Claims Investigator

About the Company

For over 40 years, APEX Investigation® has been dedicated to reducing insurance risk and combating fraud through trusted, high-quality investigations. We build lasting client relationships through integrity, clear communication, and timely, actionable results. Specializing in suspicious claims across multiple coverage areas—including workers’ compensation, property, casualty, and auto liability—we provide critical information that supports efficient claims resolution, cost control, and reduced financial loss.

About the Role

The Claims Investigator plays a critical role in the investigation of insurance claims—primarily workers’ compensation—by conducting recorded statements, field investigations, scene and medical canvasses, and producing clear, well-documented reports.

This position requires adaptability, strong communication skills, sound judgment, and the ability to manage both fieldwork and detailed administrative responsibilities. Travel and variable schedules are a regular part of this role.

Key Responsibilities

Case Management & Communication

• 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.

Investigative Field Work

• 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.

Documentation & Reporting

• 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.

Evidence & Records Handling

• 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.

Additional Responsibilities

• 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.

Physical & Work Environment Requirements

• 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.

Qualifications

• 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.

Preferred Qualifications

• 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.