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TC
The County of Santa Clara
County Counsel Investigator
Career Insights for Claims Investigator
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What they do
A Claims Investigator investigates and assesses insurance claims to verify the validity of insurance claims. Determines the level of liability and determines pay-out amounts. Prepares evaluation reports to document the evidence to be used in court.
$75,559 / year median in California
+1% projected growth
Job Description
County Counsel Investigator The County of Santa Clara - 4.0 San Jose, CA Job Details Full-time $135,711.68 - $165,127.04 a year 14 hours ago Benefits Wellness program 457(b) AD&D insurance Paid holidays Disability insurance Dependent care reimbursement Health insurance Dental insurance 401(k) Flexible spending account Tuition reimbursement Paid time off Pension plan Employee assistance program Vision insurance Life insurance Qualifications Civil rights Statistics Tort law Confidential information handling Legal presentation of evidence Investigative interviewing techniques Word processing Spreadsheets Writing skills Claims negotiation English Math Research report preparation Interview research Liability insurance knowledge Desktop applications Data interpretation Productivity software Source interviews Full Job Description Description Under general supervision, perform investigations, interview witnesses, gather evidence on behalf of County Counsel, and analyze claims and litigated matters against the County of Santa Clara and its employees. The Office of the County Counsel seeks a County Counsel Investigator to work with the Civil Rights, Tort, and Employment Litigation team on claims and litigated matters against the County of Santa Clara, including medical malpractice claims and lawsuits. Candidates should have excellent organizational, investigative, and analytical skills, and excellent written and oral communication abilities. The capability to work collaboratively with your colleagues and clients, and strong research and problem-solving abilities are valued. An eagerness to take on interesting challenges with a commitment to public service in a professional environment is an essential quality for success in this job. Experience in a legal, government, or claims office is highly desirable. Because the position will include investigation and evaluation of medical malpractice claims, experience as a medical malpractice claims analyst or other experience with medical malpractice claims is also highly desirable. You must attach a resume and writing sample to your job application in order to submit your application for this recruitment. The writing sample must include your name as the author. Typical Tasks Conducts investigations of claims and litigated matters against the County of Santa Clara; Determines scope of investigation needed to resolve a claim and directs the securing of information; Investigates the scene of a claim and gathers intelligence information through multiple avenues, including taking photographs and conducting interviews; Obtains and analyzes documents, records, and other confidential and/or sensitive material related to claims and litigated matters and ensures that collected documents are archived in the claims/case management system; Assists County Counsel Attorneys in preparation of cases for court; Gathers information by communicating with internal and external agencies, including Federal, State, local law enforcement agencies, and County departments; Prepares detailed reports of investigations, including synopses of facts, dates, names, places, statements of claimants/witnesses, and listings of evidence; Conducts research relevant to individual claims to support claim and risk analyses in reports and in support of the litigation team; Provides initial notification to excess carrier of claims, file closure, and, where appropriate, secures reimbursement; Participates in studies relating to programs and needs of the department; Prepares e-discovery holds; Maintains all claim files in readiness for legal action, recognizing the confidentiality of the investigative materials contained therein; Drafts a variety of correspondence related to claims and lawsuits, including Settlement Authority requests and tenders of defense; Represents the County in Small Claims Court; May function as the Administrator for the County's National Practitioner Data Bank (NPDB); responsible for reporting claim/litigation data to state agencies, including the Medical Board and Board of Nursing; May be assigned as a Disaster Service Worker, as required; Performs other related duties, as required. Employment Standards Sufficient education, training, and experience to demonstrate possession and direct application of the following knowledge and abilities: