CLAIMS INVESTIGATOR 3
Career Family: CLAIMS INVESTIGATOR
Claims Investigator 3 sits in the competitive class of New Jersey's state or local civil service, so reaching it runs through testing and an eligible list instead of a straight hire.
It sits mid-series for Claims Investigator, one step up from Claims Investigator 2 and one below Claims Investigator 4. It lists a bachelor's degree as the baseline, with an experience-based path open to those who do not hold the degree. Pay on the FY2026 schedule runs $73,707 to $108,073, and state payroll currently lists 8 people in the title, most of them at Treasury.
How to get hired
- Watch for an open-competitive announcement for Claims Investigator 3 on the NJ Civil Service Commission jobs portal. Announcements run for a fixed filing window.
- Apply during that window and sit the examination. Depending on the title, that can be a written test, a rating of your training and experience, or a mix of the two.
- Passing scores go onto a ranked eligible list. Veterans get preference points added on top of their score.
- When an agency has a vacancy it must appoint from the top of that list under the "Rule of Three." Many competitive jobs are first filled provisionally while the list is being built.
Read the official specification at NJ Civil Service Commission.
Pay ladder: Claims Investigator series
- Claims Investigator 1 — $56,253 – $81,897
- Claims Investigator 2 — $64,340 – $94,062
- Claims Investigator 3 — $73,707 – $108,073 (this title)
- Claims Investigator 4 — $88,530 – $130,339
Promoting to Claims Investigator 4 raises the top of the band by about $22,265. Its top salary lands around the 51st percentile of all NJ civil service titles that publish a range.
Rungs are ordered by FY2026 pay. NJ level numbers are not always sequential, so ordering follows salary rather than the title number.
Who employs this title
State payroll records show 8 people working under this title. The median actual salary is $101,200. The agencies employing the most are:
- Treasury (8)
Counts from NJ YourMoney agency payroll. See statewide workforce analytics.
Official job specification
The text below is the official specification published by the New Jersey Civil Service Commission. The plain-language summary and analysis above are derived from it by NJ Civil Service Navigator.
Definition
Under the general supervision of a Claims Investigator 4, or other supervisory official in a state or local government department or agency, supervises the processing of claims in an assigned area or, with respect to an assigned category of claims, in connection with claims by or against the governing body arising out of workers compensation, negligence, or other claims involving state/local government employees and state/local government owned property, as well as other types of negligence or tort claims encountered by the governing body, or claims for ownership of abandoned real, personal, tangible and non-tangible property accrued to the State; supervises the investigation of fraud and disaster-related claims; supervises staff and work activities; prepares and signs official performance evaluations for subordinate staff; does other related duties as required.
Examples of work
Supervises, provides guidance to, and assists claims investigators and/or other staff in the investigation/disposition of claims in the assigned area/category. May assist with the investigation/handling of unusually difficult, involved, and/or confidential cases. Supervises the examination of claims for authenticity, authorizes payment of benefits, and recommends fraud investigations as needed. Supervises the conduct of fraud investigations, and may personally perform the most complex, difficult, and sensitive investigations. This includes workers compensation, tort, contract, negligence, and/or unclaimed property claims. Supervises the review of claims that are served by writs to the State of New Jersey by the Division of Taxation to levy on specific individuals in the collection of funds being held by the Unclaimed Property Administration. Supervises the investigation and review of traumatic injury claims; researches medical and legal documentation in cases that lack precedent, and provides guidance to subordinate staff. Analyzes and makes determinations regarding the impact of comorbidities (pre-existing conditions) and psychosocial issues such as post-traumatic stress disorder. Supervises the investigation and review of disaster-related claims, in accordance with Federal Emergency Management Agency (FEMA) and New Jersey Office of Emergency Management policies, practices, and procedures. Selects damage appraisers to inspect/appraise damaged property belonging to the State of New Jersey, local government agencies, and others, and reviews reports of such appraisals. Visits scenes of accidents, makes sketches, takes photographs, and obtains police reports and medical and other data needed in the processing of all claims made by and against the state, which is to be used, when necessary, in litigated cases involving property damage claims. Supervises and/or performs accident prevention analysis to determine if safety training is required. Supervises the review of Medicare's conditional payments made on behalf of injured parties. Makes abstracts of hospital records, obtains X-rays and medical reports, and compiles other data needed to assist in the preparation and trial of cases. Develops working knowledge of new and emerging types of unclaimed property, and trains Claims Investigators of same or lower grade. Supervises and/or participates in public outreach activities to promote awareness to the citizenry about the availability of unclaimed property. Supervises work operations and/or functional programs and has responsibility for employee evaluations and for effectively recommending the hiring, firing, promoting, demoting, and/or disciplining of employees. Selects medical specialists to examine claimants and evaluates reports of such examinations. Oversees subordinates in the settlement discussion with claimants or debtors, and approves settlements according to prescribed policies/limits. Discusses claims with claimants, debtors, insurance company representatives, and their attorneys in litigated and non-litigated cases. Serves as initial approval officer covering billing for damage to properties by outside parties including all correspondence. Serves as initial approval officer for invoices covering the medical/hospital care of employees who are injured in accidents arising out of and during the course of their employment including correspondence and negotiation with hospitals/physicians concerning the amounts of their charges. Prepares answers to interrogatories and formal claim petitions for filing with the courts in litigated cases. Coordinates activities of investigative staff and/or Deputy Attorneys General in preparation of litigated cases for trial. Consults management in matters involving unusual technical problems and in matters pertaining to policies/procedures of the bureau or unit. Attends formal/informal hearings and assigns subordinates to such hearings. Attends court trials in connection with civil actions arising out of damage to public, private, and state or local government property or injury to employees, and attends police court hearings in complicated or unusual situations on assignment by the supervisor. Conducts correspondence with physicians, attorneys, insurance company representatives, and others necessary in administration of claims within the assigned sphere of activity. Supervises the establishment/maintenance of essential records, files, and reports. Will be required to learn how to utilize various types of electronic and/or manual recording and information systems used by the agency, office, or related units.
License
Appointees will be required to possess a driver's license valid in New Jersey only if the operation of a vehicle, rather than employee mobility, is necessary to perform the essential duties of the position.
Knowledge, skills and abilities
Knowledge of appropriate laws, rules, regulations, standards, policies and procedures of the investigative bureau or unit assigned as they apply to claims work. Knowledge of negligence law, tort law, contract law, and rules of evidence, or abandoned property law. Knowledge of medical and/or legal terms commonly used in claims work, including terminology specific to the Medicare program. Knowledge of the claims that are served by writs to the State of New Jersey by the Division of Taxation, to levy on specific individuals in the collection of funds. Knowledge of techniques of interviewing and their application to specific claims situations. Knowledge of the problems likely to be encountered in investigation and claims processing work. Knowledge of anti-fraud methodologies, investigation techniques, and software. If assigned to the Division of Risk Management, knowledge of Title 34 (the Workers' Compensation Statute), and Title 59 (the Tort Claims Act). If assigned to the Unclaimed Property Administration, knowledge of Title 46 of the New Jersey Statutes and Title 17:18 of the New Jersey Administrative Code. Ability to understand and apply court rules/procedures dealing with the litigation of civil actions. Ability to apply regulations, policies, and procedures of the investigative bureau or unit to the processing of claims by or against the state or local government entity for injury and/or damages. Ability to apply regulations, policies, and procedures of the abandoned property unit in the processing of claims. Ability to understand, analyze, and interpret basic law and regulations to persons of varying education, economic, and ethnic backgrounds. Ability to assign and supervise the work of investigative staff and clerical employees. Ability to organize assigned claims work and to develop effective work methods. Ability to locate and secure information, select and summarize pertinent data, and prepare and supervise the preparation of clear, sound, accurate, and informative reports of investigations and claims matters which shall include documentary evidence of varied types. Ability to confer with physicians and other members of the medical profession, hospital and clinic staff, police officers, claimants, attorneys, key witnesses, and others and to obtain such oral and other testimony and evidence, including copies of medical reports and records, as required by the particular case. Ability to work effectively with claimants, debtors, professional witnesses, police officers, insurance company representatives, attorneys, estate representatives, and the public in connection with the work of the bureau or unit. Ability to work with external stakeholders, including Medicare, the Federal Emergency Management Agency, and the New Jersey Office of Emergency Management, on various types of claims. Ability to continuously monitor claims for indicators of fraud. Ability to participate in outreach activities. Ability to acquire knowledge about new and emerging types of unclaimed property, and to train lower-ranking and/or subordinate employees. Ability to review and analyze case records, testimony, statements of witnesses, and other information. Ability to locate potential sources of information. Ability to act as a witness and to present testimony in court actions. Ability to compose and supervise preparation of correspondence to government officials, members of the legal/medical professions, claimants, debtors, and others pertaining to claims being processed by the bureau and/or unit. Ability to supervise assigned staff and plan, organize, and implement projects within the unit. Ability to supervise the establishment and maintenance of essential records, reports, and files. Ability to learn how to utilize various types of electronic and/or manual recording and information systems used by the agency, office, or related units. Ability to read, write, speak, understand, and communicate in English sufficiently to perform duties of this position. American Sign Language or Braille may also be considered as acceptable forms of communication. Persons with mental or physical disabilities are eligible if they can perform the essential functions of the job with or without reasonable accommodation. If the accommodation cannot be made because it would cause the employer undue hardship, such persons may not be eligible.
Note
The examples of work for this title are for illustrative purposes only. A particular position using this title may not perform all duties listed in this job specification. Conversely, all duties performed on the job may not be listed. Applicants must meet one of the following or a combination of both experience and education. Thirty (30) semester hour credits are equal to one (1) year of relevant experience. Seven (7) years of professional experience in workers compensation, negligence or claims investigation. OR Possession of a bachelor's degree from an accredited college or university; and three (3) years of the above-mentioned professional experience. "Professional experience" refers to work that is creative, analytical, evaluative, and interpretive; requires a range and depth of specialized knowledge of the profession's principles, concepts, theories, and practices; and is performed with the authority to act according to one's own judgment and make accurate and informed decisions.