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Siu Claims Jobs in Raleigh, NC (NOW HIRING)

Iatinsurancegroup

Claims Major Case Director

Raleigh, NC · On-site +1

$92K - $130K/yr

This role is a true complex claims handling role that is tasked with managing those claims that are ... Identifies and addresses subrogation/contribution/SIU opportunities. * Sets accurate/timely loss ...

Allied Universal

Surveillance Investigator

Henderson, NC · On-site

$20 - $24.75/hr

Advance Your Career in Insurance Claims with Allied Universal ® Compliance and Investigation ... As a global leader, we provide dynamic opportunities for claim investigators, SIU investigators ...

Allied Universal

Surveillance Investigator

Henderson, NC · On-site

$20 - $24.75/hr

Advance Your Career in Insurance Claims with Allied Universal Compliance and Investigation Services ... As a global leader, we provide dynamic opportunities for claim investigators, SIU investigators ...

Allied Universal

Surveillance Investigator

Henderson, NC · On-site

$20 - $24.75/hr

Advance Your Career in Insurance Claims with Allied Universal Compliance and Investigation Services ... As a global leader, we provide dynamic opportunities for claim investigators, SIU investigators ...

All JobsSiu Claims JobsSiu Claims Jobs in Raleigh, NC

Siu Claims information

See Raleigh, NC salary details

$29.6K

$62.8K

$87.5K

How much do siu claims jobs pay per year?

As of Aug 31, 2026, the average yearly pay for siu claims in Raleigh, NC is $62,805.00, according to ZipRecruiter salary data. Most workers in this role earn between $49,600.00 and $73,400.00 per year, depending on experience, location, and employer.

What are SIU claims?

SIU Claims refer to claims that are investigated by a Special Investigations Unit (SIU) within an insurance company. These units are responsible for identifying, investigating, and preventing insurance fraud and suspicious activities. When a claim shows signs of potential fraud or unusual circumstances, it is referred to the SIU for further review. SIU investigators use various methods, such as interviews, surveillance, and data analysis, to determine the validity of the claim. Their work helps ensure that legitimate claims are paid while fraudulent ones are detected and denied.

What skills and qualifications are needed to thrive as an SIU claims investigator?

To thrive as an SIU Claims Investigator, you need a solid understanding of insurance claims processes, investigative techniques, and relevant legal/regulatory guidelines, often supported by a bachelor's degree in criminal justice or a related field. Familiarity with claims management systems, fraud detection software, and data analysis tools is typically required, and certifications such as the Certified Insurance Fraud Investigator (CIFI) can be advantageous. Strong analytical thinking, attention to detail, and effective communication skills help investigators identify fraud and present their findings clearly. These skills and qualifications are critical for ensuring accurate claim resolutions, minimizing losses, and maintaining the integrity of the insurance process.

What are common challenges SIU claims investigators face when conducting investigations?

SIU (Special Investigations Unit) Claims investigators often encounter challenges such as gathering sufficient evidence while adhering to legal and ethical guidelines, managing tight deadlines, and navigating uncooperative witnesses or claimants. They must also stay updated on fraud trends and collaborate closely with other departments, such as legal and law enforcement, to ensure thorough and compliant investigations. Adapting to evolving technology and maintaining confidentiality are additional aspects that make the role both demanding and rewarding.

What is the difference between Siu Claims vs Insurance Adjuster?

AspectSiu ClaimsInsurance Adjuster
CredentialsTypically requires claims handling experience, industry knowledgeRequires licensing, certifications like AIC or CPCU
Work EnvironmentClaims department, often in insurance companies or third-party administratorsField or office-based, assessing damages and investigating claims
Employer & IndustryInsurance companies, third-party claims firmsInsurance companies, independent agencies

Both Siu Claims and Insurance Adjusters handle insurance claims, but Siu Claims specialists often focus on complex or specialized claims, especially in subrogation or fraud cases, while Insurance Adjusters evaluate damages and determine claim payouts. Understanding these differences helps in choosing the right career path or job search focus.

What are popular job titles related to Siu Claims jobs in Raleigh, NC?

For Siu Claims jobs in Raleigh, NC, the most frequently searched job titles are:

What job categories do people searching Siu Claims jobs in Raleigh, NC look for?

The top searched job categories for Siu Claims jobs in Raleigh, NC are:

What cities near Raleigh, NC are hiring for Siu Claims jobs?

Cities near Raleigh, NC with the most Siu Claims job openings:

Siu Claims jobs near you
Infographic showing various Siu Claims job openings in Raleigh, NC as of August 2026, with employment types broken down into 88% Full Time, 10% Part Time, and 2% Contract. Highlights an 86% Physical, 4% Hybrid, and 10% Remote job distribution, with an average salary of $62,805 per year, or $30.2 per hour.

Special Investigations Unit (SIU) Manager of Operations

Blue Cross And Blue Shield of North Carolina

Durham, NC • On-site

$107K - $172K/yr

Full-time

Medical, Dental, Vision, Retirement, PTO

Posted 14 days ago

Blue Cross and Blue Shield of North Carolina rating

7.8

Company rating: 7.8 out of 10

Based on 13 frontline employees who took The Breakroom Quiz

196th of 315 rated insurance

Job description

Job Description

Blue Cross NC is hiring a Special Investigations Unit (SIU) Manager of Operations to lead the team responsible for key SIU functions. The SIU works to detect, prevent, and correct health care fraud, waste, and abuse while supporting the health and well-being of the customers and communities it protects, including Blue Cross NC employees, members, providers, and business partners.

What You'll Do

  • Lead daily SIU operations, including intake, logging, triage, due diligence, and preliminary review of potential fraud, waste, and abuse incidents.

  • Monitor external intelligence channels and manage prepayment intervention operations to support proactive anti-FWA efforts.

  • Provide investigation support and oversee inbound and outbound correspondence related to SIU activities.

  • Establish, monitor, and drive team performance metrics, production goals, and operational outcomes aligned to organizational priorities.

  • Provide dynamic leadership, coaching, and professional development pathways for team members.

  • Serve as a liaison with internal and external partners to develop, monitor, and update anti-FWA strategies and approaches.

  • Represent the department on relevant internal committees and cross-functional initiatives, including presentations and active participation as needed.

  • Ensure SIU activities comply with contracts, the Company Code of Conduct, the Company Compliance Program, the SIU Fraud Plan, and applicable state and federal guidelines.

  • Leverage and develop AI-enabled tools to improve process efficiency and operational effectiveness.

What You Bring

  • Bachelor's degree and 8+ years of relevant experience.

  • In lieu of degree, 10+ years of experience in related field.

  • Accredited Health Care Fraud Investigator (AHFI) or Certified Fraud Examiner (CFE) preferred

Bonus Points

  • Experience leveraging data-driven insights to prioritize investigations, quantify financial impact, and support strategic SIU decision-making.

  • Data analytics, fraud detection modeling, and interpretation of complex healthcare claims data to identify emerging fraud, waste, and abuse trends.

  • Certified Professional Compliance Officer (CPCO)

  • Certified Professional Coder (CPC) and other Specialty Certifications

  • Statistics and Extrapolation.

What You'll Get

  • The opportunity to work at the cutting edge of health care delivery with a team that's deeply invested in the community.

  • Work-life balance, flexibility, and the autonomy to do great work.

  • Medical, dental, and vision coverage along with numerous health and wellness programs.

  • Parental leave and support plus adoption and surrogacy assistance.

  • Career development programs and tuition reimbursement for continued education.

  • 401k match including an annual company contribution.

  • Learn more

Where You'll Work

Our Hybrid Flex approach is built on presence with a purpose - giving you flexibility to work remotely with intentional in-person connection - that supports a workplace that's flexible, connected, and future focused.

In a Hybrid-Flex role, you'll work in the office at least two days a week for collaboration and connection. In a Remote Flex role, you'll work virtually, with a few in-office visits each year for meaningful moments that matter.

Whether your role is Hybrid Flex or Remote Flex depends on the nature of the work and distance from our Durham headquarters. We welcome candidates from outside the local area and in any states listed on this job posting. Onsite expectations will be discussed during the interview process.

Salary Range

At Blue Cross NC, we take great pride in a fair and equitable compensation package that reflects market-price and our starting salaries are typically planned near the middle of the range listed. Compensation decisions are driven by factors including experience and training, specialized skill sets, licensure and certifications and other business and organizational needs.Our base salary is part of a robust Total Rewards package that includes an Annual Incentive Bonus, 401(k) with employer match, Paid Time Off (PTO), and competitive health benefits and wellness programs.

Based on annual corporate goal achievement and individual performance.

$107,901.00 - $172,642.00

Skills

Communication, Conflict Resolution, Critical Thinking, Decision Making, Interpersonal Communication, Leadership, Legal Regulatory Compliance, Negotiation, Problem Solving, Public Speaking, Researching, Strategic Planning, Strategy Development, Time Management

_____________________________________________________________________
JOB ALERT FRAUD: We have become aware of scams from individuals, organizations, and internet sites claiming to represent Blue Cross and Blue Shield of North Carolina in recruitment activities in return for disclosing financial information. Our hiring process does not include text-based conversations or interviews and never requires payment or fees from job applicants. All our career opportunities are published on https://bcbsnc.wd5.myworkdayjobs.com/en-US/BCBSNC. If you have already provided your personal information that you suspect is fraudulent activity, please report it to your local authorities. Any fraudulent activity should be reported to: HR.Staffing@BCBSNC.com.

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