groups, and regulatory meetings as needed.

Requirements

What you’ll need

8–12+ years of insurance claims or fraud investigation experience.
5+ years leadership experience managing SIU or fraud investigation teams.
Bachelor’s degree in Criminal Justice, Insurance, Risk Management, or related field preferred.
Knowledge of insurance fraud statutes and regulatory compliance requirements.
Experience leading complex fraud investigations and litigation support.
Certified Fraud Examiner (CFE) preferred.
Certified Insurance Fraud Investigator (CIFI) preferred.
Prior law enforcement or investigative background preferred.
Experience in workers’ compensation, casualty, or liability investigations preferred.

Benefits

Comp & perks

Medical, dental, and vision plans to support your health and that of your family
A 401(k) plan with employer matching
Time‑off policies, including Discretionary Time Off (DTO) for exempt employees and Paid Time Off (PTO) for non‑exempt employees
Paid holidays
Life insurance and short‑term and long‑term disability coverage

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills & Tools

insurance fraud investigationpredictive analyticsclaims data miningfraud detectionperformance managementregulatory compliancelitigation supportcase managementinvestigative techniquesfraud prevention initiatives

Soft Skills

leadershipcommunicationcollaborationorganizational skillsanalytical thinkingproblem-solvingrelationship managementteam managementperformance evaluationstrategic planning

Certifications

Certified Fraud Examiner (CFE)Certified Insurance Fraud Investigator (CIFI)