State of Maryland

A Claims Investigator III is the full performance level of specialized investigative work in the casualty insurance and criminal injuries compensation claims field.  Employees in these classifications do not supervise other positions.

Employees in this classification receive general supervision from a Claims Investigator IV or a higher-level administrator.

Positions in this classification are evaluated using the classification job evaluation methodology.  The use of this method involves comparing the assigned duties and responsibilities of a position in the job criteria found in the Nature of Work and Examples of Work sections of the class specification.

The Claims Investigator I, Claims Investigator II and Claims Investigator III are differentiated on the basis of degree of supervisory control exercised by the supervisor of these employees.  The Claims Investigator I learns to perform duties under close supervision.  The Claims Investigator II performs duties under close supervision at times and under general supervision at other times depending on the complexity of the specific duty being performed.  The Claims Investigator III performs the full range of duties and responsibilities under general supervision.  The Claims Investigator III is differentiated from the Claims Investigator IV in that the Claims Investigator IV has supervisory responsibility for lower-level Claims Investigators.

Reviews claim cases;

Clarifies employment status of claimants;

Plans course of investigation;

Develops investigation leads; Interviews employees, employers, doctors, lawyers, hospital representatives, witnesses, police officers and others;

Gathers facts to substantiate or deny the compressibility of claims;

Conducts surveillance of claimants’ activities as required;

Prepares comprehensive reports of facts gathered that serves as the basis for decisions made in workers’ compensation or criminal injuries compensation awards;

Investigates third party liability;

Evaluates the reliability of witnesses;

Suggests witnesses that may or may not provide suitable testimony;

May testify in court concerning the investigative aspect of a case;

May take photographs of accident sites and other evidence;

Performs other related duties.

Knowledge of the techniques of interviewing, investigating and reporting;

Ability to plan the scope of an investigation;

Ability to evaluate competence of witnesses;

Ability to maintain harmonious working relationships with the legal profession, medical profession, employees, employers and third parties;

Ability to gather and report facts;

Ability to communicate effectively and to work independently;

Ability to exercise discernment and judgment in the handling of public contacts;

Ability to prepare complete, comprehensive and accurate reports;

Ability to develop information leads.

Education:   Graduation from an accredited high school or possession of a high school equivalency certificate.

Experience: Two years of experience in casualty, financial, credit, or administrative investigations; law enforcement or licensed detective work involving investigations; or the practice of law.

Notes:

1. Candidates may substitute thirty credit hours from an accredited college or university for each year of experience for up to two years of the required experience.

2. Candidates may substitute additional years of the above experience on a year-for-year basis for the required education.

Class specifications are broad descriptions covering groups of positions used by various State departments and agencies. Position descriptions maintained by the using department or agency specifically address the essential job functions of each position.

This is a Skilled Service classification in the State Personnel Management System. All positions in this classification are Skilled Service positions. Some positions in Skilled Service classifications may be designated Special Appointment in accordance with the State Personnel and Pensions Article, Section 6-405, Annotated Code of Maryland.

This classification is assigned to Bargaining Unit C, Regulatory, Inspection and Licensure classes. As provided by State Personnel and Pensions Article, Section 3-102, special appointment, temporary, contractual, supervisory, managerial, and confidential employees are excluded from collective bargaining. Additionally, certain executive branch agencies are exempt from collective bargaining and all positions in those agencies are excluded from collective bargaining.

Employees in this classification are eligible to receive overtime compensation. An employee who works more than the normal workweek is entitled to be compensated for that overtime as provided by State Personnel and Pensions Article, Section 8-305.

This classification is one level in a Non-Competitive Promotion (NCP) series. NCP promotions are promotions by which employees may advance in grade and class level from trainee to full performance level in a classification series. In order to be non-competitively promoted to the next level in a NCP series an employee must: 1) perform the main purpose of the class as defined in the Nature of Work section of the class specification; 2) receive the type of supervision defined in the class specification and 3) meet the minimum qualifications of the classification.