SIU Bodily Injury/PIP Investigator - Consultant II

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 and occasionally highly 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 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 reviews whether fraud can be substantiated and supports a lawsuit.

Key Responsibilities

• Manages, researches, and resolves complex and occasionally highly complex communications, concerns, conflicts or issues, pursues restitution
• 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
• Validates that the information provided and obtained through investigation is true and accurate and follows up on all possible leads
• Conducts complex and occasionally highly 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
• Manages vendor relationship and oversees vendor performance

Experience

• 3 or more years of SIU BI/PIP experience (Required)

Education

• 4 year Bachelors Degree (Preferred)

Skills

Analytical Thinking, Claims Review, Crime Scene Investigations, Documentations, Evidence Gathering, Fraud Investigations, Insurance Claims Investigations, Property Damage, Surveillance, Suspicious Activity Reporting (SAR), Witness Interviewing

Compensation

Compensation offered for this role is $56,500.00 - 99,962.50 annually and is based on experience and qualifications.

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

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. And one where you can impact the future for the greater good.  

You’ll do all this in a flexible environment that embraces connection and belonging. And with the recognition of several inclusivity and diversity awards, we’ve proven that Allstate empowers everyone to lead, drive change and give back where they work and live. 

Good Hands. Greater Together.®

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 is the Law” 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.