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Insurance Fraud Investigator Jobs (NOW HIRING)

3M

Fraud Investigator

Maplewood, MN · On-site

$145K - $178K/yr

Fraud Investigator Collaborate with Innovative 3Mers Around the World Choosing where to start and ... Benefits, Life Insurance, Voluntary Benefits, Paid Absences and Retirement Benefits, etc.

3M

Fraud Investigator

Maplewood, MN · On-site

$145K - $178K/yr

Fraud Investigator Collaborate with Innovative 3Mers Around the World Choosing where to start and ... Benefits, Life Insurance, Voluntary Benefits, Paid Absences and Retirement Benefits, etc.

centralins

Anti-Fraud Manager

Irving, TX · On-site +1

Senior Claims Law Associate Designation, Certified Insurance Fraud Investigator Designation, and ... Certified Fraud Examiners Designation. * Familiarity with anti-fraud analytics programs as it ...

TikTok

Fraud Investigator

New York, NY · On-site

$121K - $220K/yr

Responsibilities - Conduct investigations of policy violation, data leakage, fraud and financial ... Employees have day one access to medical, dental, and vision insurance, a 401(k) savings plan with ...

centralins

Anti-Fraud Manager

Waltham, MA · On-site +1

Senior Claims Law Associate Designation, Certified Insurance Fraud Investigator Designation, and ... Certified Fraud Examiners Designation. * Familiarity with anti-fraud analytics programs as it ...

TikTok

Fraud Investigator

San Jose, CA · On-site

$121K - $220K/yr

Responsibilities - Conduct investigations of policy violation, data leakage, fraud and financial ... Employees have day one access to medical, dental, and vision insurance, a 401(k) savings plan with ...

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Insurance Fraud Investigator information

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How much do insurance fraud investigator jobs pay per hour?

As of Jul 14, 2026, the average hourly pay for insurance fraud investigator in the United States is $30.83, according to ZipRecruiter salary data. Most workers in this role earn between $22.12 and $35.34 per hour, depending on experience, location, and employer.

What are some common challenges faced by Insurance Fraud Investigators in their daily work?

Insurance Fraud Investigators often encounter challenges such as distinguishing between legitimate and fraudulent claims, managing heavy caseloads, and keeping up with evolving fraud tactics. They must remain objective and detail-oriented while conducting interviews and gathering evidence, sometimes under tight deadlines. Working collaboratively with law enforcement, attorneys, and claims adjusters is also essential, requiring strong communication and interpersonal skills.

How to become a certified insurance fraud investigator?

To become a certified insurance fraud investigator, candidates typically need a background in law enforcement, insurance, or criminal justice, along with relevant experience. Certification programs such as the Certified Fraud Examiner (CFE) or specialized insurance fraud investigator certifications are often pursued, which require passing exams and demonstrating professional experience in fraud detection and investigation. Continuing education and familiarity with investigative tools and legal procedures are also important for certification and career advancement.

How can I become a fraud investigator?

To become an insurance fraud investigator, typically a high school diploma or equivalent is required, with many employers preferring candidates with a bachelor's degree in criminal justice, law enforcement, or a related field. Relevant experience in law enforcement, insurance, or investigations, along with strong analytical skills and attention to detail, are important. Certifications such as the Certified Fraud Examiner (CFE) can enhance job prospects and credibility in the field.

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

AspectInsurance Fraud InvestigatorClaims Adjuster
Required CredentialsTypically requires a background in criminal justice, law enforcement, or related certificationsRequires insurance licenses and sometimes adjuster certifications
Work EnvironmentInvestigates suspected fraud cases, often in an office or field settingEvaluates insurance claims, interacts with claimants, and assesses damages
Employer & Industry UsageEmployed by insurance companies, law enforcement, or specialized fraud unitsEmployed by insurance companies, public agencies, or independent adjusting firms

Insurance Fraud Investigators focus on detecting and preventing fraudulent claims, often working in investigative or law enforcement settings. Claims Adjusters handle the assessment and processing of insurance claims, ensuring proper payout. While both roles are vital in the insurance industry, their primary functions, credentials, and work environments differ significantly.

What are the key skills and qualifications needed to thrive as an Insurance Fraud Investigator, and why are they important?

To thrive as an Insurance Fraud Investigator, you need strong analytical skills, attention to detail, and a background in criminal justice or a related field, often supported by a bachelor's degree. Familiarity with case management software, data analysis tools, and knowledge of legal regulations and investigative procedures is typically required, and certifications like CIFI (Certified Insurance Fraud Investigator) can be advantageous. Excellent communication, critical thinking, and interpersonal skills help build trust, conduct thorough interviews, and present findings effectively. These skills are crucial for detecting fraudulent activity, ensuring accurate claims processing, and protecting company resources.

How much do fraud investigators earn?

Insurance fraud investigators typically earn between $45,000 and $75,000 annually, depending on experience, location, and employer. Advanced skills, certifications, and investigative tools can influence salary levels within this range.

What does an insurance fraud investigator do?

An insurance fraud investigator examines insurance claims to detect and prevent fraudulent activities. They review documentation, interview claimants and witnesses, analyze evidence, and collaborate with law enforcement when necessary, often using specialized software and investigative techniques. Their work helps ensure the integrity of insurance processes and may require knowledge of legal procedures and industry regulations.

What Does an Insurance Fraud Investigator Do?

As an insurance fraud investigator, your job is to investigate an insurance claim on behalf of your firm to determine whether or not fraud has occurred in any given case. In this role, you may examine the damaged property, coordinate with law enforcement, interview the claimant, and gather information about any casualty that's occurred. Insurance fraud is a crime, but most fraud investigators are not police officers, and you are not expected to arrest fraudsters. Instead, you may be asked to write up a report summarizing your findings and send it to a law enforcement agency. Insurance fraud investigators frequently travel to examine claim sites in person, and you may be asked to do so on short notice.

More about Insurance Fraud Investigator jobs
What cities are hiring for Insurance Fraud Investigator jobs? Cities with the most Insurance Fraud Investigator job openings:
What are the most commonly searched types of Insurance Fraud Investigator jobs? The most popular types of Insurance Fraud Investigator jobs are:
What states have the most Insurance Fraud Investigator jobs? States with the most job openings for Insurance Fraud Investigator jobs include:
What job categories do people searching Insurance Fraud Investigator jobs look for? The top searched job categories for Insurance Fraud Investigator jobs are:
Insurance Fraud Investigator jobs near you
Infographic showing various Insurance Fraud Investigator job openings in the United States as of July 2026, with employment types broken down into 100% Full Time. Highlights an 100% In-person job distribution, with an average salary of $64,132 per year, or $30.8 per hour.
Anti-Fraud Manager

Anti-Fraud Manager

Central Mutual Insurance Company

Alpharetta, GA • On-site

Full-time

Medical, Retirement

Re-posted 5 days ago

Job description

Location: Van Wert, OH; Dublin, OH; Waltham, MA; Alpharetta, GA; Irving, TX
Work Model:Hybrid or Remote based on location
Position type: Full time - salary
We're a team of employees passionate about delivering best-in-class customer service and innovation in the industry. Integrity, relationships, and excellence are at the heart of everything we do.
Our employees fully utilize their talents and bring their best selves to work. We believe who you are is just as important as what you do!
Fraud prevention is at the heart of protecting our customers and our business-and that's where this role makes an impact. As Anti-Fraud Manager, you'll lead front-line investigative efforts, tackle complex and high-impact cases, and partner with a wide network of internal teams and external agencies. This is an opportunity to shape strategy, develop talent, and bring modern tools and analytics into real-world fraud detection and deterrence.
Key Responsibilities of the Role
  • Supervises the day-to-day investigative activity of SIU field/desk investigations and support activities throughout regions.
  • Acts as the direct liaison with the various Claims Staff, Departments of Insurance and other regulatory agencies, NICB and other industry investigative representatives.
  • Monitors and evaluates the quality of performance and key results through ongoing audits and review of results of both direct adjuster and advanced cutting edge analytic referrals of both artificial intelligence and machine learning.
  • Reviews and evaluates all available information to assess the appropriateness of referrals for prosecution and/or recovery.
  • Ensures that all SIU investigation files include a concise and complete summary of the investigation, including the investigators findings regarding the suspected insurance fraud and the basis for their findings and ensure that all investigative cases are thoroughly, promptly, and efficiently investigated and referred to the proper authority within the timeframe as mandated.
  • Works with all members of the Claims Management, Underwriting and Marketing Teams, Claim Support Staff, Independent Vendors, Defense Counsel, and all other entities as may be required, to ensure effective implementation of fraud detection and deterrent protocols.
  • Assists with the training of Central Mutual Insurance anti-fraud personnel and Claims Staff in fraud detection, prevention, and suspect claim handling measures.
  • Represents the Company at various industry, state and local organizations which focus on anti-fraud activities.
  • Coordinates investigation of complex suspect claims and assignments as warranted ensuring proper resolution and documentation within case management system.
  • Collaborates with the SIU Director on all matters of the SIU function to include, but not limited to; investigation, investigative strategy, training and other department matters.
  • Oversees reporting of all suspected fraudulent insurance transactions to the appropriate departments of insurance within the required time frames for their team.
  • Establishes and maintains relationships with law enforcement, Department of Insurance officials and insurance industry personnel and assist them when required.
  • Selects, trains, and develops new employees
  • Sets expectations with regards to performance
  • Communicates with, motivate and recognize employees
  • Evaluates performance and conducts weekly check-ins and performance reviews
  • Manages staff and other resources appropriately

Required Qualifications
  • Bachelor's Degree in Criminal Justice, Criminology, or Fraud Management and 2 years relevant experience
  • Or 4 years of relevant SIU investigator/SIU Supervisor experience

Preferred Qualifications
  • Licensure & Certification: None required; One or more of the following certifications/designations are desirable: Senior Claims Law Associate Designation, Certified Insurance Fraud Investigator Designation, and Certified Fraud Examiners Designation.
  • Familiarity with anti-fraud analytics programs as it relates to fraud prevention and identification

Knowledge, Skills, and Abilities
  • SIU Supervisor needs to have significant knowledge and experience in all levels of P&C claim fraud investigation and reporting requirements to the various fraud bureaus.
  • Advanced practical knowledge of conducting medical and property investigations in the field is necessary
  • Good working knowledge of Word, Excel, and PowerPoint applications
  • Demonstrated ability to build and maintain collaborative relationships with internal and external partners and business areas.
  • Proven management skills
  • Ability to demonstrate monthly productive outcomes from investigations assigned to the SIU team
  • Excellent leadership, team building, communication and strategic thinking skills
  • Ability to prepare and present training sessions
  • Successful track record in facilitating and managing projects and teams
  • Attain and be very proficient at the SIU protocols and procedures that would include SIU compliance to the specific states the company operates in
  • Possess in-depth knowledge of insurance policies and procedures related to SIU investigations
  • As a Team Member at Central Mutual Insurance, you will be part of a growing SIU Team that continues to evolve to be a Best in Class SIU group utilizing state of the art analytic programs. Three keys words guide this unit, Unique, Innovative and Creative
  • Ability to understand Central Insurance's policies and processes

Total Rewards
Central establishes base pay based on several factors including labor market data and an evaluation of candidate qualifications relative to role requirements. Base pay is one component of a comprehensive total rewards package designed to support employees' financial, health, career, and retirement objectives. Central provides extensive health and wellness benefits to promote flexibility, work-life balance, and long-term financial security. For more information, see Central Insurance Benefits
Work Authorization
Central will only employ those who are legally authorized to work in the United States. This is not a position for which sponsorship will be provided. Individuals with temporary visas such as E, F-1(including those with OPT or CPT) , H-1, H-2, L-1, B, J or TN, or who need sponsorship for work authorization now or in the future, are not eligible for hire.
Equal Opportunity Employer
It is the policy of Central that all recruiting, hiring, training, compensation, overtime, job classification and assignment, facilities, promotions, transfers, employee treatment and all other terms and conditions of employment shall be maintained in a manner which will not discriminate against any person because of race, color, age, sex, national origin, ancestry, religion, marital status, military status, or disability. The applicant should respond to questions on this application in a way that will not divulge such information. #LI-AS1 #LI-Remote #LI-Hybrid

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