THE POSITION
Do you possess exceptional investigative skills? The Pennsylvania Insurance Department, Healthcare Division, is eagerly seeking a motivated Insurance Investigator 2 to join our team of professionals. In this role, you will investigate consumer complaints to determine company and producer compliance with existing statutes and regulations. Your ability to educate consumers and respond to inquiries on matters relating to their insurance needs is key to this position. Join us in our mission to protect Pennsylvania's insurance consumers through fair and effective regulation of the marketplace.
DESCRIPTION OF WORK
As an Insurance Investigator 2, you will review and investigate complex consumer complaints in relation to health insurance and prepare responses to complaints and inquires. You will be tasked to handle numerous telephone calls and inquiries from the public and licensees regarding various insurance regulations, statutes, adjudications, and industry trends. This position requires a detailed knowledge of insurance principles, practices, and laws.
Additional duties to include but not limited to:
* Communicating investigative findings and general insurance education in an unbiased manner; making sound decisions and recommendations.
* Recognizing and promptly referring to management any trends and suspected violations of insurance law and/or regulation.
* Being available to represent the Department at consumer events; Disaster Recovery Centers; traveling on Commonwealth business as necessary and testifying at formal hearings.
Interested in learning more? Additional details regarding this position can be found in the position description.
Work Schedule and Additional Information:
* Full-time employment
* Work hours are 8:00 AM to 4:30 PM, Monday - Friday, with a 60-minute lunch.
* Telework: You may have the opportunity to work from home (telework) full-time, 1 day per month in the office will be required. In order to telework, you must have a securely configured high-speed internet connection and work from an approved location inside Pennsylvania. If you are unable to telework, you will have the option to report to the headquarters office in
* Salary: In some cases, the starting salary may be non-negotiable.
* You will receive further communication regarding this position via email. Check your email, including spam/junk folders, for these notices.
REQUIRED EXPERIENCE, TRAINING & ELIGIBILITY
QUALIFICATIONS
Minimum Experience and Training Requirements:
* One year as an Insurance Investigator 1; or
* Seven years of experience as an insurance investigator, underwriter, agent, broker or claims adjuster. College level training may be substituted on a year-for-year basis for four years of the required experience; or
* An equivalent combination of experience and training.
Other Requirements:
* You must meet the PA residency requirement. For more information on ways to meet PA residency requirements, follow the link and click on Residency.
* You must be able to perform essential job functions.
How to Apply:
* Resumes, cover letters, and similar documents will not be reviewed, and the information contained therein will not be considered for the purposes of determining your eligibility for the position. Information to support your eligibility for the position must be provided on the application (i.e., relevant, detailed experience/education).
* If you are claiming education in your answers to the supplemental application questions, you must attach a copy of your college transcripts for your claim to be accepted toward meeting the minimum requirements. Unofficial transcripts are acceptable.
* Your application must be submitted by the posting closing date. Late applications and other required materials will not be accepted.
* Failure to comply with the above application requirements may eliminate you from consideration for this position.
Veterans:
* Pennsylvania law (51 Pa. C.S. 7103) provides employment preference for qualified veterans for appointment to many state and local government jobs. To learn more about employment preferences for veterans, go to and click the Veterans' Preference tab or contact us at ra-cs-vetpreference@pa.gov.
Telecommunications Relay Service (TRS):
* 711 (hearing and speech disabilities or other individuals).
If you are contacted for an interview and need accommodations due to a disability, please discuss your request for accommodations with the interviewer in advance of your interview date.
The Commonwealth is an equal employment opportunity employer and is committed to a diverse workforce. The Commonwealth values inclusion as we seek to recruit, develop, and retain the most qualified people to serve the citizens of Pennsylvania. The Commonwealth does not discriminate on the basis of race, color, religious creed, ancestry, union membership, age, gender, sexual orientation, gender identity or expression, national origin, AIDS or HIV status, disability, or any other categories protected by applicable federal or state law. All diverse candidates are encouraged to apply.
EXAMINATION INFORMATION
* Completing the application, including all supplemental questions, serves as your exam for this position. No additional exam is required at a test center (also referred to as a written exam).
* Your score is based on the detailed information you provide on your application and in response to the supplemental questions.
* Your score is valid for this specific posting only.
* You must provide complete and accurate information or:
* your score may be lower than deserved.
* you may be disqualified.
* You may only apply/test once for this posting.
* Your results will be provided via email.
Learn more about our Total Rewards by watching this short video!
Health & Wellness
We offer multiple health plans so our employees can choose what works best for themselves and their families. Our comprehensive benefits package includes health coverage, vision, dental, and wellness programs.*
Compensation & Financial Planning
We invest in our employees by providing competitive wages and encouraging financial wellness by offering multiple ways to save money and ensure peace of mind including multiple retirement and investment plan options.
Work/Life Balance
We know there's more to life than just work! Our generous paid leave benefits include paid vacation, paid sick leave, eight weeks of paid parental leave, military leave, and paid time off for most major U.S. holidays, as well as flexible work schedules and work-from-home opportunities.*
Values and Culture
We believe in the work we do and provide continual opportunities for our employees to grow and contribute to the greater good. As one of the largest employers in the state, we provide opportunities for internal mobility, professional development, and the opportunity to give back by participating in workplace charitable giving.
Employee Perks
Sometimes, it is the little "extras" that make a big difference. Our employees receive special employee-only discounts and rates on a variety of services and memberships.
For more information on all of these Total Rewards benefits, please visit and click on the benefits box.
* Eligibility rules apply.
01
Have you been employed by the Commonwealth of Pennsylvania as an Insurance Investigator 1 for one or more years full-time?
* Yes
* No
02
If you are claiming experience in the above question, please list the employer(s) where you gained this experience in the text box below. The employer(s) and a description of the experience must also be included in the appropriate sections of your application if you would like the experience to be considered in the eligibility decision. If you claimed you do not have experience, type N/A in the text box below.
03
How many years of full-time experience as an insurance investigator, underwriter, agent, broker or claims adjuster do you possess?
* 7 years or more
* 6 but less than 7 years
* 5 but less than 6 years
* 4 but less than 5 years
* 3 but less than 4 years
* 2 but less than 3 years
* 1 but less than 2 years
* Less than 1 year
* None
04
If you are claiming experience in the above question, please list the employer(s) where you gained this experience in the text box below. The employer(s) and a description of the experience must also be included in the appropriate sections of your application if you would like the experience to be considered in the eligibility decision. If you claimed you do not have experience, type N/A in the text box below.
05
How much graduate coursework have you completed in Insurance, Risk Management, Business Administration, Public Administration, Public Policy, Finance, Economics, Accounting, or a related area?
If you are claiming credits/degree, you must upload a copy of your college transcript(s) for this education to be considered in the eligibility decision. Unofficial transcripts are acceptable. You must attach your transcript(s) prior to the submission of your application by using the "Attachments" tab on the left. You will not be able to add a transcript(s) to the application after it has been submitted.
If your education was acquired outside of the United States, you must also upload a copy of your foreign credential evaluation. For more information on foreign education credentials, please visit and click on Other Information.
* 30 credits or more
* Less than 30 credits
* None
06
You must complete the supplemental questions below. These supplemental questions are the exam and will be scored. They are designed to give you the opportunity to relate your experience and training background to the major activities (Work Behaviors) performed in this position. Failure to provide complete and accurate information may delay the processing of your application or result in a lower-than-deserved score or disqualification. You must complete the application and answer the supplemental questions. Resumes, cover letters, and similar documents will not be reviewed for the purposes of determining your eligibility for the position or to determine your score.
All information you provide on your application and supplemental questions is subject to verification. Any misrepresentation, falsification or omission of material facts is subject to penalty. If requested, you must provide documentation, including names, addresses, and telephone numbers of individuals who can verify the validity of the information you provide in the application and supplemental questions.
Read each question carefully. Determine and select which "Level of Performance" most closely represents your highest level of experience/training. List the employer(s)/training source(s) from your Work or Education sections of the application where you gained this experience/training. The "Level of Performance" you choose must be clearly supported within the description of the experience and training information entered in your application or your score may be lowered. In order to receive credit for experience, you must have worked in a job for at least six months in which the experience claimed was a major function.
If you have read and understand these instructions, please click on the "Yes" button and proceed to the exam questions.
If you have general questions regarding the application and hiring process, please refer to our FAQ page.
* Yes
07
WORK BEHAVIOR 1 - RESEARCH
Conducts research by gathering information from insurance consumers to determine the nature of the complaint and establish relevant facts such as the parties involved, pertinent dates, coverage information, claim issues, and customer service issues.
Levels of Performance
Select the Level of Performance that best describes your claim.
* A. I have experience researching records and files and gaining information through interviews and discussions. When given an issue, I was responsible for compiling all available information from a variety of sources and determining if the information was relevant.
* B. I have experience researching records and files and gaining information through interviews and discussions. When given an issue, I was responsible for compiling all available information from a variety of sources; however, someone else determined if the information was relevant.
* C. I have successfully completed college-level coursework related to research methods, research design and analysis, interviewing techniques, or data collection.
* D. I have NO experience or coursework related to this work behavior.
08
In the text box below, please describe your experience as it relates to the level of performance you claimed in this work behavior. Please be sure your response addresses the items listed below which relate to your claim. If you indicated you have no work experience related to this work behavior, type N/A in the box below.
* The name(s) of the employer(s) where you gained this experience.
* The actual duties you performed related to research.
* Your level of responsibility.
09
If you have selected the level of performance pertaining to college coursework, please provide your responses to the three items listed below. If you indicated you have no education/training related to this work behavior, type N/A in the text box below.
* College/University
* Course Title
* Credits/Clock Hours
10
WORK BEHAVIOR 2 - ANALYZING INFORMATION
Analyzes information such as payment amounts, denial of claims, and policy terminations which was collected from all involved parties and relevant documentation. Determines if a violation has occurred and provides recommendations for further action.
Levels of Performance
Select the Level of Performance that best describes your claim.
* A. I have experience analyzing information such as payment amounts, denial of claims, and policy terminations. I was responsible for developing conclusions and providing recommendations for further action.
* B. I have experience analyzing information such as payment amounts, denial of claims, and policy terminations. I was responsible for developing conclusions; however, someone else provided recommendations for further action, based on my conclusions.
* C. I have successfully completed college-level coursework related to data analysis or accounting.
* D. I have NO experience or coursework related to this work behavior.
11
In the text box below, please describe your experience as it relates to the level of performance you claimed in this work behavior. Please be sure your response addresses the items listed below which relate to your claim. If you indicated you have no work experience related to this work behavior, type N/A in the box below.
* The name(s) of the employer(s) where you gained this experience.
* The actual duties you performed related to analyzing information.
* Your level of responsibility.
12
If you have selected the level of performance pertaining to college coursework, please provide your responses to the three items listed below. If you indicated you have no education/training related to this work behavior, type N/A in the text box below.
* College/University
* Course Title
* Credits/Clock Hours
13
WORK BEHAVIOR 3 - WRITTEN COMMUNCATION
Prepares written, technical, or narrative documents pertaining to insurance investigations and violation referrals. Authors correspondence and analytical reports that convey the findings of insurance investigations.
Levels of Performance
Select the Level of Performance that best describes your claim.
* A. I have experience drafting written materials such as letters and reports. I was responsible for the final document that conveyed customized information to the intended recipients.
* B. I have experience drafting written materials such as letters and reports. I was responsible for compiling a portion of the document, but someone else was responsible for the final version that conveyed customized information to the intended recipients.
* C. I have successfully completed college-level coursework related to business writing, technical writing, English composition, journalism, or communications.
* D. I have NO experience or coursework related to this work behavior.
14
In the text box below, please describe your experience as it relates to the level of performance you claimed in this work behavior. Please be sure your response addresses the items listed below which relate to your claim. If you indicated you have no work experience related to this work behavior, type N/A in the box below.
* The name(s) of the employer(s) where you gained this experience.
* The actual duties you performed related to written communication.
* Your level of responsibility.
15
If you have selected the level of performance pertaining to college coursework, please provide your responses to the three items listed below. If you indicated you have no education/training related to this work behavior, type N/A in the text box below.
* College/University
* Course Title
* Credits/Clock Hours
16
WORK BEHAVIOR 4 - TECHNICAL ASSISTANCE
Provides technical assistance to consumers regarding insurance laws and regulations and explains contractual provisions of insurance policies. Directs consumer inquiries to the appropriate entity when necessary.
Levels of Performance
Select the Level of Performance that best describes your claim.
* A. I have experience interacting with individuals and utilizing customer service skills to understand concerns and explain relevant information. I was responsible for answering general questions and providing technical advice as necessary.
* B. I have experience interacting with individuals and utilizing customer service skills to understand concerns and explain relevant information. I was responsible for answering general questions, but I referred technical questions to someone else to provide information.
* C. I have successfully completed college-level coursework related to counseling, public speaking, public relations, or education.
* D. I have NO experience or coursework related to this work behavior.
17
In the text box below, please describe your experience as it relates to the level of performance you claimed in this work behavior. Please be sure your response addresses the items listed below which relate to your claim. If you indicated you have no work experience related to this work behavior, type N/A in the box below.
* The name(s) of the employer(s) where you gained this experience.
* The actual duties you performed related to technical assistance.
* Your level of responsibility.
18
If you have selected the level of performance pertaining to college coursework, please provide your responses to the three items listed below. If you indicated you have no education/training related to this work behavior, type N/A in the text box below.
* College/University
* Course Title
* Credits/Clock Hours
Required Question
Agency Commonwealth of Pennsylvania
Address 613 North Street
Harrisburg, Pennsylvania, 17120
Website
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