Senior Investigator – Special Investigations Unit

West Bend Insurance Company

. Investigate suspected insurance fraud involving auto, property, casualty, workers’ compensation, and other personal, commercial, and specialty lines of business .

Posted 9/28/2026full-timeRemote • United StatesSenior💰 $77,000 - $97,000 per yearWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates advanced investigative skills in insurance fraud, including evidence gathering, interviewing, and compliance with legal requirements. Proficient in utilizing investigative databases and AI-enabled tools for effective analysis and documentation.

Highest-signal resume keywords

Fraud InvestigationEvidence GatheringInvestigative ReportingCollaborative MindsetDigital Research Tools

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Insurance Fraud InvestigationClaims InvestigationEvidence DocumentationInterviewing SkillsInvestigative ProcessesData EntryDigital Photo/Video DocumentationFraud Scoring ToolsRegulatory ComplianceComplex Claims Analysis

Soft Skills

Clear CommunicationCollaborative ApproachContinuous LearningMentoring SkillsProblem-Solving

Tools & Technologies

Investigative DatabasesStandard Office SoftwareDigital Research ToolsAI-Enabled Investigative Tools

Industry Keywords

Insurance FraudSpecialty LinesSIU SupportClaims ManagementUnderwriting ConcernsRegulatory StandardsFraud Detection ProgramsField InvestigationsIllinois TerritoryIndiana Territory

About the role

Key responsibilities & impact

Investigate suspected insurance fraud involving auto, property, casualty, workers’ compensation, and other personal, commercial, and specialty lines of business
Work independently and collaboratively with internal stakeholders and external partners to evaluate suspicious insurance transactions
Collect evidence and support fraud detection programs
Communicate investigative findings to internal and external partners, regulators, and law enforcement
Identify red flags, gather facts, and document evidence in compliance with company policy and legal requirements
Review claim files for inconsistencies, late reporting, coverage anomalies, questionable damages, and medical billing issues
Conduct and lead thorough investigations of suspect, high-exposure, and complex claims and underwriting/policy concerns
Conduct advanced investigations into organized fraud schemes and develop major cases and potential criminal fraud prosecutions
Coordinate investigative action plans with claims, underwriting, and legal partners
Coordinate and manage outside vendor activity related to assigned SIU investigations
Prepare detailed investigative reports and support referrals to law enforcement, legal action, or state fraud bureaus
Stay informed on regulations, statutes, internal protocols, and procedures
Maintain thorough documentation in accordance with SIU operating standards and best practices
Serve as a subject matter expert for claims and underwriting training on fraud detection, deterrence, prevention, and complex investigations
Mentor and peer-train SIU team members on investigative strategy and methodology
Spend at least 50% of working time in the field servicing the assigned territory

Requirements

What you’ll need

8-10 years of fraud investigation, claims investigation, SIU support, or related research/analyst experience or equivalent combination of education and experience
Advanced insurance fraud investigative skills, including evidence gathering and interviewing
Demonstrated ability to follow investigative processes and best practices
Clear written and verbal communication skills, including ability to summarize complex findings
Collaborative mindset and commitment to continuous learning as tools, regulations, and fraud tactics evolve
Proficient in investigative databases and standard office software
Ability to use computers and software for data entry, digital research tools, and investigative analysis
Ability to conduct digital photo/video documentation of loss scenes and evidence
Ability to work effectively with AI-enabled investigative tools, such as fraud scoring
Must service the Illinois, Indiana, and Michigan territory
Full-time availability

Benefits

Comp & perks

Medical & Prescription Insurance
Health Savings Account
Dental Insurance
Vision Insurance
Short and Long Term Disability
Flexible Spending Accounts
Life and Accidental Death & Disability
Accident and Critical Illness Insurance
Employee Assistance Program
401(k) Plan with Company Match
Pet Insurance
Paid Time Off; standard first year PTO is 17 days, prorated based on month of hire
Enhanced PTO may be available for experienced candidates
Bonus eligible based on performance