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Insurance Fraud Investigator Jobs in Riverside, CA

True Behavioral Health LP

Claim Specialist

Irvine, CA · On-site

$27 - $30/hr

Investigate complex claims, including fraud prevention and risk analysis, and resolve any ... Understanding of insurance policies, claims procedures, and industry regulations. Competencies: • ...

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All JobsInsurance Fraud Investigator JobsInsurance Fraud Investigator Jobs in Riverside, CA

Insurance Fraud Investigator information

See Riverside, CA salary details

$16

$32

$55

How much do insurance fraud investigator jobs pay per hour?

As of Jun 14, 2026, the average hourly pay for insurance fraud investigator in Riverside, CA is $32.17, according to ZipRecruiter salary data. Most workers in this role earn between $23.08 and $36.88 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 work experience. Obtaining certification from organizations such as the Association of Certified Fraud Examiners (ACFE) or the National Insurance Crime Bureau (NICB) involves completing training programs, passing exams, and maintaining ongoing education. Strong analytical skills, knowledge of insurance policies, and familiarity with investigative tools are also important for success in this role.

How can I become a 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 skills include attention to detail, analytical thinking, and knowledge of insurance policies and investigative techniques; certifications such as the Certified Fraud Examiner (CFE) can enhance prospects. Experience in law enforcement, claims adjusting, or related fields is often preferred, and investigators usually work in an office or field environment with regular hours.

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 do you need to be an insurance fraud investigator?

To become an insurance fraud investigator, candidates typically need a bachelor's degree in criminal justice, law enforcement, or a related field. Relevant experience in law enforcement, claims adjusting, or investigations is often required, along with strong analytical skills and knowledge of insurance policies and fraud detection techniques. Certifications such as the Certified Fraud Examiner (CFE) can enhance job prospects.

What does an Insurance Fraud Investigator do?

An Insurance Fraud Investigator is responsible for examining suspicious or questionable insurance claims to determine if fraud has occurred. They gather evidence, interview witnesses, analyze documents, and work closely with law enforcement and legal teams. Their goal is to prevent insurance companies from paying out fraudulent claims, thereby reducing costs and maintaining the integrity of the insurance system. Investigators may specialize in various types of insurance, such as health, auto, or property. They play a critical role in protecting both companies and honest policyholders from the impact of fraud.

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 are the most commonly searched types of Insurance Fraud Investigator jobs in Riverside, CA? The most popular types of Insurance Fraud Investigator jobs in Riverside, CA are:
What are popular job titles related to Insurance Fraud Investigator jobs in Riverside, CA? For Insurance Fraud Investigator jobs in Riverside, CA, the most frequently searched job titles are:
What job categories do people searching Insurance Fraud Investigator jobs in Riverside, CA look for? The top searched job categories for Insurance Fraud Investigator jobs in Riverside, CA are:
What cities near Riverside, CA are hiring for Insurance Fraud Investigator jobs? Cities near Riverside, CA with the most Insurance Fraud Investigator job openings:
Insurance Fraud Investigator jobs near you
Infographic showing various Insurance Fraud Investigator job openings in Riverside, CA as of June 2026, with employment types broken down into 1% Locum Tenens, 2% Full Time, 74% Part Time, and 23% Contract. Highlights an 92% Physical, 3% Hybrid, and 5% Remote job distribution, with an average salary of $66,907 per year, or $32.2 per hour.

Investigator, Gaming Commission

San Manuel Casino

Highland, CA • On-site

Full-time

Posted 4 days ago

Job description

Under the supervision of the Supervisor, Gaming Commission Investigation, the Investigator - Gaming Commission is responsible for conducting thorough and unbiased investigations into allegations of fraud, waste, abuse, and misconduct within the casino environment, conducts interviews, prepares detailed reports, and collaborates with law enforcement to protect the Gaming Operation and the Nation's reputation and assets.

ESSENTIAL DUTIES AND RESPONSIBILITIES

1. Conducts objective, fair, thorough, unbiased, and timely investigations into suspected violations of Applicable Law with respect to the Nation's operation of Gaming Activities on Tribal Lands, the Gaming Facility, the Gaming Operation, or the Gaming Commission including potential licensing or internal control violations and provides actionable recommendations to senior management within specified deadlines. Develops and implements an investigative plan, prepares and conducts interviews, reviews video and completes a comprehensive investigative report.
2. Collaborates and supports other departments through video review, and provides information acquired through investigative efforts and data analytics.
3. Proactively collects, analyzes, and interprets data from systems and databases associated with the Gaming Operation and/or Gaming Facility to investigate possible violations of law and ensure regulatory compliance.
4. Conducts research using open-source intelligence to improve investigative depth, educate, and to identify vulnerabilities to the Gaming Facility, Gaming Operation, patrons, and the Nation.
5. Performs other duties as assigned to support the ecient operation of the department.

EDUCATION, EXPERIENCE AND QUALIFICATIONS

  • Bachelor's Degree with an emphasis in Accounting or Business Administration, Security Management, Administration of Justice, Public Administration or related field required.

  • Minimum two (2) years' experience in state or federal law enforcement and/or other surveillance or investigation experience required.

  • Minimum two (2) years' experience conducting complex financial investigations preferred.

  • Related, relevant, and/or direct experience may be considered in lieu of minimum educational requirements indicated above.

KNOWLEDGE, SKILLS AND ABILITIES (KSA)

  • Knowledge of Gaming regulations (i.e. National Indian Gaming Commission's Minimum Internal Controls for Class III & II Gaming (NIGC MICS), the U.S. Bank Secrecy Act, the Tribal-State Gaming Compact, Tribal Gaming Ordinances, and Tribal Gaming Regulations preferred.

  • Excellent case management and written communication skills.

  • Excellent computer skills and mastery of MS Office Suite, including Word, Excel, PowerPoint preferred.

  • Upholds honesty and ethics, demonstrating exceptional integrity and confidentiality.

  • Excellent interpersonal and communication skills, with the ability to effectively engage with Casino Management, the Legal Department, and law enforcement.

  • Must be able to extract, read, and interpret data obtained from systems and databases maintained as part of the Gaming Operation and/or Gaming Facility.

  • Knowledge of camera surveillance systems in a casino and/or other environment.

LICENSES, CERTIFICATIONS AND REGISTRATIONS

  • At the discretion of the San Manuel Tribal Gaming Commission, you may be required to obtain and maintain a gaming license.

  • Certification in a related field such as Certified Fraud Examiner, Certified Anti-Money Laundering Specialist or Certified Forensic Interviewer preferred.

  • Driving Responsibilities: Role requires regular commuting between locations. A valid driver's license and vehicle insurance with minimum liability limits is required. Role will not operate or drive Tribe-owned vehicles or patron vehicles.

PHYSICAL REQUIREMENTS/ WORKING CONDITIONS - ENVIRONMENT

The physical demands and working environment described here are representative of those that an employee encounters and must be met by an employee to successfully perform the essential functions of this job.

  • Primary work environment is in a climate-controlled office setting.

  • Work requires travel to attend meetings, trade shows, and conferences.

  • Incumbents may be required to work evening, weekend and holiday shifts.

  • Must be able to work in a fast-paced, high-demand environment.

  • Strength sufficient to exert up to 10 pounds of force occasionally and/or a negligible amount of force frequently or constantly to lift, carry, push, pull or otherwise move objects and/or move up to 40 pounds occasionally.

  • Sedentary work: involves sitting most of the time. Constantly operates a computer and other office productivity machinery, such as a calculator, copy machine, and computer printer.

  • Physical activities that apply to the essential functions of the position are balancing, stooping, kneeling, crouching, reaching, pushing, pulling, lifting, grasping, talking, hearing, and repetitive motions.

  • Hearing sufficient to hear conversational levels in person, via videoconference and over the telephone.

  • Speech sufficient to make oneself heard and understood in person, in front of groups, in meetings, via videoconference and over the telephone.

  • Visual acuity that meets the requirements of the position: The worker is required to have close visual acuity to perform an activity such as preparing and analyzing data and figures; transcribing; viewing a computer terminal; expansive reading and visual inspection of employees, visitors or facility.

  • Mobility sufficient to safely move in an office environment, walk, stoop, bend and kneel, and enter, exit and operate a motor vehicle in the course of travel to promotional events, meetings, conferences, trade shows and San Manuel properties.

  • Endurance sufficient to sit, walk and stand for extended periods, and maintain efficiency throughout the entire work shift and during extended work hours.

  • The employee may be exposed to fumes or airborne particles including secondhand smoke.

Reasonable accommodation will be made in compliance with all applicable law.

As one of the largest private employers in the Inland Empire, San Manuel deeply cares about the future, growth and well-being of its employees. Join our team today!

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