SIU Investigator Auto / Property

Location
Work From Home
Salary
Competitive
Posted
Oct 13, 2021
Closes
Dec 12, 2021
Ref
93339741#GIJ--Allstate.1
Category
Claims
Job Type
Not Specified
Career Level
Not Specified

The world isnt standing still, and neither is Allstate. Were moving quickly, looking across our businesses and brands and taking bold steps to better serve customers evolving needs. Thats why now is an exciting time to join our team. Youll have opportunities to take risks, challenge the status quo and shape the future for the greater good.

Youll do all this in an environment of excellence and the highest ethical standards a place where values such as integrity, inclusive diversity and accountability are paramount. We empower every employee to lead, drive change and give back where they work and live. Our people are our greatest strength, and we work as one team in service of our customers and communities.

Everything we do at Allstate is driven by a shared purpose: to protect people from lifes uncertainties so they can realize their hopes and dreams. For more than 89 years weve thrived by staying a step ahead of whatevers coming next to give customers peace of mind no matter what changes they face. We acted with conviction to advocate for seat belts, air bags and graduated driving laws. We help give survivors of domestic violence a voice through financial empowerment. Weve been an industry leader in pricing sophistication, telematics, digital photo claims and, more recently, device and identity protection. We are the Good Hands. We dont follow the trends. We set them.

Job Summary

The Adjusting Function is responsible for verifying policy coverage and limits. The Adjusting function investigates and evaluates damage and/or liability; estimates damages, losses, or total indemnity; sets and maintains reserves; and/or negotiates and settles claims. Special Investigative Unit (SIU) work is performed by a specialized unit that proactively utilizes analytical tools to handle the most complex or specialized claims possibly in litigation and works with specialized counsel and law enforcement to detect, investigate, prosecute and deter fraud.

Under general supervision, this job is responsible for investigating, and analyzing moderately complex, Single discipline coverage and claims that have been referred to the special investigation unit (SIU) for potential fraud. The individual conducts moderately complex site inspections, including body shops, medical clinics, loss locations, etc., performs background searches, takes recorded statements and interviews witnesses, reviews medical notes and bills, and conducts social media searches. The individual reviews whether fraud can be substantiated and support a lawsuit. The individual also delivers compassionate service that is fast, fair, and easy, to ensure customer retention. The individual is capable of working independently, prioritizing the individual's own responsibilities, and managing the individual's own workload. The individual also consistently meets band level behaviors, production, quality, and/or customer service goals. This individualwill service claims from Zones 1 and 2.

Key Responsibilities

Customer Service

  • Makes and maintains a connection with the customer by understanding and meeting their needs; serves the customer with empathy; and follows up to ensure that customer needs have been met
  • Researches and responds to moderately complex customer communications, concerns, conflicts or issues

File Documentation and Reporting

  • Summarizes documents and enters into claim system notes
  • Documents a claim file with notes, evaluations and decision making process

SIU (Post-Referral)

  • Reviews moderately complex Singular claim referrals and fraud indicators to determine SIU acceptance
  • Verifies loss facts and coverage
  • Conducts thorough investigations of moderately complex, individual claims in a Singular discipline that are potentially fraudulent to determine if payment is warranted
  • Validates that the information provided and obtained through investigation is true and accurate and follows up on all possible leads
  • Has frequent customer interaction of a moderately complex nature, including taking statements, responding to document requests and handling non-formal complaints, occasionally conducting scene investigations or neighborhood canvasses
  • Conducts moderately complex online data application searches, research, and evaluation
  • Attends industry, law enforcement and NICB meetings to obtain information on latest fraud schemes
  • Reviews investigations with fraud outcomes to validate whether denial is appropriate
  • Updates files with investigation outcome, and when no fraud, or if insufficient evidence is found, returns file to MCO for further handling and settlement
  • Notifies appropriate state agencies, industry databases, and underwriting regarding fraud outcomes
  • Pursues restitution on claims where Allstate has received a judgment or agreement

Legal Bill Reviewer

  • Applies legal billing guidelines
  • Achieves acceptable legal bill review variance to re-reviews
  • Achieves acceptable turn-around time compared to the country-wide average

Other Projects and Responsibilities

  • Oversees vendors
  • Attends training as required by state law or internal compliance, to further investigation skills

Knowledge/Skills/Abilities/Experience

  • Bachelors degree in related field preferred or equivalent experience
  • Auto OR Property Claims Experience
  • Ability to interact effectively with internal or external customers and act with empathy
  • Applies general knowledge of insurance policy, coverage, and regulation
  • Applies general knowledge of claim processes, policies, procedures, claim systems, coverage, liability, damage estimating, and/or settlement, and adherence to applicable legal compliance standards
  • Applies general industry knowledge to discipline practices, including best practices, to support the business unit
  • Applies general knowledge of analytical procedures to reconcile, manipulate, and recognize patterns of data
  • Applies general knowledge of standardized problem solving and preparation of basic reports for analysis
  • Applies general ability to leverage learned technical skills in support of team objectives
  • Applies general negotiation and/or arbitration skills
  • Applies general conflict management and problem resolution skills in managing internal and external customer relationships
  • Ability to investigate, evaluate, negotiate and settle moderately complex claims
  • Provides individual decision making within authority limits
  • Has and maintains all appropriate licenses and registrations for the role per state requirements

Regular, predictable attendance is an essential function of this job.

The candidate(s) offered this position will be required to submit to a background investigation, which includes a drug screen.

Good Work. Good Life. Good Hands.

As a Fortune 100 company and industry leader, we provide a competitive salary but thats just the beginning. Our Total Rewards package also offers benefits like tuition assistance, medical and dental insurance, as well as a robust pension and 401(k). Plus, youll have access to a wide variety of programs to help you balance your work and personal life -- including a generous paid time off policy.For a full description of Allstates benefits, visit allstate.jobs/benefits/

Learn more about life at Allstate. Connect with us on Twitter, Facebook, Instagram and LinkedIn or watch a video.

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.

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