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Insurance Fraud Investigation Jobs in Florida (NOW HIRING)

SCCU

Fraud Investigator I

Melbourne, FL · Hybrid

$28.13 - $29.79/hr

As a Fraud Investigator I, you will help protect the credit union and its members by investigating ... Medical, dental, and vision insurance, plus an Employee Assistance Program. * Financial Perks ...

SCCU

Fraud Investigator I

Melbourne, FL · On-site

$28.13 - $29.79/hr

As a Fraud Investigator I, you will help protect the credit union and its members by investigating ... Medical, dental, and vision insurance, plus an Employee Assistance Program. * Financial Perks ...

SCCU

Fraud Investigator I

Miramar, FL · Hybrid

$28.13 - $29.79/hr

As a Fraud Investigator I, you will help protect the credit union and its members by investigating ... Medical, dental, and vision insurance, plus an Employee Assistance Program. * Financial Perks ...

National Insurance Crime Bureau

Special Agent

Ocala, FL · On-site

$66K/yr

Functions as a "technical" expert in fraud investigations and identifying insurance fraud schemes/claim file review. * Maintains membership in appropriate professional organizations. * Works well ...

SCCU

Fraud Investigator I

Miramar, FL · On-site

$28.13 - $29.79/hr

As a Fraud Investigator I, you will help protect the credit union and its members by investigating ... Medical, dental, and vision insurance, plus an Employee Assistance Program. * Financial Perks ...

Kemper

SIU Investigator

Miami, FL

This investigator will coordinate investigations with outside SIU contacts, the Department of Insurance Fraud Division, NICB, and various law enforcement agencies. A laptop computer, cell phone and ...

Assuranceamerica

SIU Desk Investigator - Tampa

Tampa, FL

$21 - $27/hr

Previous experience in insurance claims investigation, fraud detection, or law enforcement helpful. * Excellent communication and interpersonal skills, with the ability to interact effectively with ...

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Insurance Fraud Investigation information

What does an insurance fraud investigator do?

An insurance fraud investigator is responsible for detecting, investigating, and preventing fraudulent activities related to insurance claims. They gather and analyze evidence, interview claimants and witnesses, and collaborate with law enforcement and legal professionals when necessary. Their work helps insurance companies identify false or exaggerated claims, ensuring that legitimate policyholders are protected and financial losses are minimized. Insurance fraud investigators often use surveillance, background checks, and various investigative techniques to uncover fraud.

What skills and qualifications are needed to thrive as an insurance fraud investigator?

To thrive as an Insurance Fraud Investigator, you need a solid background in investigative techniques, analytical reasoning, and knowledge of insurance policies, often supported by a degree in criminal justice or a related field. Familiarity with case management software, data analysis tools, and sometimes certifications like Certified Insurance Fraud Investigator (CIFI) are typically required. Strong attention to detail, ethical judgment, and effective communication skills help investigators build credible cases and collaborate with various stakeholders. These skills ensure thorough, accurate investigations that protect insurers from losses and uphold industry integrity.

What are common challenges faced by insurance fraud investigators, and how can they be managed?

Insurance fraud investigators often face challenges such as handling large volumes of complex case files, staying updated on evolving fraud tactics, and balancing thoroughness with efficiency. Investigators must pay close attention to detail while maintaining clear documentation and adhering to legal procedures. Collaborating with colleagues in claims, legal, and law enforcement teams is crucial for gathering evidence and building strong cases. Ongoing training and effective time management can help professionals stay ahead of industry trends and manage caseloads successfully.

What is the difference between Insurance Fraud Investigation vs Insurance Claims Adjuster?

AspectInsurance Fraud InvestigationInsurance Claims Adjuster
CredentialsTypically requires certifications like CIFI or CPCURequires state licensing and adjuster certifications
Work EnvironmentInvestigative settings, often in offices or on-siteClaims processing, office and field work
Employer & IndustryInsurance companies, government agenciesInsurance companies, third-party administrators

Insurance Fraud Investigators focus on detecting and preventing fraudulent claims, often conducting investigations and interviews. Insurance Claims Adjusters evaluate and settle claims, verifying damages and coverage. While both roles require knowledge of insurance policies and certifications, Fraud Investigators emphasize investigative skills, whereas Adjusters focus on claims assessment and settlement.

How do you become an insurance fraud investigator?

To become an insurance fraud investigator, candidates typically need a high school diploma or equivalent, with some roles requiring a bachelor's degree in criminal justice, law enforcement, or a related field. Relevant experience in law enforcement, claims adjusting, or investigations is often preferred, and certifications such as the Certified Fraud Examiner (CFE) can enhance job prospects. Strong analytical skills, attention to detail, and knowledge of insurance policies and legal procedures are important for success in this role.

How to become an insurance fraud investigator?

To become an insurance fraud investigator, candidates typically need a background in criminal justice, law enforcement, or insurance claims, along with strong analytical and interviewing skills. Relevant certifications, such as the Certified Fraud Examiner (CFE), can enhance job prospects, and experience in claims adjusting or law enforcement is often preferred. The role may require a background check and adherence to industry regulations.

Is insurance fraud investigation a good career?

Insurance fraud investigation is a specialized law enforcement or insurance industry role that involves detecting and preventing fraudulent claims. It often requires analytical skills, attention to detail, and knowledge of insurance policies, with opportunities for advancement and job stability in the field.

What are popular job titles related to Insurance Fraud Investigation jobs in Florida?

For Insurance Fraud Investigation jobs in Florida, the most frequently searched job titles are:

What job categories do people searching Insurance Fraud Investigation jobs in Florida look for?

The top searched job categories for Insurance Fraud Investigation jobs in Florida are:

What cities in Florida are hiring for Insurance Fraud Investigation jobs?

Cities in Florida with the most Insurance Fraud Investigation job openings:

Insurance Fraud Investigation jobs near you
Infographic showing various Insurance Fraud Investigation job openings in Florida as of August 2026, with employment types broken down into 100% Full Time. Highlights an 100% In-person job distribution.

Insurance Fraud Investigator SIU - Orlando Florida

United Automobile Insurance Company

Orlando, FL • On-site, Remote

$20.75 - $26.50/hr

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Posted 6 days ago

Job description

COMPANY OVERVIEW:
Founded in 1989, United Automobile Insurance Company is an innovative and established organization looking for Insurance Fraud Investigator (SIU) to join our team. Family-owned, UAIC, is one of the largest privately held property and casualty insurance companies in the United States. The key to our growth and success is a commitment to providing quality service to our agents and customers, by providing disciplined underwriting, and strategic claims handling. Our ongoing efforts to invest substantial resources in personnel and technology are the foundation of our promise of assuring maximum efficiency and specialized operations in the industry. We are proud that our independent agents and customers have recognized our dedication by making UAIC the market leader in every state where we conduct business.
Remote position, and must be located in the Orlando, Florida area
SCOPE:
As a Insurance Fraud Investigator I(SIU) for UAIC, you will be responsible for conducting field as well as desk investigations to detect fraud on high complexity claims involving staged auto accidents, fraud rings, and questionable medical treatment. You will provide investigative expertise to limit exposure and protect company assets. These investigations involve auto liability private passenger and commercial auto lines for non-standard policies. Investigations may include database searches, Examinations Under Oath, and scene canvasses. Focusing on thoroughness, quality, timeliness, and cost control. Our special investigator II will prepare and submit SIU investigative reports covering all phases of the investigation in each case for approval. You will maintain continued contact during investigations with supervision, internal legal professionals, external medical professionals, government/regulatory agencies, NICB, Law Enforcement, and outsourced vendors. The Investigator will also be responsible for effectively carrying out investigations of alleged Fraud, Waste, and Abuse by medical providers, body shops, and others.
DUTIES:
  • Conduct clinic inspections and examinations under oath.
  • Conduct in-depth research and review of suspected fraudulent or abusive patterns to develop sufficient evidence to conclusively establish facts involving insureds, claimants, medical and auto body shop providers, or other entities.
  • Collect, utilize, and interpret data from a variety of computer-generated reports and other sources; thereby identifying and documenting questionable patterns related to medical modalities, procedures, and other practices which merit further investigation.
  • Maintains assigned investigation files, documents evidence, and prepares comprehensive investigation reports at the completion of each investigation.
  • Assist in conducting comprehensive interviews: medical and other providers aforementioned, insureds/claimants in the presence of their attorneys where applicable, and witnesses to obtain statements and information admissible under accepted rules of evidence in civil and criminal court proceedings.
  • Conducts special projects initiatives/investigations referred by the House Counsel.
  • Establishes and maintains liaison with NICB, Law Enforcement officers, and others to obtain assistance in conducting, facilitating, and enhancing investigations.
  • Knowledgeable about all applicable insurance regulations, especially PIP regulations to ensure duties and assignments are carried out within the requirements of applicable law and office expectations.
  • Mentor and teach less experienced investigators, promoting teamwork and collaboration among the department. Encourage sharing of insights, experiences, and best practices within the SIU team.

EDUCATION:
  • Associate or bachelor's degree in a related field preferred and/or 5 years of related work experience.
SKILLS & EXPERIENCE:
  • Bilingual (English & Spanish)
  • Knowledge of current procedural terminology.
  • Strong critical thinking and analytical skills with the ability to interpret data and trends.
  • In-depth knowledge of applicable fraud statutes, regulations, and industry best practices.
  • High degree of integrity as demonstrated by appropriate treatment of confidential information, and adherence to policies, rules, and regulations.
  • Effective communication and interpersonal skills, with the ability to build and maintain relationships with internal and external stakeholders.
  • Excellent organizational and project management abilities, with a keen eye for detail.
  • Expert knowledge of medical claims processing and investigations, a strong plus.
  • Experience in CPT codes and medical terminology is highly preferred.
  • Detail-oriented investigator with strong organizational and time management abilities
  • Analytical and interview skills: ability to make deductions; logical and sequential thinker.
  • Computer literate; database and Internet proficient. Has knowledge of available resources (internal and external) to assist in investigations.
  • Ability to work with others in a team environment.

BENEFITS:
  • 401(k) Retirement Savings Plan with employer match.
  • Comprehensive Medical, Prescription Drug, Vision, and Dental Insurance
  • Paid Time Off, Holidays, and Leave programs.
  • Flexible spending accounts
  • Basic Life Insurance and Voluntary Life/ADD
  • Short Term and Long-Term Disability

UAIC participates in the E-Verify program to confirm the employment eligibility of all newly hired employees. For more information about E-Verify, please visit https://www.e-verify.gov/.
UAIC is an Equal Opportunity Employer and is committed to the principle of equal employment opportunity for all employees. All employment decisions at UAIC are based on business needs, job requirements, and individual qualifications, without regard to race, color, religion, or belief, family or parental status, or any other status protected by the laws or regulations in the locations where we operate.
Compensation Notice: Compensation ranges and estimates displayed by third-party job platforms may be automatically generated and may not reflect United Auto Insurance's established compensation range for this position. Where required by applicable law, United Auto Insurance will provide the applicable pay range and other required compensation information. For questions regarding compensation for this position, please contact our Recruiting Team.

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