Senior Insurance Fraud & Claims Investigation Specialist in United States at Jobgether

This position is listed on behalf of a partner company, who manages all applications and next steps. Our partner is looking for a Senior Insurance Fraud & Claims Investigation Specialist based in the United States.

The Senior Insurance Fraud & Claims Investigation Specialist will contribute to a specialized AI training and evaluation project focused on detecting staged incidents and fraudulent insurance claims. In this fully remote contract role, you will apply your investigative and forensic expertise to assess complex insurance claims and determine the authenticity and potential causes of reported losses. Working with diverse digital evidence, including CCTV footage, dashcam recordings, photographs, witness statements, and engineering reports, you will reconstruct incidents and identify inconsistencies or suspicious patterns. Your findings will help strengthen the accuracy and reliability of next-generation AI systems used in insurance investigations. This opportunity is particularly suited to experienced claims and fraud professionals who can deliver objective, well-supported assessments. Previous experience working with AI is not required.

You will use your professional investigative judgment to analyze insurance claims, evaluate supporting evidence, and produce structured assessments that help identify suspicious incidents and improve AI training and evaluation processes.

• Analyze digital claim evidence, including CCTV footage, dashcam recordings, scene photographs, witness statements, and engineering reports.

• Identify inconsistencies, anomalies, and warning signs that may indicate staged incidents or fraudulent insurance claims.

• Reconstruct accident and loss events using visual, technical, and documentary evidence.

• Assess the authenticity of reported incidents and evaluate potential causes and circumstances of loss.

• Prepare detailed, structured investigative assessments for Special Investigation Unit (SIU) investigators, forensic engineers, and insurance professionals.

• Explain investigative findings clearly and support conclusions with objective, verifiable evidence.

• Identify recurring patterns associated with staged-loss incidents, suspicious claims, and potentially organized fraud schemes.

• Review technical reports, visual materials, and claim documentation to assess accuracy, reliability, and consistency.

• Contribute specialist investigative knowledge and industry best practices to AI training and evaluation datasets.

• Collaborate remotely with project stakeholders, providing professional feedback, explanations, and clarifications when required.

Requirements

The ideal candidate brings substantial experience in insurance investigations, fraud detection, or forensic analysis, along with the ability to interpret complex evidence and communicate findings in a clear, objective, and structured manner.

• Minimum of 7 years of relevant professional experience in one or more of the following areas:

  • Special Investigations or Special Investigation Units (SIU).

  • Insurance fraud detection.

  • Insurance claims investigation.

  • Forensic engineering.

  • Fleet safety investigation or review.

• Demonstrated experience analyzing insurance claim evidence and assessing incident authenticity and causation.

• Strong ability to interpret visual evidence, technical reports, witness statements, and supporting documentation.

• Proven ability to recognize inconsistencies and potential indicators of staged-loss incidents or fraudulent activity.

• Excellent analytical, investigative, and critical-thinking skills.

• Strong written communication skills, with the ability to produce detailed, structured, and evidence-based reports.

• Ability to work independently, exercise sound professional judgment, and communicate findings effectively in a remote environment.

• Previous AI training or evaluation experience is not required; relevant investigative expertise is the primary qualification.

Benefits

• Fully remote working arrangement.

• Contract-based engagement offering flexibility in how you contribute to the project.

• Opportunity to apply specialist insurance investigation and forensic expertise to an innovative AI training and evaluation initiative.

• Opportunity to contribute to the development and improvement of next-generation AI systems.

• Collaboration with professionals working across insurance investigations, forensic analysis, and technology.