Insurance fraud investigator Jobs in USA

Fraud Investigator I

The Fraud Investigator I plays a key role in protecting the bank and its customers from financial loss by investigating fraud claims and suspicious activity across deposit, payment, card, and digital banking channels. This position conducts thorough investigations, evaluates evidence, determines claim validity, and ensures timely, accurate, and compliant case resolution.

Working in a fast-paced environment, the Fraud Investigator I partners with customers and internal teams to resolve fraud cases, maintain regulatory compliance, and identify emerging fraud trends and recovery opportunities. Success in this role requires strong analytical and decision-making skills, attention to detail, and a commitment to delivering an exceptional customer experience. This position is available in Greenville, SC and Blairsville, GA.

What You'll Do

• Conduct investigations into suspected fraud involving debit cards, deposits, checks, ACH, wires, online banking, and other channels.
• Review account activity, transaction patterns, and supporting documentation to assess the validity of fraud claims.
• Gather and evaluate evidence from customers, internal systems, external institutions, and third-party sources.
• Contact customers as needed to obtain information, clarify transactions, and obtain supporting documents.
• Document all case activity, findings, and determinations accurately and within required timeframes using the fraud management system.
• Prepare and submit required reports (e.g., IC3) in accordance with internal guidelines.
• Prepare Letters of Indemnity (LOI), Hold Harmless Letters (HHL), and other fraud-related correspondence; follow up with external institutions as necessary.
• Ensure all investigative actions comply with bank policies, regulatory requirements, and applicable frameworks (e.g., Regulation E, NACHA, BSA/AML, card network rules).
• Communicate with customers to gather facts, confirm activity, and support case resolution.
• Provide ongoing communication and support throughout the investigation process.
• Deliver professional and empathetic service, particularly when customers have experienced financial loss.
• Explain investigation outcomes, including approvals and denials, in a clear and supportive manner.
• Educate customers on fraud prevention and account security best practices.
• Partner with internal teams (e.g., Fraud Agents, Online Banking, Card Services, Deposit Operations, Branch Leadership) to support investigations and resolutions.
• Coordinate with Legal, Corporate Security, and Compliance on cases involving law enforcement, subpoenas, or regulatory matters.
• Escalate high-risk, complex, or emerging fraud trends to leadership.
• Share insights to help improve fraud prevention strategies and customer experience.
• Maintain accurate, complete, and compliant case records aligned with regulatory and internal requirements.
• Ensure adherence to all operational procedures and regulatory requirements.
• Manage a high volume of cases while maintaining accuracy and attention to detail.
• Balance investigative work with customer communication (inbound and outbound).
• Complete investigations within required timelines.
• Produce well-supported, defensible decisions aligned with policy and evidence.
• Maintain clear, audit-ready documentation.
• Identify and pursue recovery opportunities when applicable.
• Participate in all required compliance training, including Bank Secrecy Act/anti-money laundering training, as well as internal and external training programs, online training, meetings, and seminars/conferences, etc.
• Other duties, responsibilities and activities may change or be assigned at any time with or without notice.

Requirements For Success

• High school diploma or equivalent.
• Minimum of 3+ years of experience in banking, financial services, fraud investigations, risk, disputes, customer service or a related field.
• Strong analytical and investigative skills with the ability to recognize suspicious activity and inconsistencies.
• High attention to detail and accuracy in alert review and documentation.
• Excellent communication skills with the ability to engage customers professionally and empathetically.
• Sound judgment and decision-making in routine to moderately complex situations.
• Ability to manage multiple priorities and maintain productivity in a fast-paced environment.
• Proficiency with fraud platforms, case management systems, and Microsoft Office.
• Working knowledge of applicable regulations, including:
• Regulation E
• NACHA rules
• Regulation CC
• Card network rules
• BSA/AML/OFAC requirements
• UCC
• Elder Financial Exploitation
• Experience with core banking systems (e.g., Director, Wires, ACH, Online Banking, Debit Cards, Research/Returns, File Maintenance).
• Familiarity with fraud platforms such as Verafin, Q6, or BlueVoyant.
• Experience with ServiceNow or similar case management tools.

Conditions of Employment

• Must be able to pass a criminal background & credit check.
• This is a full-time, non-remote position that requires schedule flexibility to work evenings and weekends as needed.

FLSA Status: Non-Exempt

Ready to take your career to the next level? Apply now and become a vital part of our team!

We are an Equal Opportunity Employer and do not discriminate against any employee or applicant for employment because of race, color, sex, age, national origin, religion, sexual orientation, gender identity and/or expression, status as a veteran, and basis of disability or any other federal, state, or local protected class.

Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Pay Range: USD $38,769.00 - USD $57,876.00 /Yr.