SIU Investigative Analyst

The salary range for this job posting is $61,742.00 - $98,788.00 annually + bonus + benefits. Pay Type: Salary

The above represents the full salary range for this job requisition. Ultimately, in determining your pay and job title, we'll consider your location, education, experience, and other job-related factors, and will fall within the stated range. Your recruiter can share more information about the specific salary range during the hiring process.

Encova Insurance is seeking an SIU Investigative Analyst. This role will be home-based and we have a strong preference for you to reside in Ohio; however, we are open to hiring a well qualified candidate in any state where we can hire as seen in this posting.

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.

Unique residence requirements are listed in each job posting, please review closely for details.

Encova is only able to employ associates who reside and work within specific U.S. states. Our current policies are based on the laws in states in which we are registered for payroll. Our current footprint includes:

Connecticut, Delaware, Florida, Georgia, Illinois, Indiana, Iowa, Kansas, Kentucky, Maryland, Massachusetts, Michigan, Minnesota, Missouri, Nebraska, New Hampshire, New Jersey, North Carolina, Ohio, Pennsylvania, South Carolina, Tennessee, Texas, Virginia, West Virginia, Wisconsin.

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.