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Become A Senior Investigator

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Working As A Senior Investigator

  • Identifying Objects, Actions, and Events
  • Interacting With Computers
  • Getting Information
  • Documenting/Recording Information
  • Processing Information
  • Unpleasant/Angry People

  • Mostly Sitting

  • Make Decisions

  • Stressful

  • $56,690

    Average Salary

What Does A Senior Investigator Do

Claims adjusters, appraisers, examiners, and investigators evaluate insurance claims. They decide whether an insurance company must pay a claim and, if so, how much.

Duties  

Claims adjusters, appraisers, examiners, and investigators typically do the following:

  • Investigate, evaluate, and settle insurance claims
  • Determine whether the insurance policy covers the loss claimed
  • Decide the appropriate amount the insurance company should pay
  • Ensure that claims are not fraudulent
  • Contact claimants’ doctors or employers to get additional information on questionable claims
  • Confer with legal counsel on claims when needed
  • Negotiate settlements
  • Authorize payments

Claims adjusters, appraisers, examiners, and investigators have varying duties, depending on the type of insurance company they work for. They must know a lot about what their company insures. For example, workers in property and casualty insurance must know housing and construction costs to properly evaluate damage from floods or fires. Workers in health insurance must be able to determine which types of treatments are medically necessary and which are questionable. 

Adjusters inspect property damage to determine how much the insurance company should pay for the loss. They might inspect a home, a business, or an automobile.

Adjusters interview the claimant and witnesses, inspect the property, and do additional research, such as look at police reports. They may consult with other workers, such as accountants, architects, construction workers, engineers, lawyers, and physicians, who can offer a more expert evaluation of a claim.

Adjusters gather information—including photographs and statements, either written or recorded on audio or video—and put together a report for claims examiners to evaluate. When the examiner approves the claim, the adjuster negotiates with the policyholder and settles the claim.

If the claimant contests the outcome of the claim or the settlement, adjusters work with attorneys and expert witnesses to defend the insurer’s position.

Some claims adjusters work as self-employed public adjusters. Often, they are hired by claimants who prefer not to rely on the insurance company’s adjuster. The goal of adjusters working for insurance companies is to save as much money for the company as possible. The goal of a public adjuster working for a claimant is to get the highest possible amount paid to the claimant. They are paid a percentage of the settled claim.

Sometimes, self-employed adjusters are hired by insurance companies in place of hiring adjusters as regular employees. In this case, the self-employed adjusters work in the interest of the insurance company.

Appraisers estimate the cost or value of an insured item. Most appraisers who work for insurance companies and independent adjusting firms are auto damage appraisers. They inspect damaged vehicles after an accident and estimate the cost of repairs. This information then goes to the adjuster, who puts the estimated cost of repairs into the settlement.

Claims examiners review claims after they are submitted to ensure claimants and adjusters followed proper guidelines. They may assist adjusters with complicated claims or when, for example, a natural disaster occurs and the volume of claims increases.

Most claims examiners work for life or health insurance companies. Examiners who work for health insurance companies review health-related claims to see whether the costs are reasonable, given the diagnosis. After they review the claim, they authorize appropriate payment, deny the claim, or refer the claim to an investigator.

Examiners who work for life insurance companies review the causes of death and pay particular attention to accidents, because most life insurance companies pay additional benefits if a death is accidental. Examiners also may review new applications for life insurance policies, to make sure that the applicants have no serious illnesses that would make them a high risk to insure.

Insurance investigators handle claims in which the company suspects fraudulent or criminal activity such as arson, staged accidents, or unnecessary medical treatments. The severity of insurance fraud cases varies, from overstated claims of damage to vehicles to complicated fraud rings. Investigators often do surveillance work. For example, in the case of a fraudulent workers’ compensation claim, an investigator may covertly watch the claimant to see if he or she does anything that would be ruled out by injuries stated in the claim.

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How To Become A Senior Investigator

A high school diploma or equivalent is typically required for a person to work as an entry-level claims adjuster, examiner, or investigator. Higher level positions may require a bachelor’s degree or some insurance-related work experience. Auto damage appraisers typically have either a postsecondary nondegree award or work experience in identifying and estimating the cost of automotive repair.

Education

A high school diploma or equivalent is typically required for a person to work as an entry-level claims adjuster, examiner, or investigator. However, employers sometimes prefer to hire applicants who have a bachelor’s degree or some insurance-related work experience or vocational training. Auto damage appraisers typically have either a postsecondary nondegree award or experience working in an auto repair shop, identifying and estimating the cost of automotive repair.

The varying types of work in these occupations can require different backgrounds or different college coursework. For example, a business or an accounting background might be best for someone who wishes to specialize in claims of financial loss due to strikes, equipment breakdowns, or merchandise damage. College training in architecture or engineering is helpful for adjusting industrial claims, such as those involving damage from fires or other accidents. A legal background is beneficial to someone handling workers’ compensation and product liability cases. A medical background is useful for examiners working on medical and life insurance claims.

Although auto damage appraisers are not required to have a college education, most companies prefer to hire people who have the formal training, experience, or knowledge and technical skills to identify and estimate the cost of automotive repair. Many vocational schools and some community colleges offer programs in auto body repair and teach students how to estimate the cost of repairing damaged vehicles.

For investigator jobs, a high school diploma or equivalent is the typical education requirement. Most insurance companies prefer to hire people trained as law enforcement officers, private investigators, claims adjusters, or examiners, because these workers have good interviewing and interrogation skills.

Training

At the beginning of their careers, claims adjusters, examiners, and investigators work on small claims, under the supervision of an experienced worker. As they learn more about claims investigation and settlement, they are assigned larger, more complex claims.

Auto damage appraisers typically get on-the-job training, which may last several months. This training usually involves working under the supervision of a more experienced appraiser while estimating damage costs, until the employer decides that the trainee is ready to do estimates on his or her own.

Licenses, Certifications, and Registrations

Licensing requirements for claims adjusters, appraisers, examiners, and investigators vary by state. Some states have few requirements; others require either completing prelicensing education or receiving a satisfactory score on a licensing exam (or both).

In some states, claims adjusters employed by insurance companies do not have to become licensed themselves because they can work under the company license.

Public adjusters may need to meet separate or additional requirements.

Some states that require licensing also require a certain number of continuing education credits per year to renew the license. Federal and state laws and court decisions affect how claims must be handled and what insurance policies can and must cover. Examiners working on life and health claims must stay up to date on new medical procedures and the latest prescription drugs. Examiners working on auto claims must be familiar with new car models and the most recent repair techniques. In order to fulfill their continuing education requirements, workers can attend classes or workshops, write articles for claims publications, or give lectures and presentations.

Important Qualities

Analytical skills. Adjusters and examiners must both evaluate whether the insurance company is obligated to pay a claim and determine the amount to pay. Adjusters must carefully consider various pieces of information to reach a decision.

Communication skills. Claims adjusters and investigators must get information from a wide range of people, including claimants, witnesses, and medical experts. They must know the right questions to ask in order to gather the information they need.

Detail oriented. Adjusters, appraisers, examiners, and investigators must carefully review documents and damaged property, because small details can have large financial consequences.

Interpersonal skills. Adjusters, examiners, and investigators often meet with claimants and others who may be upset by the situation that requires a claim or by the settlement the company is offering. These workers must be understanding, yet firm with their company’s policies.

Math skills. Appraisers must be able to calculate property damage.

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Senior Investigator jobs

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Senior Investigator Career Paths

Senior Investigator
Compliance Officer Safety Manager Human Resources Manager
Assistant Vice President
7 Yearsyrs
District Manager Operations Manager
Branch Manager
6 Yearsyrs
Team Leader Team Manager Unit Manager
Collections Manager
5 Yearsyrs
Assistant Vice President Human Resources Coordinator
Director Of Human Resources
10 Yearsyrs
Team Leader Security Officer Loss Prevention Manager
District Loss Prevention Manager
7 Yearsyrs
Senior Analyst Senior Finance Analyst
Finance Manager
7 Yearsyrs
Manager Correction Officer Loss Prevention Officer
Loss Prevention/Safety Manager
7 Yearsyrs
President President & Chief Operating Officer Executive Assistant/Office Manager
Manager Executive
6 Yearsyrs
Operations Manager Account Executive Assistant Vice President
Manager, Assistant Vice President
7 Yearsyrs
Chief Investigator Chief Deputy Chief Of Staff
Medical Director
9 Yearsyrs
Program Manager General Manager
Operations Director
9 Yearsyrs
Security Officer Service Technician Service Manager
Operations Manager
7 Yearsyrs
Program Manager Operations Director
President Of Operations
11 Yearsyrs
Security Officer Technician Project Manager
Program Manager
8 Yearsyrs
Chief Investigator Security Officer Operations Manager
Purchasing Manager
9 Yearsyrs
Compliance Officer Compliance Manager Senior Manager
Regional Director
9 Yearsyrs
Assistant Vice President Project Manager General Manager
Regional Manager
8 Yearsyrs
District Manager Regional Manager Operations Manager
Regional Operation Manager
9 Yearsyrs
Senior Analyst Project Manager Program Manager
Senior Manager
10 Yearsyrs
Operations Manager Branch Manager Assistant Vice President
Vice President And Manager
10 Yearsyrs
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Senior Investigator Demographics

Gender

Male

64.0%

Female

33.2%

Unknown

2.8%
Ethnicity

White

77.2%

Hispanic or Latino

12.9%

Asian

7.5%

Unknown

1.9%

Black or African American

0.6%
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Languages Spoken

Spanish

71.4%

French

10.7%

German

3.6%

Russian

3.6%

Indonesian

1.8%

Vietnamese

1.8%

Serbian

1.8%

Arabic

1.8%

Italian

1.8%

Croatian

1.8%
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Senior Investigator Education

Schools

University of Phoenix

14.0%

John Jay College of Criminal Justice of the City University of New York

7.7%

The Academy

7.0%

Northeastern University

6.3%

Virginia Commonwealth University

5.6%

Boston University

4.9%

Liberty University

4.9%

University of California - Berkeley

4.2%

University of Maryland - University College

4.2%

Arizona State University

4.2%

Florida International University

4.2%

Kaplan University

4.2%

Western Michigan University

4.2%

Syracuse University

3.5%

Villanova University

3.5%

Columbia Southern University

3.5%

The College of New Jersey

3.5%

Columbus State University

3.5%

University of Louisville

3.5%

University of Wisconsin - Milwaukee

3.5%
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Majors

Criminal Justice

32.1%

Business

17.3%

Law

5.6%

Management

4.1%

Political Science

4.1%

Psychology

3.9%

Chemistry

3.8%

Public Administration

3.7%

Finance

3.2%

Accounting

3.2%

Law Enforcement

3.0%

Sociology

2.4%

Education

2.1%

English

1.8%

Criminology

1.8%

Health Care Administration

1.7%

Social Work

1.5%

Biology

1.5%

Communication

1.5%

Legal Support Services

1.5%
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Degrees

Bachelors

37.8%

Masters

21.9%

Other

20.0%

Doctorate

8.9%

Associate

6.7%

Certificate

3.7%

License

0.5%

Diploma

0.5%
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Full Time
Part Time
Internship
Temporary

Real Senior Investigator Salaries

Job Title Company Location Start Date Salary
Senior Investigator National Institutes of Health, HHS Bethesda, MD Nov 02, 2014 $300,000
Senior Investigator National Institutes of Health, HHS Bethesda, MD Jan 11, 2015 $265,000
Senior Investigator National Institutes of Health, HHS Bethesda, MD Mar 15, 2010 $230,000
Senior Investigator Los Angeles Biomedical Research Institutute Torrance, CA Apr 01, 2012 $200,000
Senior Investigator & Physician Specialist Los Angeles Biomedical Research Institutute Torrance, CA Nov 01, 2012 $200,000
Senior Investigator National Institutes of Health, HHS Bethesda, MD Aug 30, 2012 $191,300
Senior Investigator National Institutes of Health, HHS Bethesda, MD Aug 30, 2009 $178,464
Senior Investigator National Institutes of Health, HHS Rockville, MD Oct 21, 2015 $165,360
Senior Investigator Novartis Pharmaceuticals Corporation East Hanover, NJ Feb 17, 2012 $162,029
SR. Investigator H3 Biomedicine Inc. Cambridge, MA Aug 16, 2014 $158,500
Senior Investigator National Institutes of Health, HHS Bethesda, MD Mar 01, 2015 $150,800
Senior Investigator National Institutes of Health, HHS Rockville, MD Mar 01, 2015 $150,800
Senior Investigator National Institutes of Health, HHS Rockville, MD Oct 21, 2012 $150,000
Senior Investigator National Institutes of Health, HHS Bethesda, MD Sep 20, 2015 $146,000
Senior Investigator National Institutes of Health, HHS Rockville, MD Nov 07, 2013 $140,000
Senior Investigator I, Biomarker Development Novartis Institutes for Biomedical Research, Inc. Cambridge, MA Dec 15, 2012 $130,029
SR. Investigator H3 Biomedicine Inc. Cambridge, MA Aug 05, 2015 $105,539 -
$164,048
Senior Investigator Arqule, Inc. Woburn, MA Jul 31, 2011 $96,263

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Top Skills for A Senior Investigator

BackgroundInvestigationsInsuranceFraudLawEnforcementAgenciesEnsureComplianceProceduresPersonnelSurveillanceFinancialCrimesSARSafetyLossInvestigativeReportsSuspiciousActivityNewInvestigatorsCompanyAssetsComplexInvestigationsCriminalInvestigationsLocalLawEnforcementCourtProceedingsDueDiligence

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Top Senior Investigator Skills

  1. Background Investigations
  2. Insurance Fraud
  3. Law Enforcement Agencies
You can check out examples of real life uses of top skills on resumes here:
  • Demonstrated knowledge and experience to conduct highly effective traditional investigations, background investigations, and security investigations.
  • Assigned as a Senior Investigator in South Florida region (remote employee) to investigate insurance fraud in personal injury claims.
  • Prepare case summaries including data analysis for referral to government and law enforcement agencies.
  • Conduct over 100 compliance examinations on commercial vessels to ensure compliance with minimal standards required by Federal regulations.
  • Developed strategies and procedures to reduce theft during the transportation and warehousing of Target Corporation assets.

Top Senior Investigator Employers