Claims Investigator

Terrance Private Investigator; Houston (TX); On-site; USD 65,000 - 95,000; Full time

Job summary

TJS Private Investigations in Houston is seeking a seasoned Claims Investigator. You will conduct field investigations, take statements, and perform detailed research to uncover fraud indicators and inform carrier decisions. The role requires discretion, accuracy, and the ability to produce court-admissible reports.

Travel between markets is expected, with availability outside standard hours. A valid private investigator license and an adjuster license are preferred, and bilingual Spanish is a

Qualifications

• Minimum of 2 years of professional claims investigation or SIU experience.
• Experience taking recorded statements from claimants and witnesses.
• Knowledge of fraud indicators across workers' compensation, auto, property, and liability claims.
• Ability to produce clear, court-admissible investigative reports.

Responsibilities

• Investigate assigned claims and conduct scene, vehicle, and loss site investigations.
• Take recorded statements and verify information with proper consent.
• Research claims history and index results to identify patterns.
• Prepare comprehensive, deliverable reports for carrier clients.

Skills

Recorded statements

Fraud indicators

Investigative writing

Analytical reasoning

Bilingual Spanish

Education

Private Investigator license

Adjuster license

Insurance credential

Tools

ISO ClaimSearch

Case management software

Microsoft Office

Google Workspace

Job description

# Claims InvestigatorField Investigations* Houston* Full time## About UsTJS Private Investigations is a leading private investigation firm serving clients nationwide. We provide professional investigative services for individuals, attorneys, businesses, and insurance professionals, specializing in infidelity investigations, criminal defense support, surveillance, background checks, asset searches, missing persons, and complex investigative assignments. Our reputation is built on integrity, discretion, professionalism, and delivering results that matter. Every investigation is handled with precision, thorough documentation, and a commitment to helping our clients get answers and uncover the truth.As our firm continues to grow across multiple markets, we are seeking an experienced Claims Investigator to handle questionable claims and SIU referrals for carriers, third party administrators, and self-insured clients. Most claims are exactly what they appear to be. Some are not, and the difference is rarely obvious from the file. This role is about finding out which is which and documenting it well enough that the answer holds, whether the finding supports the claim or defeats it. If you can run a claim to ground objectively and write it up so an adjuster, a fraud bureau, or a court can rely on it, we would like to hear from you.## Position OverviewThis is a full-time position handling claims investigations across all firm markets. The Claims Investigator conducts recorded statements, scene and vehicle investigation, activity checks, canvasses, and background research on assigned claims, and produces investigative reports delivered to carrier clients and used in claim decisions, litigation, and fraud referrals. Assignments arrive on carrier timelines and the role requires availability outside standard business hours, as claimants, witnesses, and scenes do not conform to a schedule. Travel within and between markets is required.## Required Qualifications, Experience & Licensing* Minimum of 2 years of professional claims investigation, SIU, or insurance defense investigative experience* Demonstrated experience taking recorded statements from claimants, insureds, and witnesses* Working knowledge of fraud indicators across workers' compensation, auto, property, and liability claims* Experience conducting scene, vehicle, and loss site investigation with photographic documentation* Familiarity with claims files, coverage concepts, policy language, and the questions an adjuster actually needs answered* Working knowledge of ISO ClaimSearch, prior claims history research, and index reporting* Strong investigative writing; your report is the deliverable and it may be produced in litigation* Ability to maintain objectivity and reach a defensible conclusion regardless of which side it favors* Private Investigator license in the state of assignment, or registration under the agency license, current or obtainable prior to start. The firm will sponsor registration for qualified candidates.* Adjuster license where required by the state of assignment, or willingness to obtain* Valid driver's license with a clean driving record* Ability to pass a background check and maintain confidentiality at all times* Preferred: prior carrier SIU, adjuster, or law enforcement fraud unit experience* Preferred: CIFI, FCLS, CFE, or comparable fraud investigation credential* Preferred: bilingual, particularly Spanish## Equipment & ResourcesThe firm provides the tools required for the role:* Laptop, mobile device, and full access to the firm case management platform* Investigative database, public records, and claims history platform access* Camera, audio recording, and scene documentation equipment* Secure evidence storage and cloud infrastructure* Mileage reimbursement or vehicle allowance for case travelYou are expected to maintain a personal vehicle in good mechanical condition and be capable of working in the field on short notice.## Core Responsibilities* Investigate assigned claims within the scope, authority, and deadlines established by the carrier client* Take recorded statements from claimants, insureds, witnesses, and involved parties, obtaining consent as required by applicable law* Conduct scene, loss site, and vehicle investigation, including photographs, measurements, diagrams, damage documentation, and consistency analysis* Perform activity checks and canvasses to verify reported limitations, occupancy, employment, and circumstances* Conduct AOE and COE investigation on workers' compensation claims, including employment verification, prior injury history, and mechanism of injury analysis* Research claims history, prior losses, and index results; identify patterns across claims, parties, providers, and addresses* Conduct background research on claimants, witnesses, providers, and involved businesses within permissible purpose* Canvass for and preserve third party video, business records, and physical evidence before it is lost* Identify, document, and analyze fraud indicators; distinguish genuine red flags from coincidence* Coordinate with surveillance investigators, providing subject intelligence and integrating field findings into the claim file* Prepare clear, comprehensive, court-admissible investigative reports and claim summaries for carrier clients* Maintain evidence integrity and chain of custody on all recordings, photographs, documents, and physical evidence* Support referrals to state fraud bureaus, NICB, and law enforcement where the file warrants it* Testify at deposition, hearing, examination under oath proceedings, or trial regarding investigative findings* Operate in compliance with all applicable federal, state, and local law, including state private security regulations, unfair claims settlement practices requirements, recording consent law, FCRA, DPPA, and GLBA* Communicate timely case updates with case managers, carrier contacts, and leadership throughout the investigation* Safeguard confidential claim information and maintain the highest level of discretion and professionalism## Investigation SpecialtiesYou will support the full range of claims matters:Workers' compensation fraud · Auto and staged accident claims · Property claims including fire, theft, and water loss · Liability claims · Disability and long term disability claims · Premium fraud · Provider and medical billing fraud · Contents and inventory claims · AOE and COE investigations · Activity checks · Recorded statements · SIU referrals · Examination under oath supportDepth in workers' compensation or SIU investigation is strongly valued.## Required Skills & Attributes* Genuine interview skill, the ability to take a complete recorded statement that closes the gaps rather than leaving them open* Objectivity under client pressure, you report what the evidence shows, not what the file was hoping for* Strong analytical reasoning; able to identify inconsistencies across statements, records, scene evidence, and claims history* Working knowledge of fraud indicators and the judgment to know when a red flag is just an unusual fact* Excellent written communication and investigative report writing* Proficient with investigative databases, claims history systems, case management software, Microsoft Office, and Google Workspace* Skilled with camera, video, and audio documentation* Ability to manage digital evidence, recordings, photographs, and case files securely* Exceptional attention to detail and observational skill* Professional composure with claimants who may be distressed, hostile, or represented* Command of the legal boundaries governing claims investigation, including permissible purpose, consent, and fair claims handling requirements* High level of integrity, discretion, and professionalism* Ability to work independently with minimal supervision while keeping the client informed* Strong time management and organization against carrier deadlines across concurrent claims* Calm under pressure and adaptable to changing investigative circumstances* Reliable, dependable, and responsive in all communications* Professional appearance and demeanor when representing the company* Self-motivated with a strong work ethic and commitment to delivering high-quality investigative results## Physical Requirements* Ability to conduct field investigation and canvassing on foot for extended periods* Ability to work outdoors in varying weather and environmental conditions* Ability to access and document loss sites, including damaged structures, vehicles, and work environments* Ability to safely operate camera, audio, and scene documentation equipment* Ability to drive for extended periods during case travel* Ability to bend, kneel, and reach when documenting scenes and physical evidence* Valid driver's license with a clean driving record and reliable transportation* Ability to occasionally lift and carry investigative equipment or case materials weighing up to 30 pounds## What We Offer* Substantive investigative work with established carrier, TPA, and self-insured clients* Competitive compensation based on claims investigation experience and qualifications* Consistent assignment flow from an established insurance client base* Firm-provided equipment, database access, and administrative support* Comprehensive case briefings with clearly defined objectives and carrier requirements* Coordination with a surveillance team rather than carrying every claim alone* Guidance and support from an experienced leadership team* Quality assurance reviews and constructive feedback to maintain investigative excellence* Advancement track within a growing multi-market firm* A professional environment focused on quality investigations## Compensation StructureCompensation is commensurate with claims investigation experience, SIU background, credentials, and case complexity. Rates are discussed during the interview process. Mileage reimbursement or vehicle allowance is provided for case travel.## Safety & Professional StandardsThe Claims Investigator handles confidential claim information and regulated data and is expected to maintain the highest standards of professionalism, objectivity, and legal compliance while representing TJS Private Investigations. This includes full compliance with applicable state private security and adjuster licensing requirements, unfair claims settlement practices regulations, recording consent law, permissible purpose requirements under FCRA, DPPA, and GLBA, company safety policies, confidentiality and data security protocols, evidence handling and chain of custody standards, and our professional code of ethics. Investigators must never misrepresent their identity or purpose to a claimant, never pressure or lead a statement, and must immediately report to firm leadership any safety concern, contact with a represented party, or client request that would exceed a lawful or ethical boundary.## Equal OpportunityTJS Private Investigations is committed to creating a diverse and inclusive team. We welcome applications from qualified candidates of all backgrounds. All applicants will be considered based on qualifications, experience, and professional merit.## At a glanceCategory: Field InvestigationsLocation: HoustonHours: Full time## Apply for this positionTell us about yourself. Anything you are unsure of, leave blank — we would rather hear from you than not.About youLicenceActive, pending, nonePDF or photo, up to 12MBExperienceEquipment & vehicleAvailabilityBackgroundA yes is not automatically a problem — context helps.Your applicationPDF or Word, up to 12MB