Claims Investigator

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Riverside, CA, USA
Hybrid
Information Technology
The Role
APEX Investigation

APEX Investigation is a leader in Insurance, Workers' Compensation, Liability and Human Resource Investigations. Our experience investigating thousands of cases, and our ability to adapt to the ever-changing laws impacting our clients gives APEX the leading edge in defending frivolous, exaggerated or fraudulent claims.

About Us

APEX Investigation® is a trusted leader in Insurance, Workers' Compensation, Liability, and Human Resource Investigations. For over 40 years, APEX has stood firm in its dedication to reducing insurance risks and combating fraudulent claims. Our commitment to delivering fast, high-quality, and reliable investigations has made us the partner of choice for our clients. APEX Investigation’s mission is to build lasting relationships through trust, integrity and quality investigations. The APEX team lives out that mission by providing constant communication, results you can use, delivered fast at a fair price.

The Role

Claims Investigators are responsible for conducting thorough interviews of all parties involved in workers’ compensation claim injuries, providing timely updates to the client and writing comprehensive reports in a timely manner.

APEX employees thrive in their positions through the autonomy and support that they receive. The Claims Investigator role is highly flexible in operation based upon the interests of the employee; you can choose where you would like to live and operate. We strive to grow our employee retention rate through fair compensation and offering the tools required for our employees to be successful and to enjoy working with us. The work is independent, however the Claims Investigation team is strong in support as well as camaraderie.

Key Responsibilities

Case Management & Communication

  • Receive, review, and manage assigned cases from start to completion.
  • Communicate professionally with clients, claimants, witnesses, and other involved parties.
  • Provide timely case updates and correspondence in accordance with company guidelines via CaseLink.
  • Maintain objectivity and professionalism in all interactions.

Investigative Field Work

  • Conduct recorded statements at various locations, including claimants’ homes, workplaces, medical offices, and public settings.
  • Ask open-ended questions, interpret responses, and conduct appropriate follow-up without reliance on scripted questionnaires.
  • Perform scene and neighborhood canvasses, including walking on varied terrain.
  • Meet with treating physicians and medical offices as required.
  • Travel to designated locations, including overnight stays when necessary.
  • Respond to rush cases within business hours when required.

Documentation & Reporting

  • Enter case updates, notes, hours worked, mileage, and expenses into CaseLink on a daily basis.
  • Upload all obtained statements, documents, recordings, photographs, and evidence to CaseLink the same day they are acquired.
  • Compose clear, concise, and grammatically correct case updates within 24 hours of obtaining statements.
  • Prepare and submit comprehensive investigative reports within 72 hours of final update submission.

Evidence & Records Handling

  • Retrieve records from agencies and entities both in-person and remotely.
  • Take clear photographs and video when necessary and label all electronic files accurately.
  • Securely collect, store, and maintain custody of evidence when required.
  • Maintain organized and protected case files and establish backup procedures to safeguard data in the event of technical failure.

Additional Responsibilities

  • Identify and recommend additional investigative services outside the scope of the original assignment when appropriate.
  • Work overtime as needed to meet case demands and deadlines.
  • Maintain an efficient, safe, and organized telecommuter workspace.

Physical & Work Environment Requirements

  • Ability to sit for extended periods performing computer-based work and report writing.
  • Ability to stand for extended periods while conducting interviews and canvasses.
  • Ability to lift and carry items weighing between 5–30 lbs (e.g., laptop, briefcase, equipment).
  • Ability to operate digital audio recording equipment.

Qualifications

  • Experience with workers’ compensation claims and investigative processes.
  • Strong written and verbal communication skills.
  • Ability to work independently, manage time effectively, and meet strict deadlines.
  • Willingness and ability to travel up to (but not limited to) 150 miles per assignment.
  • Possession of a personal credit card with available balance for reimbursable business expenses.
  • Proficiency with case management systems; CaseLink experience preferred.
  • Access to a personal scanner for document upload and record handling.

Preferred Qualifications

  • Prior experience conducting recorded statements and field investigations.
  • Experience with process service assignments.
  • Familiarity with evidence handling and documentation standards.
  • Background in insurance investigations or a related field.

What You'll Need to Apply

  • Valid driver’s license with a clean driving record
  • Access to a working computer, digital recorder, and multi-page scanner/copier
  • Ability and willingness to travel up to 150 miles, including same-day and overnight trips
  • Flexible availability, including early mornings, occasional weekends, overtime, and short-notice rush cases
  • Personal credit card with available balance for reimbursable business expenses
  • Ability to lift up to 30 lbs, sit for long periods, and walk varied terrain for fieldwork
  • Comfortable working remotely in a secure, distraction-free home office environment
  • Proficient in Microsoft Word and familiar with case management tools

Benefits Offered to Full-time Employees
- Medical
- Dental
- Vision
- PTO
- FSA
- Simple IRA Plan
- Mileage and Travel Reimbursement for Surveillance and Claims positions

Equal Opportunity Employer
All qualified applicants will receive consideration for employment without regard to their race, creed, color, disability, sex, sexual orientation, national origin, age, religion, Vietnam era Veteran’s status, political affiliation, or any other non-merit factor.

After making a conditional offer of employment, the company will conduct a job-related background check. A comprehensive background check may consist of prior employment verification, motor vehicle records, professional reference checks, education confirmation and/ or criminal record and credit checks. Third-party services will be hired to perform these checks. Employer will consider for employment qualified applicants with criminal histories in a manner consistent with the requirements of the ordinance.

**After an offer is made and accepted, the employer will comply with the Immigration and Nationality Act I-9 requirements to establish your identity and employment eligibility.

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The Company
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What We Do

Today’s professionals rely on investigative firms to help manage risk by detecting and preempting problem situations.

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