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 .

Posted 9/23/2026full-timeRemote • United StatesSenior💰 $68,000 - $90,000 per yearWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in fraud investigation and claims analysis, utilizing evidence-gathering techniques and investigative databases. Proficient in communicating complex findings and collaborating with stakeholders to develop effective investigative action plans.

Highest-signal resume keywords

Fraud InvestigationEvidence-Gathering SkillsInvestigative Databases ProficiencyAnalytical SkillsClear Communication Skills

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Fraud DetectionClaims InvestigationDocumenting EvidenceInvestigative AnalysisData EntryDigital Research ToolsAnomaly DetectionEntity/Link AnalysisAutomated SummarizationFire Cause and Origin Knowledge

Soft Skills

Collaborative MindsetProblem-Solving SkillsInterpersonal SkillsContinuous Learning Commitment

Tools & Technologies

AI-Enabled Investigative ToolsStandard Office Software

Certifications & Qualifications

Valid Driver's License

Industry Keywords

Insurance FraudSIU StandardsRegulatory ComplianceClaims ManagementInvestigative Reporting

About the role

Key responsibilities & impact

Investigate suspected insurance fraud involving auto, property, casualty, workers’ compensation, and other personal, commercial, and specialty lines
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 vendor activity for assigned SIU investigations
Prepare detailed investigative reports and support referrals to law enforcement, legal action, or state fraud bureaus when necessary
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, including 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 Tennessee, North Carolina, Kentucky, and Virginia 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, pro-rated based on month of hire
Enhanced PTO may be available for experienced candidates
Bonus eligible based on performance
Remote/work from home arrangement
Opportunities for meaningful work and professional growth