Wendy Bernstein
Vancouver,WA
Summary
PROFESSIONAL SUMMARY Experienced Special Investigations Unit and claims investigator with more than fourteen years of combined experience conducting claimant and witness interviews, analyzing complex medical documentation, performing desktop investigations, and preparing detailed investigative summaries across Workers’ Compensation, disability, auto liability, and property lines. Demonstrated ability to identify inconsistencies, verify provider information, reconcile conflicting documentation, and evaluate red flags and potential misrepresentation. Skilled in structured recorded statements, regulatory compliance, timeline reconstruction, and preparation of materials for potential
Overview
26
26
years of professional experience
Work History
Lead SIU Investigator
AFLAC Program CoventBridge Group
09.2019 - Current
- Serves as the lead SIU investigator for AFLAC programs, overseeing high volume desktop investigations and ensuring strict compliance with SIU protocols and regulatory standards.
- Conducts detailed review of medical records, provider notes, treatment histories, and claim documentation to identify inconsistencies, timeline discrepancies, and possible misrepresentation.
- Performs provider verification to confirm dates of service, procedures, and billing accuracy, resolving documentation conflicts.
- Completes structured claimant and witness interviews through telephone and video platforms, evaluating credibility, symptoms, and incident mechanics.
- Prepares comprehensive SIU summaries outlining factual findings, red flags, and supporting evidence.
- Compiles complete fraud referral packets for potential submission to Departments of Insurance.
- Maintains meticulous case documentation, ensures confidentiality, and provides adjusters and SIU leadership with actionable investigative findings.
- Provides informal mentorship to developing investigators on investigative standards, documentation quality, and workflow expectations.
Senior Claims Investigator
iUnlimited Inc.
02.2014 - 11.2025
- Conducted claimant and witness interviews and recorded statements across Workers’ Compensation, auto liability, and property claims, ensuring clear and chronological documentation for claims decision-making.
- Performed detailed evaluation of incident narratives, injury mechanisms, job duties, and medical treatment histories to determine consistency and identify discrepancies.
- Verified prior claims history, employment information, time loss reporting, and treatment timelines for accuracy and policy alignment.
- Reviewed photographs, videos, and supporting materials and synthesized findings into well organized written summaries relied upon by examiners and management.
- Coordinated professionally with employers, providers, and involved parties to reconcile conflicting accounts and improve case clarity.
- Completed desktop investigations requiring event reconstruction, comparison of differing statements, and development of accurate, well supported reports.
- Demonstrated strong analytical judgment, confidentiality discipline, and reliability in managing a steady, high volume investigative workload.
Administrative Services Coordinator
Girl Scouts of Greater Los
04.2007 - 11.2025
- Provided administrative and frontoffice support for a highactivity regional office.
- Managed multiline reception, visitor assistance, and daily publicfacing communication.
- Maintained correspondence, prepared meeting materials, and supported internal communication and newsletter projects.
- Coordinated communitybased activities with local businesses in alignment with municipal and organizational guidelines.
- Performed database entry, softwarebased purchasing, and system updates with accuracy and attention to detail.
- Built and maintained constructive relationships with parents, volunteers, and community partners.
Operations Support Specialist
Bernstein Investigations
10.2004 - 11.2025
- Supported the establishment and operational development of a small investigative firm by managing case intake and coordinating investigator schedules.
- Maintained evidentiary files for surveillance and recordedstatement assignments.
- Ensured documentation accuracy, carrier compliance, and timely submission of investigative materials.
- Tracked case flow through multiple databases and improved efficiency through structured filing systems and workflow practices.
- Consolidated medical records, prepared reports, updated documentation, and scanned/indexed materials to maintain auditabley files.
- Demonstrated confidentiality discipline, precision, and strong organizational support within a fastpaced investigative environment.
Administrative Support Specialist
Administrative Support St. Jude Medical, Cardiac Rhythm Management Division
07.1999 - 11.2025
- Provided highlevel administrative and operational support within a regulated medical device environment.
- Assisted with organization of internal software systems used to manage cardiac equipment upgrade kits for global distribution.
- Coordinated documentation workflows, monitored release schedules, and ensured compliance with quality standards.
- Supported multiple departments by tracking deadlines, maintaining timelines, and facilitating communication.
- Managed executive travel arrangements, documentation preparation, and reporting.
- Organized meetings, prepared agendas, and recorded accurate minutes while maintaining confidentiality.
Education
General Education Courses -
Pierce College
Woodland Hills12.1990
General Education Courses -
Clark College
VancouverSkills
SIU case review, investigative analysis, and structured fact-finding
Timeline reconstruction, incident validation, and verification of conflicting documentation
Fraud indicator identification and red-flag assessment
Claims management systems, CRM platforms, and document-tracking tools
Medical record portals, provider documentation systems, and healthcare verification workflows
Video review, photographic evidence assessment, and digital evidence management
Policy interpretation, benefit analysis, and claims analysis
Confidentiality discipline, privacy compliance, and regulatory alignment
Court testimony preparation and familiarity with evidentiary requirements
High-volume desktop investigations, provider verification, and claimant or witness interviews
Investigative summary writing, fact-pattern analysis, and fraud-referral packet preparation
Case file organization, data integrity maintenance, and audit-ready documentation
SIU TRAINING & PROFESSIONAL DEVELOPMENT
- Internal SIU program training
- Fraud awareness and redflag identification
- Workers’ Compensation claim-handling principles and state requirements
- Structured interview and recorded-statement methodology
- Medical terminology and medical record organization
- Confidentiality, privacy, and compliance standards
Timeline
Lead SIU Investigator
AFLAC Program CoventBridge Group
09.2019 - Current
Senior Claims Investigator
iUnlimited Inc.
02.2014 - 11.2025
Administrative Services Coordinator
Girl Scouts of Greater Los
04.2007 - 11.2025
Operations Support Specialist
Bernstein Investigations
10.2004 - 11.2025
Administrative Support Specialist
Administrative Support St. Jude Medical, Cardiac Rhythm Management Division
07.1999 - 11.2025
General Education Courses -
Pierce College
General Education Courses -
Clark College