Description

At Allstate, great things happen when our people work together to protect families and their belongings from life's uncertainties. And for more than 90 years, our innovative drive has kept us a step ahead of our customers' evolving needs. From advocating for seat belts, air bags and graduated driving laws, to being an industry leader in pricing sophistication, telematics, and, more recently, device and identity protection.

Job Description
This job is responsible for investigating and analyzing complex, multi-discipline coverage and claims that have been referred to the special investigation unit (SIU) for potential fraud. This role typically handles a combination of complex attorney represented and unrepresented claims and moderate to complex losses, in which suspicious activity has been identified. The individual performs a thorough investigation including; (1) conducting background searches, scene investigations, and clinic inspections; (2) taking recorded statements; (3) reviewing and analyzing medical notes, bills, and property damage; and (4) conducting witness interviews and social media searches. The individual conducts surveillance on property and/or creates scene reconstructions on some investigations and reviews whether fraud can be substantiated and supports a lawsuit. The individual provides work guidance and direction to less senior employees and provides mentoring and coaching to the team.

Key Responsibilities

• Enters SIU claim data information into multiple SIU systems
• Reviews investigations with fraud outcomes to validate whether denial is appropriate
• Updates files with investigation outcome, and when no fraud or insufficient evidence is found, returns file to MCO for further handling and settlement
• Conducts complex online data application searches, research, and evaluation
• Conducts complex site inspections, including body shops, medical clinics, loss locations etc.
• Conducts thorough investigations of complex that are potentially fraudulent to determine if payment is warranted, including scene investigations and surveillance as needed
• Validates that the information provided and obtained through investigation is true and accurate and follows up on all possible leads
• Summarizes documents and enters into claim system notes, documenting a claim file with notes, evaluations and decision-making process
• Utilizes analytic tools or SIU field intelligence to identify complex claims for investigation and/or for support in the evidence of the fraud and damages
• Researches and responds to complex customer communications, concerns, conflicts or issues

Qualifications:

• 3+ years of previous SIU experience required
• Previous experience reviewing medical information and/or handling provider investigations
• Texas Adjuster License preferred

Remote Home-Based Work
This position is a permanent remote home-based role. Your home office does not need to be near an Allstate office, but it does need to be in the United States. This position is not available for California, Alaska, Hawaii, or Puerto Rico residents.

When you work from home full time, you'll need:

• A home office - a dedicated workspace in your residence that is private and free from distractions
• A minimum internet bandwidth of 50 MB down/5 MB up
• Appropriate work surface and seating

What will Allstate provide?

• A technology bundle that includes all equipment needed to perform your work from home (laptop, monitors, headset, keyboard, mouse)
• Connectivity reimbursement of $80 per month to off set some of the cost of internet

Notes:
The preceding description is not designed to be a complete list of all duties and responsibilities. May be required to perform other related duties as assigned. Regular, predictable attendance is an essential function of this job.

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Skills
Analytical Thinking, Claims Processing, Critical Thinking, Documentations, Evidence Gathering, Fraud Investigations, Information Collection, Insurance Claims Investigations, Insurance Investigation, Special Investigations

Compensation
Compensation offered for this role is 62,100.00 - 103,950.00 annually and is based on experience and qualifications.

The candidate(s) offered this position will be required to submit to a background investigation.

Joining our team isn't just a job - it's an opportunity. One that takes your skills and pushes them to the next level. One that encourages you to challenge the status quo. One where you can shape the future of protection while supporting causes that mean the most to you. Joining our team means being part of something bigger - a winning team making a meaningful impact.

Allstate generally does not sponsor individuals for employment-based visas for this position.

Effective July 1, 2014, under Indiana House Enrolled Act (HEA) 1242, it is against public policy of the State of Indiana and a discriminatory practice for an employer to discriminate against a prospective employee on the basis of status as a veteran by refusing to employ an applicant on the basis that they are a veteran of the armed forces of the United States, a member of the Indiana National Guard or a member of a reserve component.

For jobs in San Francisco, please click " here " for information regarding the San Francisco Fair Chance Ordinance.

For jobs in Los Angeles, please click " here " for information regarding the Los Angeles Fair Chance Initiative for Hiring Ordinance.

To view the "EEO Know Your Rights" poster click " here ". This poster provides information concerning the laws and procedures for filing complaints of violations of the laws with the Office of Federal Contract Compliance Programs.

To view the FMLA poster, click " here ". This poster summarizing the major provisions of the Family and Medical Leave Act (FMLA) and telling employees how to file a complaint.

It is the Company's policy to employ the best qualified individuals available for all jobs. Therefore, any discriminatory action taken on account of an employee's ancestry, age, color, disability, genetic information, gender, gender identity, gender expression, sexual and reproductive health decision, marital status, medical condition, military or veteran status, national origin, race (include traits historically associated with race, including, but not limited to, hair texture and protective hairstyles), religion (including religious dress), sex, or sexual orientation that adversely affects an employee's terms or conditions of employment is prohibited. This policy applies to all aspects of the employment relationship, including, but not limited to, hiring, training, salary administration, promotion, job assignment, benefits, discipline, and separation of employment.

Requisition #: 363208409

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