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Top 50 Insurance Investigator Skills

Below we've compiled a list of the most important skills for a Insurance Investigator. We ranked the top skills based on the percentage of Insurance Investigator resumes they appeared on. For example, 13.1% of Insurance Investigator resumes contained Insurance Company Representatives as a skill. Let's find out what skills a Insurance Investigator actually needs in order to be successful in the workplace.

These Are The Most Important Skills For A Insurance Investigator

1. Insurance Company Representatives
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high Demand
Here's how Insurance Company Representatives is used in Insurance Investigator jobs:
  • Reported findings to insurance company representatives, which were used in claim paymentdecisions.

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2. Insurance Fraud Organizations
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high Demand
3. General Liability
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high Demand
Here's how General Liability is used in Insurance Investigator jobs:
  • Performed investigations for general liability and automobile.
  • Directed the recorded statements of witnesses to Workers' Compensation, automobile, general liability, and disability insurance claims.

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4. Insurance Companies
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high Demand
Here's how Insurance Companies is used in Insurance Investigator jobs:
  • Performed full investigations on Market Regulation complaints/referrals regarding Insurance Companies and Agents.
  • Documented and submitted information for review by underwriters and insurance companies.
  • Worked with patients' insurance companies to verify eligibility for procedure.
  • Call Insurance companies to verify eligibility and benefits for patients.
  • Provide insurance companies with written or recorded statements, summarized or transcribed, complete reports with descriptions of all evidence collected.
  • Served on a special task force that reviewed and approved non-admitted insurance companies to transact business.
  • Researched products and verify with database, hard copies, case files and /or Insurance Companies.
  • Compiled various in detail chronological reports for by insurance companies and Superior Court.
  • Requested and gathered data on related files from Insurance Companies and Agents.
  • Communicate with insurance companies regarding patients'' admission status and treatment diagnoses.
  • Conducted surveillance, as required by insurance companies and court order.
  • Verified and created claim numbers by communicating with various insurance companies.
  • Assisted attorneys and insurance companies with trial preparations.
  • Run test claims prior to calling insurance companies.
  • Worked with thousands of insurance companies, TPAs and self-insured customers.
  • Recorded patient information into database * Followed up with insurance companies for additional verification * Coordinated high volume of calls

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2 Insurance Companies Jobs

No jobs at selected location

5. Law Enforcement
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high Demand
Here's how Law Enforcement is used in Insurance Investigator jobs:
  • Assist Law Enforcement Agencies in the collection of facts, the analysis of facts, and criminal prosecution of suspects.
  • Lead Investigator on one case of auto insurance fraud which involved the participation of over 40 law enforcement personnel.
  • Assisted and conducted joint investigations with local, state, and federal law enforcement agencies.
  • Work closely with Law Enforcement and Administrative Agencies to build and maintain working relationships.
  • Testified in depositions and served as a liaison to law enforcement agencies.
  • Coordinated with law enforcement and other state agencies.
  • Investigated multi-line insurance claims from initial referral through final law enforcement referral.

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7 Law Enforcement Jobs

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6. Providers
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high Demand
Here's how Providers is used in Insurance Investigator jobs:
  • Coordinated insurance benefits for medical providers nationally.
  • Evaluated the validation of medical claims, verified insurance coverage and status with insurance providers to determine if fraud was evident.
  • Handled daily phone contact and correspondence with insured policyholders, attorneys, medical providers, and insurance adjusters.
  • Provided support services to patient care providers, processed patient records.
  • Make inquiry calls to providers to determine status of claim payments.

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63 Providers Jobs

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7. Workers Compensation
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high Demand
Here's how Workers Compensation is used in Insurance Investigator jobs:
  • Conducted field investigations of construction and non-construction businesses to determine compliance with Florida Workers Compensation Law 69L and Florida Statute 440.
  • Conducted investigations and surveillance on persons receiving workers compensation benefits.
  • Investigated workers compensation claims for clients Retrieved information via computer, video or any other method about claimants.

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8. Customer Service
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high Demand
Here's how Customer Service is used in Insurance Investigator jobs:
  • Contributed in providing excellent customer service, exceeding customer expectations and contributing to a positive net promoter score for the organization.
  • Ensured adherence to customer service goals, litigation management guidelines and proper methods of file documentation.
  • Provided excellent customer service by interacting and assisting patients to ensure timely service.
  • Utilize excellent customer service skills with insured's claimants and other involved parties.
  • Tracked insurance for finance agency * Customer Service
  • Provided telephone, online and face-to-face customer service/support within high-volume call centers Handling an average of 95 calls/internet inquiries daily).

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129 Customer Service Jobs

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9. Background Checks
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high Demand
Here's how Background Checks is used in Insurance Investigator jobs:
  • Investigate subrogation claims, skip trace new address, perform asset and background checks on individuals and corporations.

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10. Health Care
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high Demand
Here's how Health Care is used in Insurance Investigator jobs:
  • Lead collaborative investigations with health care providers and insured members to research and resolve medical claim cases on time.
  • Assisted members find appropriate health care.

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81 Health Care Jobs

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11. SIU
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high Demand
Here's how SIU is used in Insurance Investigator jobs:
  • Obtained, documented, and preserved physical evidence to support inquiries as well as a hand in hand relationship with SIU.
  • Prepared detailed written reports for the legal department, SIU unit, and insurance company.
  • Provide professional investigative services including SIU as requested by clients in a home office setting.
  • Conducted SIU and suspicious insurance claims.

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12. Crime Scenes
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high Demand
13. Unemployment Claims
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high Demand
14. Medical Records
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high Demand
Here's how Medical Records is used in Insurance Investigator jobs:
  • Evaluated medical records, auto estimates and property estimates for accuracy and validity of claims.
  • Associated with Medical Records clerks and other record holders for Hospitals, Pharmacies, Doctors offices etc.
  • Gathered documentation, such as medical records and police reports.

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15. Phone Calls
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average Demand
Here's how Phone Calls is used in Insurance Investigator jobs:
  • Handled elevated telephone calls in a call center regarding complaints from customers.
  • Maintained professional "home" working environment with limited distractions and quiet backgrounds for making and receiving work related phone calls.

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16 Phone Calls Jobs

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16. Insurance Agents
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Here's how Insurance Agents is used in Insurance Investigator jobs:
  • Assisted handling insurance complaints from consumers relating to insurance agents and carriers.

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17. Computer System
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average Demand
14 Computer System Jobs

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18. Medicaid
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average Demand
Here's how Medicaid is used in Insurance Investigator jobs:
  • Research commercial coverage plans and government plans such as Medicare and Medicaid.
  • clerk, ER clerk, Clinic Clerk Responsible for obtaining the pertinent documents from patients necessary for the Medicaid insurance applications.

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15 Medicaid Jobs

No jobs at selected location

19. Activity Checks
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average Demand
Here's how Activity Checks is used in Insurance Investigator jobs:
  • Conducted background checks, activity checks, and courthouse research.
  • Conduct full investigations related to insurance fraud, to include surveillance, activity checks, background checks, locates and statements.

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20. Conduct Surveillance
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average Demand
Here's how Conduct Surveillance is used in Insurance Investigator jobs:
  • Conduct surveillance investigations pursuant to the investigation of potentially fraudulent Workman's Compensation claims.
  • Conduct Surveillance and Investigation for Worker's Compensation Cases, Personal Injury Cases, Activity Checks and Alive and Well checks.
  • safeguard documents and verify public and private records conduct surveillance to obtain background and personal information on claimants

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21. Forteo
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average Demand
Here's how Forteo is used in Insurance Investigator jobs:
  • Answered telephones, called Dr. Offices, called insurance companies to verify and gather copay information for the drug Forteo.
  • Helped patients find the lowest out of pocket costs for the FORTEO medication by confirming pharmacy benefits.

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22. Insurance Investigation
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average Demand
Here's how Insurance Investigation is used in Insurance Investigator jobs:
  • Developed and implemented insurance investigations, which resulted in increased company efficiency and productivity.
  • Conduct insurance investigation, surveillance and identification.
  • Completed Health Insurance Investigation/Verification and Referral retrieval.

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23. Consumer Complaints
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average Demand
Here's how Consumer Complaints is used in Insurance Investigator jobs:
  • Developed recommendations for improving the implementation of regulatory guidelines, statutes, and instructions by conducting trend analysis of consumer complaints.
  • Investigated consumer complaints regarding the activities of insurance companies and insurance agents.
  • Enforce the California Insurance Code through independent investigation of consumer complaints.
  • Investigate and exam consumer complaints regarding auto/home insurance transactions.
  • Investigated consumer complaints against insurance companies and producers.

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24. Patient Insurance Information
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25. Premises Liability
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average Demand
26. Pharmacy Benefits
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average Demand
Here's how Pharmacy Benefits is used in Insurance Investigator jobs:
  • Contacted various companies to research if the drug REMICADE would be covered under their pharmacy benefits.

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27. Insurance Laws
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average Demand
Here's how Insurance Laws is used in Insurance Investigator jobs:
  • Conducted investigations for various consumers under the insurance laws of the Delaware Department of Insurance.

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28. Accurate Reports
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average Demand
Here's how Accurate Reports is used in Insurance Investigator jobs:
  • Utilize on-line case reporting system, to prepare concise and accurate reports depicting all aspects of the progression of an investigation.
  • Prepared accurate reports identifying all aspects of the progression of the investigation and updating clients that include time & expense payroll.
  • Provided accurate reports for use by upper management on a daily basis.

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29. No-Fault
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average Demand
Here's how No-Fault is used in Insurance Investigator jobs:
  • Handled PIP reviews and approved claims under auto no-fault PIP coverage.

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30. Arrest Warrants
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low Demand
Here's how Arrest Warrants is used in Insurance Investigator jobs:
  • Write and execute search warrants and write arrest warrants.

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31. Video Evidence
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low Demand
Here's how Video Evidence is used in Insurance Investigator jobs:
  • Write reports and submit with video evidence to field office.

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32. Surveillance Investigations
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low Demand
Here's how Surveillance Investigations is used in Insurance Investigator jobs:
  • Conducted surveillance investigations in IA, NE, MN and MO.

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33. Administrative Hearings
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low Demand
Here's how Administrative Hearings is used in Insurance Investigator jobs:
  • Testified at criminal and civil administrative hearings.
  • Assisted in preparation of serving search warrants, testify in grand Juries, Administrative Hearings, and other judicial proceedings.
  • Attended meetings, compliance and enforcement sweeps statewide, conferences and administrative hearings.

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34. Complex Cases
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low Demand
Here's how Complex Cases is used in Insurance Investigator jobs:
  • Assist other teams in overflow of complex cases.

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35. Liability Decisions
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low Demand
36. Party Claims
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low Demand
Here's how Party Claims is used in Insurance Investigator jobs:
  • Processed outside casualty claims, engaged in bodily injury negotiating, and settled third party claims.
  • Conducted 1st and 3rd Party Claims Investigations.

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37. Data Entry
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low Demand
2 Data Entry Jobs

No jobs at selected location

38. Scene Diagrams
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low Demand
Here's how Scene Diagrams is used in Insurance Investigator jobs:
  • Conducted Accident/Loss Scene investigations which include creating scene diagrams and obtaining photographs.
  • Performed courthouse research, scene diagrams and photographs, secured police reports and participated in collegial mentorship program.

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39. Hippa
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low Demand
Here's how Hippa is used in Insurance Investigator jobs:
  • Followed all HIPPA guidelines and procedures to protect patients and company interest.
  • Understand HIPPA laws and regulations.

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1 Hippa Jobs

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40. Business Owners
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low Demand
5 Business Owners Jobs

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41. Insurance Policies
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low Demand
Here's how Insurance Policies is used in Insurance Investigator jobs:
  • Gathered evidence such as insurance policies, payment histories and financials.

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1 Insurance Policies Jobs

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42. Office Setting
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low Demand
Here's how Office Setting is used in Insurance Investigator jobs:
  • Provided services for a variety of client insurance companies in multiple states, in a home office setting.

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3 Office Setting Jobs

No jobs at selected location

43. Health Benefits
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low Demand
44. Interview Witnesses
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low Demand
Here's how Interview Witnesses is used in Insurance Investigator jobs:
  • Take statements and interview witnesses and subjects.

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45. Courthouse Records
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low Demand
46. General Public
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low Demand
Here's how General Public is used in Insurance Investigator jobs:
  • Respond to insurance-related inquiries from the general public.

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2 General Public Jobs

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47. Appropriate Action
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low Demand
Here's how Appropriate Action is used in Insurance Investigator jobs:
  • Verified alleged or probable allegations, made judgment after evaluating all available facts and recommended appropriate action.
  • Prepare detailed investigative reports and recommend appropriate action.

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48. Expert Testimony
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low Demand
Here's how Expert Testimony is used in Insurance Investigator jobs:
  • Provide clients with detailed reports, still and video evidence, and available for expert testimony.

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49. Red Flags
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low Demand
50. Claims Processing
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low Demand
Here's how Claims Processing is used in Insurance Investigator jobs:
  • Trained in MetLife Policy Finder program, electronic death claims processing, policy investigation, data entry, typing
  • Provided training to claims adjusters and other employees involved in claims processing.

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1 Claims Processing Jobs

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Insurance Investigator Jobs

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20 Most Common Skills For An Insurance Investigator

Insurance Company Representatives

17.7%

Insurance Fraud Organizations

13.6%

General Liability

11.3%

Insurance Companies

10.6%

Law Enforcement

4.8%

Providers

4.6%

Workers Compensation

4.4%

Customer Service

3.7%

Background Checks

3.7%

Health Care

3.2%

SIU

2.8%

Crime Scenes

2.8%

Unemployment Claims

2.5%

Medical Records

2.5%

Phone Calls

2.3%

Insurance Agents

2.1%

Computer System

2.1%

Medicaid

1.8%

Activity Checks

1.8%

Conduct Surveillance

1.8%
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Typical Skill-Sets Required For An Insurance Investigator

Rank Skill
1 Insurance Company Representatives 13.1%
2 Insurance Fraud Organizations 10.1%
3 General Liability 8.3%
4 Insurance Companies 7.8%
5 Law Enforcement 3.6%
6 Providers 3.4%
7 Workers Compensation 3.2%
8 Customer Service 2.7%
9 Background Checks 2.7%
10 Health Care 2.4%
11 SIU 2.0%
12 Crime Scenes 2.0%
13 Unemployment Claims 1.9%
14 Medical Records 1.9%
15 Phone Calls 1.7%
16 Insurance Agents 1.5%
17 Computer System 1.5%
18 Medicaid 1.4%
19 Activity Checks 1.4%
20 Conduct Surveillance 1.4%
21 Forteo 1.2%
22 Insurance Investigation 1.2%
23 Consumer Complaints 1.2%
24 Patient Insurance Information 1.2%
25 Premises Liability 1.0%
26 Pharmacy Benefits 1.0%
27 Insurance Laws 1.0%
28 Accurate Reports 1.0%
29 No-Fault 1.0%
30 Arrest Warrants 1.0%
31 Video Evidence 0.9%
32 Surveillance Investigations 0.9%
33 Administrative Hearings 0.9%
34 Complex Cases 0.9%
35 Liability Decisions 0.9%
36 Party Claims 0.9%
37 Data Entry 0.9%
38 Scene Diagrams 0.9%
39 Hippa 0.7%
40 Business Owners 0.7%
41 Insurance Policies 0.7%
42 Office Setting 0.7%
43 Health Benefits 0.7%
44 Interview Witnesses 0.7%
45 Courthouse Records 0.7%
46 General Public 0.7%
47 Appropriate Action 0.7%
48 Expert Testimony 0.7%
49 Red Flags 0.7%
50 Claims Processing 0.7%
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879 Insurance Investigator Jobs

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