Occ. Code 6805110

 

Compensation Claims Investigator 1, GRADE 14

6805110

Compensation Claims Investigator 2, GRADE 18

6805220

Compensation Claims Investigator 3, GRADE 22

6805330

Compensation Claims Investigator 4, M-2

6805440

 

New York State Department of Civil Service

 

Classification Standard

 

BRIEF DESCRIPTION OF CLASS SERIES

 

            Positions in this title series investigate workers compensation and disability benefit claims by gathering information from various individuals and documents to verify accidents and determine qualifications for benefits and continued eligibility of claimants. 

 

These positions are found only at the New York State Insurance Fund. 

 

DISTINGUISHING CHARACTERISTICS

 

COMPENSATION CLAIMS INVESTIGATOR 1:  full performance level; performs independently.

 

            COMPENSATION CLAIMS INVESTIGATOR 2:  first supervisory level; supervises a team of Compensation Claims Investigators 1; investigates sensitive and difficult cases.

 

            COMPENSATION CLAIMS INVESTIGATOR 3:  one-position class; supervises Compensation Claims Investigators 2; plans and monitors all investigative activities Statewide.

 

            COMPENSATION CLAIMS INVESTIGATOR 4:  one-position class; formulates policy, procedures and guidelines for all investigations; directs the Investigation Division.

 

ILLUSTRATIVE DUTIES

 

COMPENSATION CLAIMS INVESTIGATOR 1:  under the general direction of a Compensation Claims Investigator 2, independently investigates workers compensation and disability benefit claims; verifies the continued eligibility of claimants; conducts thorough on-site interviews with employers, claimants, their co-workers and neighbors, medical personnel, insurance carriers, police, governmental officials and  agents,  and other parties who may serve as witnesses; examines photographs and records of accident scenes; develops comprehensive narrative reports of findings and/or affidavits at the time of completion, including all data accumulated on each assignment; submits periodic reports on ongoing investigations; testifies at hearings; and provides information concerning workers compensation and related matters to claimants and employers. 

 

COMPENSATION CLAIMS INVESTIGATOR 2:  under the general direction of a Compensation Claims Investigator 3, supervises lower level investigators; assigns work and reviews completed cases for quality and adherence to standards; establishes controls to ensure productive workloads; prepares various statistical reports for management; recommends policy and procedural changes; trains new investigators and instructs staff in changes in Workers Compensation Law and in department investigative policies and procedures; and conducts the more sensitive, difficult and extra-territorial investigations. 

 

            COMPENSATION CLAIMS INVESTIGATOR 3:  under the general direction of a Compensation Claims Investigator 4, supervises Compensation Claims Investigators 2; manages and trains contracted investigative staff; formulates procedures and guidelines for investigative staff and ensures staffs compliance with department investigative policies and procedures: serves as the claims liaison to the Private Investigation Committee and the Information Technology Services Department; and develops, conducts and prepares for Statewide audits of the departments investigative process.

 

            COMPENSATION CLAIMS INVESTIGATOR 4: formulates policy, standards, procedures, guidelines and goals for the investigative staff; determines if certain investigations are best done by internal or contracted investigators; directs field integrity program for all investigators; assists in negotiations with outside providers of investigative services; evaluates staffing and equipment needs and submits data for budget requests; and establishes and maintains liaison with assureds and governmental entities. 

 

MINIMUM QUALIFICATIONS

 

COMPENSATION CLAIMS INVESTIGATOR 1

 

Satisfactory completion of a one-year traineeship as a Compensation Claims Investigator Trainee. 

 

COMPENSATION CLAIMS INVESTIGATOR 2

 

Promotion: one year of permanent competitive service as a Compensation Claims Investigator 1.

 

 

COMPENSATION CLAIMS INVESTIGATOR 3

 

Promotion:  one year of permanent competitive service as a Compensation Claims Investigator 2. 

 

COMPENSATION CLAIMS INVESTIGATOR 4

 

Promotion:  one year of permanent competitive service as a Compensation Claims Investigator 3. 

 

 

 

Date:  12/08

 

 

NOTE: Classification Standards illustrate the nature, extent and scope of duties and responsibilities of the classes they describe.  Standards cannot and do not include all of the work that might be appropriately performed by a class.  The minimum qualifications above are those which were required for appointment at the time the Classification Standard was written.  Please contact the Division of Staffing Services for current information on minimum qualification requirements for appointment or examination.