Our Claims Investigator job description includes the responsibilities, duties, skills, education, qualifications, and experience.
About the Claims Investigator role
A Claims Investigator is responsible for researching and evaluating insurance claims to determine their validity. This involves reviewing medical records, interviewing witnesses, and conducting field investigations to gather evidence and make recommendations about the claim. The job requires excellent communication and investigative skills, as well as knowledge of relevant laws and regulations.
Role Purpose
The purpose of a Claims Investigator is to investigate, analyze, and resolve insurance claims. They are responsible for gathering evidence and information to evaluate the validity of a claim and to determine the amount of compensation owed to a policyholder. They may investigate a variety of claims, including auto, property, health, and life insurance. Claims Investigators must have excellent communication skills and be able to review and interpret documents and data to ensure accuracy. They must also be able to remain objective and unbiased while conducting their investigations.
Claims Investigator Summary
Claims Investigator Job Summary
The Claims Investigator is responsible for conducting independent investigations into insurance claims to determine the validity of the claim and the amount of compensation due. The Claims Investigator will interview witnesses, review records, and analyze data to develop a thorough understanding of the claim. The Claims Investigator will then provide a detailed written report that outlines their findings to the insurance company. The Claims Investigator must have excellent communication and interpersonal skills, as well as strong investigative and analytical skills in order to effectively perform their duties.
Claims Investigator Duties
- Conduct research to verify factual information of insurance claims
- Interview claimants and witnesses to verify facts related to the claim
- Gather evidence to support or refute claims
- Analyze documents and other evidence to determine the validity of claims
- Prepare reports detailing findings and recommendations
- Testify in court as an expert witness on behalf of the insurance company
Claims Investigator Skills
- Excellent communication skills
- Strong organizational and analytical skills
- Knowledge of legal procedures and investigative techniques
- High level of accuracy and attention to detail
Claims Investigator Requirements
- Bachelor's degree in criminal justice or related field
- Previous experience in conducting investigations
- Excellent research and investigative skills
- Strong problem-solving skills
- Proficiency in Microsoft Office
- Excellent written and verbal communication skills
- Ability to work independently and on a team
- Ability to maintain confidentiality
Personal Traits
- Strong analytical and problem-solving skills
- Attention to detail
- Excellent communication skills
- Ability to work independently
- Ability to accurately document findings