Investigator – Special Investigations Unit

West Bend Insurance Company•West Bend, WI

1d•Hybrid

About The Position

West Bend is seeking an Investigator for its Special Investigations Unit (SIU). This role involves investigating suspected insurance fraud across various lines of business, including auto, property, casualty, and workers’ compensation. The position offers remote and hybrid work options, with hybrid schedules for candidates within 50 miles of an office location (West Bend, Madison, Appleton). Fully remote candidates may occasionally travel for in-person events. The Investigator will play a key role in protecting policyholders and the business by uncovering fraud and communicating findings to internal partners, regulators, and law enforcement.

Requirements

6–8 years of fraud investigation, claims investigation, SIU support, or related analyst/research experience (or equivalent combination).
Strong evidence gathering and interviewing skills with demonstrated adherence to investigative processes and best practices.
Clear, confident communication - able to summarize complex findings in writing and verbally.
Strong analytical/problem-solving skills, interpersonal skills, and attention to detail.
Valid driver’s license and ability to travel within an assigned territory.

Nice To Haves

Knowledge of fire cause and origin.
Bachelor’s degree in criminal justice, business, data analytics - or equivalent experience.
Fraud/investigation coursework from NICB, NICTA, IASIU, ACFE, or other recognized organizations.
Designations such as CIFI, CFE, FCLS, FCLA , and/or general insurance/claims/underwriting designations.

Responsibilities

Conduct thorough, compliant, and well-documented investigations using the most effective approach (field, desktop, or a combination) based on case requirements.
Identify fraud indicators, gather facts, and document evidence in line with company policy and legal requirements.
Review claim files for red flags (inconsistencies, late reporting, coverage anomalies, questionable damages, billing concerns) and use checklists/referral criteria/scoring tools to determine next steps.
Investigate moderate to high complexity cases with minimal supervision, maintaining accuracy, efficiency, and strong investigative judgment.
Partner closely with Claims, Underwriting, and Legal to recommend and coordinate investigative action plans.
Coordinate and monitor outside vendor activity connected to SIU investigations.
Produce clear, detailed investigative reports that support internal decisions and referrals (law enforcement/legal/state fraud bureaus) when needed.
Stay current on regulations/statutes and maintain audit-ready documentation aligned to SIU best practices.
Serve as a subject matter expert, supporting training for Claims and/or Underwriting on fraud detection, deterrence, and prevention.