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$33.5K

$69.9K

$119K

How much do special investigations unit insurance jobs pay per year?

As of Aug 6, 2026, the average yearly pay for special investigations unit insurance in the United States is $69,931.00, according to ZipRecruiter salary data. Most workers in this role earn between $48,000.00 and $86,000.00 per year, depending on experience, location, and employer.

What is a Special Investigations Unit (SIU) in insurance?

A Special Investigations Unit (SIU) in insurance is a specialized department within an insurance company responsible for detecting, investigating, and preventing insurance fraud. SIU professionals analyze suspicious claims, conduct interviews, gather evidence, and work with law enforcement agencies when necessary. Their goal is to reduce fraudulent activity, protect the company from financial losses, and ensure the integrity of the claims process. SIUs play a crucial role in maintaining trust within the insurance industry.

What is the difference between Special Investigations Unit Insurance vs Claims Adjuster?

AspectSpecial Investigations Unit InsuranceClaims Adjuster
CredentialsInsurance licenses, investigative certificationsInsurance licenses, claims handling certifications
Work EnvironmentInvestigative settings, offices, fieldworkClaims offices, field inspections
Employer & IndustryInsurance companies, law enforcement collaborationInsurance companies, third-party administrators

Special Investigations Unit Insurance professionals focus on detecting fraud and investigating suspicious claims, often requiring investigative skills and certifications. Claims Adjusters handle claims processing, assessing damages, and settling claims. While both roles work within the insurance industry and may require similar licenses, their core functions differ: one investigates fraud, the other manages claims.

What are some common challenges faced by professionals in a Special Investigations Unit (SIU) in the insurance industry?

SIU professionals often encounter challenges such as handling a high volume of complex cases, staying updated on evolving fraud schemes, and conducting thorough investigations under tight deadlines. Balancing investigative work with detailed documentation and collaboration with legal teams and law enforcement can also be demanding. Additionally, maintaining objectivity and confidentiality while interacting with claimants and internal stakeholders is crucial for success in this role.

What are the key skills and qualifications needed to thrive as a Special Investigations Unit (SIU) insurance investigator?

To thrive as a Special Investigations Unit Insurance Investigator, you need strong analytical skills, attention to detail, and a background in criminal justice, insurance, or a related field, often supported by certifications like the Certified Insurance Fraud Investigator (CIFI). Familiarity with case management systems, surveillance tools, and database research is common in this role. Exceptional communication, critical thinking, and ethical judgment help investigators gather evidence, conduct interviews, and document findings effectively. These skills ensure accurate, thorough investigations that help detect and prevent insurance fraud, protecting both the company and policyholders.
More about Special Investigations Unit Insurance jobs
What cities are hiring for Special Investigations Unit Insurance jobs? Cities with the most Special Investigations Unit Insurance job openings:
What states have the most Special Investigations Unit Insurance jobs? States with the most job openings for Special Investigations Unit Insurance jobs include:
What job categories do people searching Special Investigations Unit Insurance jobs look for? The top searched job categories for Special Investigations Unit Insurance jobs are:
Special Investigations Unit Insurance jobs near you
Infographic showing various Special Investigations Unit Insurance job openings in the United States as of August 2026, with employment types broken down into 1% As Needed, 74% Full Time, 20% Part Time, and 5% Contract. Highlights an 91% Physical, 1% Hybrid, and 8% Remote job distribution, with an average salary of $69,931 per year, or $33.6 per hour.

Manager, Special Investigations Unit - Healthcare Fraud

Oak St. Health

Remote

$54K - $159K/yr

Other

Medical, Dental, Vision, Retirement, PTO

Posted 3 days ago

New

Job description

Special Investigations Unit Manager

We're building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you'll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time.

The Manager of the Special Investigations Unit is responsible for leading investigative work related to potential fraud, waste, and abuse across health care claims, provider activity, and related operational and/or compliance concerns. This role manages day-to-day investigative workflows, supports the development of staff, and helps ensure investigations are conducted thoroughly, consistently, and in alignment with organizational standards and regulatory expectations.

This leader plays an important role in translating investigative priorities into clear team direction, monitoring case progress, identifying risks, and elevating significant findings to leadership and stakeholders as appropriate. This position requires strong judgment, analytical rigor, and the ability to balance quality, timeliness, and accountability in a highly sensitive environment.

Required Qualifications:

  • Minimum of two years of experience in health care fraud, waste, and abuse investigations, special investigations, compliance, audit, or a related field
  • Minimum of 5 years of investigative work experience
  • Experience leading or coordinating investigative teams, workflows, and complex case activity
  • Strong analytical, problem-solving, and decision-making skills
  • Strong written and verbal communication skills, including the ability to summarize complex findings clearly
  • Ability to manage sensitive information with professionalism and discretion
  • Experience working across cross-functional teams in a regulated environment
  • Knowledge of investigative practices, documentation standards, and risk-based decision-making

Preferred Qualifications:

  • CFE, AHFI, or CPC certification
  • Experience with Medicaid investigations and regulatory requirements
  • Advanced analytical skills
  • Ability to apply critical thinking and sound judgment to complex issues
  • Strong ability to think innovatively and develop solutions to improve efficiency, quality, and team performance

Education:

  • Bachelor's degree in criminal justice, finance, business administration, or a related field

Anticipated Weekly Hours: 40

Time Type: Full time

Pay Range: $54,300.00 - $159,120.00

Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.

Great benefits for great people

We take pride in offering a comprehensive and competitive mix of pay and benefits that reflects our commitment to our colleagues and their families. This full-time position is eligible for a comprehensive benefits package designed to support the physical, emotional, and financial well-being of colleagues and their families. The benefits for this position include medical, dental, and vision coverage, paid time off, retirement savings options, wellness programs, and other resources, based on eligibility.

Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.

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