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Allstate · 19 hours ago

SIU Investigation Adjuster Consultant II - Remote

United States

Full-time

Remote

Mid Level

$62K/yr - $104K/yr

3+ years exp

Allstate Insurance Co. is committed to protecting families and their belongings from life’s uncertainties. The SIU Investigation Adjuster Consultant II role involves investigating and analyzing complex claims referred to the special investigation unit for potential fraud, conducting thorough investigations, and providing guidance to less senior employees.

BankingFinanceFinancial ServicesInsuranceInsurTechVenture Capital

No H1B

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

Qualification

SIU experienceFraud InvestigationsMedical information reviewClaims ProcessingAnalytical ThinkingEvidence GatheringInformation CollectionInsurance Claims InvestigationsInsurance InvestigationSpecial InvestigationsCritical ThinkingDocumentations