A Claims Investigator investigates and assesses insurance claims to verify the validity of insurance claims. Determines the level of liability and determines pay-out amounts. Prepares evaluation reports to document the evidence to be used in court.
Loyalty MGA is looking for a SIU Investigator to identify and investigate potential fraudulent claims. This position offers a hybrid work schedule upon successfully completing the company's probation period. The SIU Investigator will be responsible for conducting thorough investigations, gathering evidence, and collaborating with internal teams to prevent and detect fraud. The ideal candidate will have a keen eye for detail, strong investigative skills, and experience in claims fraud prevention.
Responsibilities:
Fraud Investigation:
Investigate suspicious claims for potential fraud, including interviews, surveillance, and evidence collection. Analyze claims data to identify patterns and red flags that may indicate fraudulent activity.
Reporting & Documentation:
Prepare detailed investigation reports, documenting findings and supporting evidence. Present investigative findings to management and regulatory bodies as needed.
Collaboration:
Work closely with claims adjusters, legal teams, and law enforcement to support fraud investigations. Assist in developing strategies to prevent fraud and improve claims processes.
Compliance:
Ensure investigations comply with company policies, industry regulations, and legal requirements. Maintain confidentiality of sensitive information related to investigations.
Requirements:
High School Diploma or
G.E.D. 6
months of claims handling or investigative experience in any field. Experience in Loss Prevention and Surveillance preferred. Bilingual in English and Spanish is required. Active insurance adjuster's license preferred; must obtain and maintain as needed. Strong customer service and communication skills. Basic proficiency in Microsoft Office. Negotiate settlements with claimants or their representatives, ensuring fair and equitable agreements. Adhere to ethical standards and guidelines while handling claims and interacting with stakeholders. High school diploma or equivalent; bachelor's degree in business, or related field preferred. Strong problem-solving skills with a focus on delivering timely and effective resolutions to customer issues. Strong organizational and time management skills to handle multiple tasks efficiently. Professional, energetic, and ability to thrive in a fast-paced environment and adapt to changing priorities. Excellent verbal and written communication skills. Ability to articulate solutions clearly and concisely.
ABOUT US
We are a fast-growing, bilingual insurance agency serving clients across Florida and Texas! Our team helps families and businesses protect what matters most — through auto, home, life, and commercial insurance solutions built around each client's needs. We are not your average insurance agency. We invest in our people, recognize performance, and create real paths for growth — from your first day in the office to owning your own location. If you are bilingual, driven, and want a career that rewards your work, you have found the right team.
WHY JOIN US
We know talented bilingual insurance professionals have options. Here is what makes us different: ✓ Real base pay — Competitive salary based on experience and license held ✓ Paid Time Off — 1 week PTO to start, growing with tenure ✓ Medical Insurance — Comprehensive health coverage for you ✓ Sick Time — Dedicated sick time separate from your PTO ✓ Dental & Vision — Comprehensive dental and vision coverage ✓ Performance Bonus — Structured plan tied directly to your results ✓ Supplemental Plans — Voluntary supplemental options available ✓ Employee Referral — Earn rewards for bringing great talent in ✓ Basic Life Insurance — Company-paid life insurance ✓ Career Growth Path — CSR Agent Team Lead Manager Owner ✓ 401(k) with Match — Invest in your retirement savings with us! ✓ Training & Development — Ongoing sales, product, customer service & compliance training
OUR CORE VALUES
"The harder we work, the luckier we are." ️ PROTECT Safety for our communities We ensure the safety of our communities by offering robust insurance options for life's many facets. Quality and comprehensiveness are the hallmarks of our coverage. HELP Swift, personalized support Our agents are ready to assist with any insurance questions, providing swift and personalized support to guide clients through their options. PROMOTE Investing in our workforce We invest in the future of our workforce with career paths and training for aspiring agents, contributing to the growth of the insurance sector. BUILD Trust & transparency Our client relationships are built on trust and transparency, with each interaction tailored to meet individual insurance needs.
EDUCATE & GUIDE
Clarity & empowerment Clarity and empowerment are the goals of our resources, aimed at helping clients make informed insurance decisions. PROVIDE Accessible solutions We deliver affordable and innovative insurance solutions made readily accessible through tools like our app, enhancing convenience for our clients.
