Pip Siu Investigator (Remote)

749410-en_US

The world isn’t standing still, and neither is Allstate. We’re moving quickly, looking across our businesses and brands and taking bold steps to better serve customers’ evolving needs. That’s why now is an exciting time to join our team. You’ll have opportunities to take risks, challenge the status quo and shape the future for the greater good.

You’ll 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 life’s uncertainties so they can realize their hopes and dreams. For more than 89 years we’ve thrived by staying a step ahead of whatever’s 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. We’ve been an industry leader in pricing sophistication, telematics, digital photo claims and, more recently, device and identity protection.

We are the Good Hands. We don’t follow the trends. We set them.

Job Summary

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.

A Day in the Life

• Investigating No Fault claims to detect or deter fraud in accordance with state guidelines and Allstate policies and procedures
• Working in a flexible environment investigating potentially fraudulent insurance claims
• Communicate empathetically with customers and help them through their claim process in a fast, fair and easy manner
• Investigating claims and damages resulting from First Party PIP claims
• Investigations include the analysis of injuries, performing background and social media searches, obtaining evidence, interviewing parties and witnesses, verifying policy coverage and limits, reviewing medical records and bills, and assisting in the evaluation of potentially fraudulent claims.

Key Responsibilities

• Conducts complex site inspections, including body shops, medical clinics, loss locations etc.
• Updates files with investigation outcome, and when no fraud or insufficient evidence is found, returns file to MCO for further handling and settlement
• Makes claim decisions regarding complex investigations, and pursues restitution
• Summarizes documents and enters into claim system notes, documenting a claim file with notes, evaluations and decision-making process
• 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
• Enters SIU claim data information into multiple SIU systems
• 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 complex online data application searches, research, and evaluation
• Reviews investigations with fraud outcomes to validate whether denial is appropriate
• Researches and responds to complex customer communications, concerns, conflicts or issues

Job Qualifications

• High School Diploma/GED or higher (Bachelor’s Degree preferred)
• Applies broad knowledge of claim processes, policies, procedures, claim systems, coverage, liability, damage estimating, and/or settlement, and adherence to applicable legal compliance standards
• Applies broad negotiation and/or arbitration skills
• Ability to investigate, evaluate, negotiate and settle complex claims
• Med-Pay experience, a plus
• 2 years of PIP experience, strongly preferred
• Being bilingual and/or having prior military experience is a plus
• Value providing an effortless customer service experience
• Possess clear and professional communication skills – both written and verbal
• Are organized and able to multi-task in a fast-paced environment
• Casualty claims handling, a plus
• Applies broad knowledge of analytical procedures to reconcile, manipulate, and recognize patterns of data
• Applies broad knowledge of insurance policy, coverage, and regulation
• Applies broad knowledge of training facilitation and coaching skills
• Have a passion for investigation and cutting insurance fraud out of the system
• Applies broad knowledge of problem solving and preparation of reports for analysis

What We Offer

• 401(k) match and pension plan
• Tuition Reimbursement
• Generous Paid Time Off
• A culture of learning where you can expect to develop foundational skills for the future
• Opportunities for both personal and professional development
• Leadership teams that are communicative and engaged
• Medical, Dental, and Vision coverage (cafeteria style health insurance plane - starts day one!)
• Internet reimbursement
• Recognition and advancement opportunities
• Volunteer opportunities & donation program
• Learn more about Allstate benefits @ https://allstategoodlife.com

Additional Information

• In our virtual environment, employees are required to engage and participate on camera during online meetings and trainings
• Employees who have been in their current role for at least one year will receive screening preference
• This position is eligible for a monthly connectivity reimbursement to offset the costs of internet and phone expenses
• 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
• This position is not available for Puerto Rico, California, Alaska and Hawaii residents

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.

Compensation offered for this role is $57,500.00-$94,625.00 per year 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.

Good Work. Good Life. Good Hands®.

As a Fortune 100 company and industry leader, we provide a competitive salary – but that’s 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, you’ll 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 Allstate’s 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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