Senior Investigator – Special Investigations Unit
West Bend Insurance Company
Posted: 10/21/2026
SIU Investigator
Travelers
Posted: 10/21/2026
Healthcare Investigator
Simple Staffing Group
Posted: 10/21/2026
Senior Investigator
Integrity Management Services, Inc.
Posted: 10/21/2026H
Investigator II
Horizon Connect @ Wall BCBSNJ
Posted: 10/20/2026
SIU Investigator
Centene Corporation
Posted: 10/20/2026
Internal Investigator
Alo Yoga
Posted: 10/20/2026
Surveillance Investigator
Huntington National Bank
Posted: 10/20/2026
Investigator II
Elevance Health
Posted: 10/20/2026Investigator I
Elevance Health
Posted: 10/20/2026
Field Investigator
Advantage Investigations
Posted: 10/20/2026
Commission Investigator
State of Florida
Posted: 10/20/2026Healthcare Investigator
Simple Staffing Group
Posted: 10/18/2026Healthcare Investigator
Simple Staffing Group
Posted: 10/18/2026Field Investigator
Advantage Investigations
Posted: 10/17/2026Field Investigator
Advantage Investigations
Posted: 10/17/2026Healthcare Investigator
Simple Staffing Group
Posted: 10/17/2026Investigator Assistant
Elevance Health
Posted: 10/16/2026
Global Investigator – Triage
TRM Labs
Posted: 10/15/2026
Senior Investigator
Attain Talent
Posted: 10/15/2026Senior Investigator – Special Investigations Unit
West Bend Insurance CompanyCore Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates expertise in fraud investigation and claims analysis, utilizing investigative databases and AI-enabled tools for effective evidence gathering and reporting. Strong communication and collaboration skills are essential for working with internal and external partners while adhering to legal and regulatory standards.
Highest-signal resume keywords
Fraud InvestigationEvidence GatheringAnalytical SkillsInvestigative DatabasesClaims Analysis
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
- Collaborate 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
- Apply checklists, referral criteria, and scoring tools to determine whether further investigation is warranted
- Conduct moderate- to high-complexity investigations with minimal supervision using field, desktop, or combined methods
- Evaluate, coordinate, and recommend investigative action plans with claims, underwriting, and legal partners
- Coordinate and monitor outside vendors involved in SIU investigations
- Prepare detailed investigative reports and support referrals to law enforcement, legal action, and state fraud bureaus when applicable
- Stay informed about regulations, statutes, internal protocols, and procedures
- Maintain documentation of investigative actions and work products according to SIU standards and best practices
- Serve as a subject matter expert for Claims and Underwriting training on fraud detection, deterrence, and prevention
Requirements
What you’ll need- 6-8 years of fraud investigation, claims investigation, SIU support, or related research/analyst experience, or equivalent combination of education and experience
- Well-developed evidence-gathering and interviewing skills
- Ability to follow investigative processes and best practices
- Clear written and verbal communication skills
- Ability to summarize complex findings
- Collaborative mindset and commitment to continuous learning
- Proficiency with investigative databases and standard office software
- Ability to use computers and software for data entry, digital research tools, and investigative analysis
- Ability to document loss scenes and evidence using digital photo/video
- Ability to work effectively with AI-enabled investigative tools, including fraud scoring, anomaly detection, entity/link analysis, and automated summarization, while applying sound judgment and documenting decision rationale
- Analytical and problem-solving skills
- Interpersonal skills
- Knowledge of fire cause and origin
- Valid driver’s license required
- Ability to travel within the assigned territory
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
- Opportunities for meaningful work and professional growth
- Remote/work-from-home arrangement
- Team meetings, training, and corporate events
ATS Keywords
✓ Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills
Fraud DetectionInvestigative ProcessesData EntryDigital Research ToolsEvidence DocumentationAnomaly DetectionEntity/Link AnalysisAutomated SummarizationInterviewing SkillsProblem-Solving
Soft Skills
Clear CommunicationCollaborative MindsetInterpersonal SkillsContinuous Learning
Tools & Technologies
AI-Enabled Investigative ToolsStandard Office SoftwareDigital Photo/Video Documentation
Certifications & Qualifications
Valid Driver’s License
Industry Keywords
Insurance FraudSIU StandardsClaims InvestigationRegulatory ComplianceFire Cause and Origin