Claims Investigator

🌍 Remote, USA 🎯 Full-time 🕐 Posted Recently

Job Description

APEX Investigation is a leader in Insurance, Workers' Compensation, Liability and Human Resource Investigations. The Claims Investigator role involves conducting thorough interviews related to workers’ compensation claims, providing updates to clients, and writing comprehensive reports in a timely manner.


Responsibilities

  • Receive, review, and manage assigned cases from start to completion
  • Communicate professionally with clients, claimants, witnesses, and other involved parties
  • Provide timely case updates and correspondence in accordance with company guidelines via CaseLink
  • Maintain objectivity and professionalism in all interactions
  • Conduct recorded statements at various locations, including claimants’ homes, workplaces, medical offices, and public settings
  • Ask open-ended questions, interpret responses, and conduct appropriate follow-up without reliance on scripted questionnaires
  • Perform scene and neighborhood canvasses, including walking on varied terrain
  • Meet with treating physicians and medical offices as required
  • Travel to designated locations, including overnight stays when necessary
  • Respond to rush cases within business hours when required
  • Enter case updates, notes, hours worked, mileage, and expenses into CaseLink on a daily basis
  • Upload all obtained statements, documents, recordings, photographs, and evidence to CaseLink the same day they are acquired
  • Compose clear, concise, and grammatically correct case updates within 24 hours of obtaining statements
  • Prepare and submit comprehensive investigative reports within 72 hours of final update submission
  • Retrieve records from agencies and entities both in-person and remotely
  • Take clear photographs and video when necessary and label all electronic files accurately
  • Securely collect, store, and maintain custody of evidence when required
  • Maintain organized and protected case files and establish backup procedures to safeguard data in the event of technical failure
  • Identify and recommend additional investigative services outside the scope of the original assignment when appropriate
  • Work overtime as needed to meet case demands and deadlines
  • Maintain an efficient, safe, and organized telecommuter workspace
  • Ability to sit for extended periods performing computer-based work and report writing
  • Ability to stand for extended periods while conducting interviews and canvasses
  • Ability to lift and carry items weighing between 5–30 lbs (e.g., laptop, briefcase, equipment)
  • Ability to operate digital audio recording equipment

Skills

  • Experience with workers' compensation claims and investigative processes
  • Strong written and verbal communication skills
  • Ability to work independently, manage time effectively, and meet strict deadlines
  • Willingness and ability to travel up to (but not limited to) 150 miles per assignment
  • Possession of a personal credit card with available balance for reimbursable business expenses
  • Proficiency with case management systems; CaseLink experience preferred
  • Access to a personal scanner for document upload and record handling
  • Valid driver's license with a clean driving record
  • Access to a working computer, digital recorder, and multi-page scanner/copier
  • Ability and willingness to travel up to 150 miles, including same-day and overnight trips
  • Flexible availability, including early mornings, occasional weekends, overtime, and short-notice rush cases
  • Ability to lift up to 30 lbs, sit for long periods, and walk varied terrain for fieldwork
  • Comfortable working remotely in a secure, distraction-free home office environment
  • Proficient in Microsoft Word and familiar with case management tools
  • Prior experience conducting recorded statements and field investigations
  • Experience with process service assignments
  • Familiarity with evidence handling and documentation standards
  • Background in insurance investigations or a related field

Benefits

  • Medical
  • Dental
  • Vision
  • PTO
  • FSA
  • Simple IRA Plan
  • Mileage and Travel Reimbursement for Surveillance and Claims positions

Company Overview

  • Today’s professionals rely on investigative firms to help manage risk by detecting and preempting problem situations. It was founded in 2011, and is headquartered in Sacramento, California, USA, with a workforce of 51-200 employees. Its website is http://apexpi.com/.

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