CLAIMS INVESTIGATOR DEFINITION:
Under direction, investigates general liability, property damage, and personal injury insurance claims of a noncomplex nominal nature; does related work as required.
NOTE: The definition and examples of work for this title are for illustrative purposes only. A particular position using this title may not perform all duties listed in this job specification. Conversely, all duties performed on the job may not be listed.
EXAMPLES OF WORK:
Investigates routine accident claims to authenticate claim as reported.
Interviews, telephones, or corresponds with victims, witnesses, and claimants.
Inspects and assesses damage to property.
Takes photographs of accident scene.
Reports findings and analyzes other data such as police reports, witness accounts, hospital records, and so forth.
Makes recommendations to supervisor concerning claim consistency with information received.
Aids claimants in completing claim forms.
Answers questions concerning the processing of insurance claims.
Maintains essential records and files.
Will be required to learn to utilize various types of electronic and/or manual recording and computerized information systems used by the agency, office, or related units.
REQUIREMENTS:
NOTE: Applicants must meet one of the following or a combination of both experience and education. Thirty (30) semester hour credits are equal to one (1) year of relevant experience.
Four (4) years of professional experience in conducting investigations which involved the collection of facts and obtaining information by observing conditions, examining records, interviewing individuals, and preparing investigative reports of findings.
OR
Possession of a bachelor's degree from an accredited college or university.
NOTE: "Professional experience" refers to work that is analytical, evaluative, and interpretive; requires a range of basic knowledge of the profession's concepts and practices; and is performed with the authority to act and make accurate and informed decisions.
LICENSE:
Appointees will be required to possess a driver's license valid in New Jersey only if the operation of a vehicle, rather than employee mobility, is necessary to perform the essential duties of the position.
KNOWLEDGE AND ABILITIES:
Knowledge of principles and techniques of conducting investigations.
Knowledge of methods of recording significant information gained from various sources.
Knowledge of the preparation of reports containing findings and recommendations.
Ability to organize assigned work and develop effective work methods.
Ability to analyze, interpret, and evaluate information obtained.
Ability to report facts accurately in a concise, logical, and objective manner.
Ability to prepare essential reports.
Ability to maintain accurate and accessible records and files.
Ability to communicate effectively and gain peoples' respect and cooperation.
Ability to understand medical and legal terminology and insurance laws, regulations, and procedures.
Ability to learn to utilize various types of electronic and/or manual recording and information systems used by the agency, office, or related units.
Ability to read, write, speak, understand, or communicate in English sufficiently to perform the duties of this position. American Sign Language or Braille may also be considered as acceptable forms of communication.
Persons with mental or physical disabilities are eligible as long as they can perform the essential functions of the job after reasonable accommodation is made to their known limitations. If the accommodation cannot be made because it would cause the employer undue hardship, such persons may not be eligible.
