Investigator - Special Investigations Unit

Investigator - Special Investigations Unit

Job Locations US-WI-West Bend ID 2026-3590 Category Claims Full-Time Remote/Hybrid Hybrid

Company Overview

Recognized as a Milwaukee Journal Sentinel Top Workplace for 14 consecutive years, including three years of being honored as number one! Join us at West Bend, where we believe that our associates are our greatest asset. We hire talented individuals who are conscientious, dedicated, customer focused, and able to build lasting relationships. We create and maintain an environment where you feel a sense of belonging and appreciation. Your diversity of thought, experience, and knowledge are valued. We're committed to fostering a welcoming culture, offering you opportunities for meaningful work and professional growth. More than a workplace, we celebrate our successes and take pride in serving our communities.

Job Summary

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

Work Location

This position offers both remote and hybrid work locations. Candidates who reside within 50 miles of an office location (West Bend, Madison, Appleton) will be offered a hybrid work schedule. Candidates who are fully remote (beyond 50 miles) may occasionally be asked to travel to an office location for in-person engagement activities such as team meetings, training and corporate events.

Responsibilities & Qualifications

SIU Investigator (Field) - Special Investigations Unit (Claims)

Help protect our policyholders by uncovering the truth behind suspicious insurance activity.
If you're an experienced investigator who thrives on connecting dots, conducting solid fieldwork, and turning complex facts into clear, defensible conclusions, this role offers meaningful, high-impact work - backed by a collaborative team and strong internal partnerships.

Why this role matters

Insurance fraud drives up costs for everyone. In this role, you'll play a key part in protecting customers and the business by investigating suspected fraud across auto, property, casualty, workers' compensation, and other personal, commercial, and specialty lines - and communicating findings to internal partners and, when appropriate, regulators and law enforcement.

Posting note (optional): This role may be posted without the level in the title to allow flexibility based on candidate experience.

What you'll do (day-to-day)

You'll conduct thorough, compliant, and well-documented investigations - using the most effective approach (field, desktop, or a combination) based on what the case requires.

Key responsibilities include:

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.

What we're looking for

Preferred experience & skills

• 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.
• Knowledge of fire cause and origin (preferred).
• Valid driver's license and ability to travel within an assigned territory.

Preferred education & training

• 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.

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Salary Statement

The salary range for this position is $68,000-$86,000.

The actual base pay offered to the successful candidate will be based on multiple factors, including but not limited to job-related knowledge/skills, experience, business needs, geographical location, and internal equity. Compensation decisions are made by West Bend and are dependent upon the facts and circumstances of each position and candidate.

Benefits

West Bend offers a comprehensive benefit plan including but not limited to:

• 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

• West Bend will comply with any applicable state and local laws regarding employee leave benefits, including, but not limited to providing time off pursuant to the Colorado Healthy Families and Workplaces Act for Colorado employees, in accordance with its plans and policies.

EEO

West Bend provides equal employment opportunities to all associates and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws. This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, and promotion.