CLAIMS INVESTIGATOR 4
Career Family: CLAIMS INVESTIGATOR
In New Jersey, Claims Investigator 4 is filled through the competitive process: candidates take a civil service exam and are hired off a ranked list, not picked at will.
Of the 4 Claims Investigator grades this one pays the most, sitting just above Claims Investigator 3. The stated bar is a bachelor's degree, but candidates can swap in added experience for the diploma. The FY2026 range lands between $88,530 and $130,339, and state payroll currently lists 5 people in the title, most of them at Treasury.
How to get hired
- Watch for an open-competitive announcement for Claims Investigator 4 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
- Claims Investigator 4 — $88,530 – $130,339 (this title)
Its top salary lands around the 72nd 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 5 people working under this title. The median actual salary is $121,977. The agencies employing the most are:
- Treasury (5)
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 direction of a supervisory official in a state or local government department or agency, has charge of a unit responsible for investigation, evaluation, processing claims and/or settlement or payment of claims arising out of workers compensation, negligence or tort claims filed against the state or other claims involving state or local employees and/or state government owned property, as well as other types of negligence or tort claims made against the state or agency, 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
Plans and supervises the work of Claims Investigators and clerical employees processing claims arising out of Workers Compensation, and other claims involving state or local employees and state or local-owned property, as well as other types of negligence or tort claims encountered by the state or local government. Plans and supervises the examination of claims for authenticity, authorizes payment of benefits, and recommends fraud investigations as needed. Plans and supervises the conduct of fraud investigations and provides guidance to primary-level supervisors and employees on the most complex, difficult, and sensitive investigations, such as workers compensation, tort, contract, negligence, and/or unclaimed property claims. Plans and 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. Plans and supervises the investigation and review of traumatic injury claims; researches medical and legal documentation in cases that lack precedent; may confer with higher level management, the Attorney General's Office, or other stakeholders. Provides guidance and clarification of policy to subordinate staff. Plans and supervises the analysis regarding the impact of comorbidities (pre-existing conditions) and psychosocial issues such as post-traumatic stress disorder; makes determinations on the most complex, difficult, and sensitive cases. Plans and supervises accident prevention analysis. Plans and supervises the review of Medicare's conditional payments made on behalf of injured parties. Plans and supervises the work of Claims Investigators and clerical employees processing claims arising from the abandoned real and personal property that has accrued to the State. 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. Receives and assigns initial cases and supervises investigations. Reviews the work of the investigation staff to determine completeness, accuracy, and compliance with law and to make certain that all legal papers and documents are properly prepared prior to court presentation or before a hearing officer. Works on the most complex and/or sensitive cases and may make final settlement of claims. Supervises the interviewing of claims applicants, physicians, professional specialists, state employees, witnesses, police officers and others and sees that their testimony is recorded accurately; sees that abstracts of hospital records, copies of x-ray and medical reports, and other materials are obtained. Interprets law and bureau regulations to claimants, bureau staff and others. Makes confidential investigations and prepares reports. Attends hearings and assigns staff to such hearings. Supervises the establishment and maintenance of records and files of the investigative bureau or unit. Develops working knowledge of new and emerging types of unclaimed property, including obtaining information from external entities, and trains Claims Investigators of various grades. May direct and/or participate in public outreach activities to promote awareness to the citizenry about the availability of unclaimed property. Will be required to learn how to utilize various types of electronic and/or manual recording and computerized information system 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 the appropriate laws, rules, regulations, standards, policies, and procedures of the investigative bureau or unit assigned as they apply to claims work. Knowledge of anti-fraud methodologies, investigation techniques, and software. Knowledge of medical/or legal terms commonly used in claims work. Knowledge of the techniques of interviewing and their application to specific claims situations, 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 supervisory methods and techniques. 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 Claims Investigators 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 review and supervise staff in the review and analysis of case records, testimony, statements of witnesses, police reports and other information. Ability to locate potential sources of information. 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 see that cases are prepared for court or hearings. 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 of the investigative bureau or unit. 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 the 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. Eight (8) years of professional experience in workers compensation, negligence or claims investigation, one (1) year of which shall have been in a supervisory capacity. OR Possession of a bachelor's degree from an accredited college or university; and four (4) years of the above-mentioned professional experience, one (1) year of which shall have been in a supervisory capacity. "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.
Study guides for this exam
- Supervisory Test Battery (STB) National Learning Corporation · $56.99
- General Supervisor National Learning Corporation · $49.90 · general prep, not specific to this title
The Civil Service Commission does not publish official study guides or release past tests. These are independent equivalency guides.