Investigator II – Special Investigations Unit, Tennessee, North Carolina, Kentucky, Virginia

West Bend Insurance Company

Investigator II handling insurance fraud investigations for West Bend, focusing on various personal, commercial, and specialty lines. Collaborating with internal stakeholders and external partners to evaluate and investigate suspicious transactions.

Posted 8/2/2026full-timeRemote • Kentucky, North Carolina, Tennessee, Virginia • 🇺🇸 United StatesMid-LevelSenior💰 $68,000 - $90,000 per yearWebsite

Core Competencies

Role fit

Core Competencies

Use this summary to align your resume positioning with the role.

Demonstrates expertise in fraud investigation and claims analysis, with a strong focus on evidence gathering, documentation, and compliance with legal requirements. Proficient in collaborating with internal and external stakeholders to effectively communicate findings and support fraud detection initiatives.

Highest-signal resume keywords

Fraud InvestigationEvidence GatheringAnalytical SkillsClaims InvestigationCommunication Skills

ATS Keywords

Tailor your resume

Applicant Tracking System Keywords

Tip: use these terms in your resume and cover letter to boost ATS matches.

Hard Skills

Fraud InvestigationClaims InvestigationEvidence GatheringAnalytical SkillsProblem-Solving SkillsDocumentationInvestigative ProcessesKnowledge of Fire Cause and OriginAttention to DetailInterviewing Skills

Soft Skills

Interpersonal SkillsCollaborative MindsetContinuous Learning

Tools & Technologies

Investigative DatabasesStandard Office SoftwareDigital Tools for ResearchDigital Photo/Video Documentation

Certifications & Qualifications

Valid Driver’s License

Industry Keywords

Insurance FraudSIU SupportRegulatory ComplianceClaimsUnderwritingFraud Detection ProgramsInvestigative Action PlansState Fraud Bureaus

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.
Collaborative with internal stakeholders and external partners to evaluate and investigate suspicious insurance transactions (claims, underwriting, policy, etc.), collect evidence, support fraud detection programs, and communicate investigative findings to internal and external partners, regulators, and law enforcement.
Support fraud detection and investigation by identifying red flags, gathering facts, and documenting evidence in compliance with company policy and legal requirements.
Review claim files for basic red flags (inconsistencies, late reporting, coverage anomalies, questionable damages, medical billing issues).
Apply checklists, referral criteria, and scoring tools to determine whether further investigation is warranted.
Conduct thorough investigations of suspect insurance claims on moderate to high complexity cases with minimal supervision.
Meticulous attention to detail to ensure accuracy and thoroughness in investigations and ensure efficient and effective investigations are completed using the most appropriate method of investigation through either field, desktop, or combination thereof.
Evaluate, coordinate, and recommend investigative action plans in collaboration with claims, underwriting, and legal partners.
Coordinate and monitor outside vendor activity related to assigned SIU investigations.
Prepare detailed investigative reports for internal decision-making; support referrals to law enforcement or legal action when necessary, and where applicable to state fraud bureaus.
Stay informed on regulations and statutes as well as internal protocols and procedures.
Maintain thorough documentation of investigative actions and work products in accordance with accepted SIU operating standards and best practices.
Serve as a subject matter expert for claims and/or Underwriting Department training on the detection, deterrence, and prevention of fraud.

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 skills in evidence gathering and interviewing with demonstrated ability to follow investigative processes and best practices are essential.
Clear written and verbal communication skills, including the ability to summarize complex findings; collaborative mindset and commitment to continuous learning as tools, regulations, and fraud tactics evolve.
Proficient with investigative databases and standard office software.
Ability to proficiently use computers and software for data entry, digital tools for research, and investigative analysis; digital photo/video documentation of loss scenes and evidence.
Analytical and problem-solving Skills
Interpersonal Skills
Knowledge of fire cause and origin
Valid driver’s license required; ability to travel within 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