WORKERS' COMPENSATION INVESTIGATOR 0950

DISTINGUISHING FEATURES OF THE CLASS

An employee in this class performs investigations to uncover fraudulent Workers' Compensation claims. Investigations include examination of records, interviews and surveillance, and may include night and weekend assignments. Work requires independent judgment and initiative and is performed under the general supervision of a unit supervisor or administrator. Supervision may be exercised over a clerical support staff. Does related work as required.

TYPICAL WORK ACTIVITIES

Investigates Workers' Compensation claims in an effort to uncover fraudulent claims, by review of records and by conducting interviews with claimants, their supervisors and any witnesses to accidents and/or incidents;

Investigates anonymous allegations, phone calls, letters and any leads, which may indicate questionable claims;

Compiles written reports which may be used as evidence at hearings, documenting investigation results;

Discusses cases with unit staff members and Workers' Compensation attorneys, and reviews cases to assure that appropriate evidence gathered is included in the file;

Conducts unannounced visits and activity checks on employees on the Workers' Compensation payroll and/or indemnity claimants, video tapes activities which provide evidence of a fraudulent claim;

Coordinates the activities of any outside investigators utilized for specialized work or out-of-area surveillance;

Testifies before the Workers' Compensation Board or at other hearings.

FULL PERFORMANCE KNOWLEDGES, SKILLS, ABILITIES AND PERSONAL CHARACTERISTICS

Good knowledge of the principles, practices and methods employed in investigative work; working knowledge of Workers' Compensation laws and regulations and the legal aspects of Workers' Compensation claims; working knowledge of geography; ability to obtain information through interviews and observations; ability to make independent decisions; ability to reason deductively; ability to deal tactfully with witnesses and the general public; ability to exercise good judgment in handling investigations; ability to express oneself clearly and concisely, both orally and in writing; physical condition commensurate with the demands of the position.

MINIMUM QUALIFICATIONS

OPEN COMPETITIVE

(a) Graduation from high school or possession of a high school equivalency diploma and six (6) years of investigative experience, one (1) of which has been insurance related; or,

(b) Graduation from a college with federally-authorized accreditation or registration by NY State with a Bachelor's Degree and two (2) years of investigative experience, one (1) of which has been insurance related; or,

(c) A satisfactory equivalent combination of education and experience as defined by the limits of (a) and (b), with no substitution permitted for the one (1) year of specialized experience.

NECESSARY SPECIAL REQUIREMENT

At the time of appointment and during employment in this title, employees will be required to possess a valid license to operate a motor vehicle in New York State.

R4/07/06

SUFFOLK COUNTY

Competitive

Review 7/23/15