| Claims Investigator Job Description |
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| The following is a full job description for Claims Investigator. Here are the requirements and responsibilities for Claims Investigator along with statistics. If after reading this page you determine that Claims Investigator is not the position you are looking for, you may want to try one of these similar titles: Claims Senior Investigator, Disability Claims Examiner III, Claims Examiner II, Claims Examiner I, Claims Examiner III, Claims Examiner IV, Claims Clerk IV, Claims Adjuster II - P&C, Claims Adjuster III - P&C |
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| Requirements and Responsibilities For Claims Investigator |
| Investigates assigned claims to determine validity, detect potential fraud, and gather facts to support claim decisions. Conducts interviews, surveillance, record reviews, and field investigations to obtain relevant evidence. Analyzes statements, documentation, and data to identify inconsistencies and indicators of fraud. Documents investigative findings, evidence, and conclusions in clear and accurate reports. Ensures compliance with applicable laws, regulations, and investigative standards. Requires a bachelor's degree. Typically reports to a manager. Occasionally directed in several aspects of the work. Gaining exposure to some of the complex tasks within the job function. Typically requires 2-4 years of related experience. |
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| Also referred to as: Claim Compliance Investigator, Insurance Compliance Investigator, Insurance Fraud Investigator, Suspicious Claims Investigator |
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| Similar Jobs: Claims Senior Investigator, Disability Claims Examiner III, Claims Examiner II, Claims Examiner I, Claims Examiner III, Claims Examiner IV, Claims Clerk IV, Claims Adjuster II - P&C, Claims Adjuster III - P&C |
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| Level of Education: Claims Investigator Salaries with No Diploma, Claims Investigator Salaries with a High School Diploma or Technical Certificate, Claims Investigator Salaries with an Associate's Degree, Claims Investigator Salaries with a Bachelor's Degree, Claims Investigator Salaries with a Master's Degree or MBA, Claims Investigator Salaries with a JD, MD, PhD or Equivalent |
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| Industries: Business Services, Construction, Edu., Gov't. & Nonprofit, Energy & Utilities, Financial Services, Healthcare, Insurance, Retail & Wholesale, Telecom, Transportation | |
