Job Description

Overview Join the Auto Club Group (ACG) as a Claim Investigator (CSIU). The role involves independently performing comprehensive assessment and investigation of personal lines claims for the potential of claim fraud, with opportunities to collaborate with claim representatives and other stakeholders. Responsibilities Maintain a thorough understanding of insurance policies, claim handling practices, eligibility, and underwriting requirements. Understand claim fraud, including fraud scenarios and methods used by insureds, claimants, service providers, and others; recognize how fraud rings operate. Comply with state laws, regulations, and case law affecting claim fraud and investigation activities. Collaborate with the assigned claim representative, review claims for potential fraud scenarios, and identify both claim fraud and policy premium fraud. Complete investigative activities to prove or disprove the presence of fraud. Conduct interviews or recorded statements with insureds, claimants, witnesses, service providers, and other parties when appropriate. Obtain customer records and relevant documents with the insured’s permission when necessary. Perform vehicle inspections, home inspections, or site visits; obtain and follow up on public records and official reports. Perform link analysis to understand relationships between people, places, and things; arrange for and attend Examinations Under Oaths; obtain legal counsel opinion when necessary. Attend court hearings when necessary and manage vendors for specialized tasks (e.g., home fire origin analysis, surveillance, accident reconstruction, forensic accounting) with clear expectations and expense review. Balance investigative thoroughness with cost considerations and claim exposure; research fraud collaborators and potentially fraudulent service providers. Document investigative activities, results, and evidence; work with law enforcement, other SIUs, attorneys, and others; prepare written summaries and report findings to the assigned claim handler, management, and underwriters. Promote fraud awareness and provide training of company personnel when assigned. Supervisory None Work Environment This position is currently able to work remotely from a home office for day-to-day operations, with possible travel for meetings or team activities as determined by leadership. This may change based on updates to the ACG Flex Work policy. The role supports a rewarding career path within AAA The Auto Club Group. Benefits Claim Investigators earn a salary range of $65,728.00 to $82,000 annually with annual bonus potential based on performance. Benefits include: 401k Match Medical, Dental, Vision PTO and Paid Holidays Tuition Reimbursement Qualifications Required Qualifications College level coursework in Business Administration, Insurance, Criminology or related field, or equivalent work experience. Bachelor’s degree preferred. Valid State Driver's License Experience Five years of experience as a claim representative handling Auto, Casualty or Home personal lines claims; or three years as an investigator in a claims SIU; or five years in law enforcement in roles such as detective, auto theft investigator, or arson investigator. Knowledge Laws and regulations pertaining to insurance and investigative activity; policy coverages, eligibility, and underwriting rules. Claim handling practices and fraud indicators; fraud investigation techniques. Abilities Communicate effectively with the public and professionals; analyze policies and claims for relevant provisions; gather evidence and documentation. Maintain expert knowledge on fraud indicators and manage experts for specialized tasks. Impart fraud awareness training; operate in a PC environment; present testimony in civil/criminal settings; prepare written reports. Process complex, time-sensitive data; handle multiple cases under deadline pressure; safely operate a motor vehicle. Preferred Qualifications Bachelor’s degree in related fields or equivalent experience; completion of AIC/CPCU or other coursework; Fraud Claim Law Specialist or Certified Insurance Fraud Investigator certifications. Experience in both claims handling and fraud investigation. About Us The Auto Club Group (ACG) provides membership, travel, insurance, and financial services to approximately 14+ million members across 14 states and 2 U.S. territories. ACG is part of the national AAA federation, the second largest AAA club in North America. AAA emphasizes advanced technology, innovative products, and a diverse, inclusive workforce. For more information, visit Equal Opportunity and Compliance The Auto Club Group is an equal opportunity employer. All qualified applicants will receive consideration without regard to race, color, religion, sex, gender identity, sexual orientation, national origin, disability, or protected veteran status. Regular and reliable attendance is essential. A background and drug screen may be required for employment as appropriate to the position. #J-18808-Ljbffr The Auto Club Group

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