Investigative Specialist

Dept of Insurance

Industrial Commission

Program Coordinator II (NS)

65020585

NC10

Mission of the Industrial Commission:

The North Carolina Industrial Commission is vested as a court of exclusive and original jurisdiction by the General Assembly to adjudicate and administer the North Carolina Workers' Compensation Act. The Industrial Commission processes over 65,000 Workers’ Compensation injury reports and claims filed annually under the Act. This responsibility includes overseeing and providing for the trial of contested cases, as well as administering non-contested cases. Workers who are injured by accident on the job or who contract an occupational disease receive disability and medical benefits as ordered by the Industrial Commission.

The Industrial Commission is also a court of original jurisdiction for litigating tort claims against the State under the North Carolina State Tort Claims Act. Additionally, the General Assembly has mandated the Industrial Commission to provide an adjudicated process for Childhood Vaccine-Related Injury claims, Compensation to Persons Erroneously Convicted of Felonies, and Eugenics claims. It acts as a court of exclusive and final jurisdiction for death claims made by families of law enforcement officers, firefighters, rescue squad workers and Civil Air Patrol members arising under the Public Safety Employees' Death Benefits Act.  Each of these adjudicatory systems require administration of contested and uncontested claims, review of agreements, and supervision of payment of benefits.

For more information regarding the NC Industrial Commission visit: https://www.ic.nc.gov/


Position Number: 65020585
Salary Recruitment Range: $43,267 -$50,000
Salary Grade: NC 10

This position currently qualifies for a hybrid telework option with routine office and up to one remote workday per week. The NC Department of Insurance/Industrial Commission trusts our employees to be self-motivated and successful in hybrid/remote roles. Telework options are subject to change at the discretion of management.

The posting will close at 11:59 p.m. the night before the closing date.

Primary Purpose of the Organizational Unit

The Criminal Investigations Section of the North Carolina Industrial Commission operates as a law enforcement agency and is responsible for conducting criminal investigations into cases of suspected workers’ compensation fraud, employee misclassification, and violations related to workers’ compensation claims involving employees, employers, insurers, health care providers, attorneys, and vocational rehabilitation providers. Criminal Investigators investigate all criminal complaints filed with the Industrial Commission regarding failure of employers to maintain workers’ compensation insurance (N.C. Gen. Stat. § 97-94(d), fraud on the part of employees with regard to the collection or obtaining of workers’ compensation benefits (N.C. Gen. Stat. § 97-88.2), fraud on the part of employers with regard to payment or collection of workers’ compensation premiums from employees’ salaries (N.C. Gen. Stat. § 97-21), medical payment fraud (N.C. Gen. Stat. § 97-88.3), and any other claims arising out of violations of Chapter 97 by employees or employers. The Criminal Investigations Section works with judicial officials and other law enforcement agencies throughout the State to resolve the above investigations in criminal court.

The Criminal Investigations Section collaborates with the Industrial Commission’s Employee Classification Section to proactively identify and investigate employee misclassification, thus helping ensure compliance with the North Carolina Employee Fair Classification Act and North Carolina Workers’ Compensation Act.

Primary Purpose of the Position

The primary purpose of the Investigative Specialist is to provide comprehensive administrative support to the Industrial Commission’s Investigators and the Division Chief. The Investigative Specialist is the primary point of contact for the Division, documenting formal complaints received via U.S. Mail, phone, or email and synthesizing pertinent documents and other information received from complainants, other State agencies, attorneys, insurance providers, and other Industrial Commission sections and divisions.

The Investigative Specialist researches, collects, and analyzes information from databases and public records and presents findings and recommendations to the Investigators and Division Chief. Among other things, the Investigative Specialist carefully analyzes workers’ compensation insurance coverage information to help determine whether a violation of N.C. Gen. Stat. §97-93 has occurred. The Investigative Specialist also carefully analyzes information received through the Employee Classification Application to help determine whether an employer may be misclassifying employees as independent contractors.

The Investigative Specialist supports the Industrial Commission’s Investigators with criminal investigations by preparing case files, organizing documentary evidence, and creating trial exhibits. The Investigative Specialist is required to utilize the Industrial Commission’s approved intake system for the Criminal Investigations & Employee Classification Division so that cases reported can be easily tracked and accessed by all authorized employees. Additionally, the Investigative Specialist is required to follow all relevant Industrial Commission procedures for the uploading and filing of documents associated with Criminal Investigations & Employee Classification Division cases.

The Investigative Specialist assists the Division Chief with compiling accurate statistical information, ensuring compliance with the Division of Criminal Information/Criminal Justice Information System, CJLEADS, and serves as the Division’s Certified Notary Public.

To perform the position duties, the Investigative Specialist must have a working knowledge of relevant North Carolina criminal and civil statutes, including but not limited to the North Carolina Workers’ Compensation Act and the Employee Fair Classification Act. The Investigative Specialist must also have a working knowledge of relevant Industrial Commission rules and an understanding of Industrial Commission procedures, the North Carolina criminal justice system as it pertains to criminal investigations, and workers’ compensation insurance industry terms, concepts, and principles.

Laeng Lorn

LAENG.LORN@NCDOI.GOV