Allstate · 3 hours ago

SIU NY and NY/NE PIP Singular Investigator

Illinois, United States

Full-time

Remote

Mid Level

$56K/yr - $100K/yr

3+ years exp

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Responsibilities

Researches and responds to complex customer communications, concerns, conflicts or issues

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

Conducts thorough investigations of complex 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

Conducts complex online data application searches, research, and evaluation

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

Enters SIU claim data information into multiple SIU systems

Makes claim decisions regarding complex investigations, and pursues restitution

This role handles claims in New York and New England

Qualification

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Insurance Fraud InvestigationsEvidence GatheringCasualty InsuranceSpecial InvestigationsPIP ExperienceMED PAY ExperienceClaims Handling ExperienceLicensing in NY/NE