Established in 2021, Independence Pet Holdings is a corporate holding company that manages a diverse and broad portfolio of modern pet health brands and services, including insurance, pet education, lost recovery services, and more throughout North America.
We believe pet insurance is more than a financial product and build solutions to simplify the pet parenting journey and help improve the well-being of pets. As a leading authority in the pet category, we operate with a full stack of resources, capital, and services to support pet parents. Our multi-brand and omni-channel approach include our own insurance carrier, insurance brands and partner brands.
Independence American Insurance Co is seeking a Carrier Operations Fraud Analyst who will report to the Director, Carrier Operations. The Carrier Operations Fraud Analyst is responsible for managing and overseeing the Special Investigations Unit (SIU) program for IAIC and IPIC, ensuring compliance with state regulations and filed fraud plan. This role leads fraud investigations, coordinates reporting and required audits, and develops processes to detect and prevent fraudulent activity. The analyst collaborates with internal teams, administrators, and state regulators to maintain program integrity, drive continuous improvement, and support operational compliance.
Job Location: Remote – USA
Main Responsibilities:
- Lead fraud investigations of referrals; report referrals to regulatory bodies and assist state investigators with requests.
- Manage annual SIU reporting requirements for the IPH carriers; submit reports to state regulatory bodies.
- Collaborate with administrators to proactively detect fraud, analyze trends, and escalate emerging concerns.
- Oversee SIU program operations, collaborate with Director of Carrier Operations and administrators to evaluate processes, workflows, and key risk indicators (KRIs).
- Collaborate with DOI law enforcement on fraud investigations and case development.
- Create and maintain monthly fraud reporting for carrier leadership.
- Facilitate SIU Committee meetings; prepare agendas, present fraud referrals
- Facilitate fraud meetings internally and with administrators; prepare agendas, share trends, schemes, and fraud activity.
- Ensure completion of DOI-mandated annual fraud training for all SIU employees; manage distribution, follow-ups, certificate collection, and maintain logs for state submission.
- Audit administrators and carrier employees annually to confirm fraud training adherence; work with HR and management to resolve gaps.
- Maintain and update carrier fraud training programs to meet state requirements, coordinate scheduling and delivery with HR.
- Build and maintain fraud-related workflows and handoffs between carrier and administrators.
- Develop and maintain process documentation, procedures, and carrier guidelines; provide to states as needed.
- Maintain and update fraud plans and organizational charts for carriers; ensure annual review and filing with states.
- Create and manage documentation and logs for referrals and investigations.
- Create notices and cancellation letters for policyholders and other required parties.
- Conduct administrator audits to validate adherence to fraud processes, filed fraud plan and state requirements.
- Collaborate with leadership to identify process improvements and drive efficiencies across fraud detection and reporting.
- Provide backup support to other areas in the Carrier Operations department.
- Performs other duties and responsibilities as assigned.
Basic Qualifications:
- Bachelor’s degree in Business, Insurance, Criminal Justice, or related field preferred.
- Minimum of 3 years of experience in insurance operations, fraud investigation, or compliance.
- Strong understanding of insurance operations, regulatory standards, and compliance requirements.
- Claims and claims data analysis experience is a plus.
- Experience with state fraud reporting, audits, and fraud investigation.
- Familiarity working with state investigators highly desirable.
- Experience developing workflows, processes, and training programs preferred.
- Strong understanding of operations, insurance fraud detection, SIU requirements, and regulatory compliance.
- Excellent investigative and analytical skills with attention to detail.
- Strong organizational and project management abilities.
- Ability to interpret and apply state regulations related to fraud and SIU programs.
- Proficiency in Microsoft Office Suite (Excel, Word, Outlook, PowerPoint).
- Strong written and verbal communication skills; ability to present complex fraud cases clearly.
Expected Hours of Work:
- This is a full-time position: Days and hours to be determined by needs of business. Hours to be determined between employee and director
#li-Remote
All of our jobs come with great benefits including healthcare, parental leave and opportunities for career advancements. Some offerings are dependent upon the location of where you work and can include the following:
Comprehensive full medical, dental and vision Insurance
Basic Life Insurance at no cost to the employee
Company paid short-term and long-term disability
12 weeks of 100% paid Parental Leave
Health Savings Account (HSA)
Flexible Spending Accounts (FSA)
Retirement savings plan
Personal Paid Time Off
Paid holidays and company-wide Wellness Day off
Paid time off to volunteer at nonprofit organizations
Pet friendly office environment
Commuter Benefits
Group Pet Insurance
On the job training and skills development
Employee Assistance Program (EAP)
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