Senior SIU Investigation Adjuster

This is a fully remote position, open to applicants in United States.

📋 Description

• Explore and evaluate intricate and sometimes highly intricate, multi-disciplinary coverage and claims referred to the Special Investigation Unit for possible fraud.

• Manage complicated claims represented by attorneys as well as those without representation, complex losses, and claims associated with extra-contractual liability.

• Perform background searches, conduct scene investigations, and inspect clinics.

• Collect recorded statements and carry out interviews with witnesses.

• Review and assess medical records, bills, and property damage.

• Conduct searches on social media and utilize online data applications.

• Ascertain whether fraud can be validated and provide support for lawsuits.

• Make determinations regarding claims and pursue restitution.

• Oversee, investigate, and resolve intricate customer communications, concerns, conflicts, or issues.

• Verify investigation data and follow up on potential leads.

• Employ analytical tools or SIU field intelligence to pinpoint claims and bolster evidence of fraud and damages.

• Summarize documents and input claim system notes, evaluations, and decision-making processes.

• Enter SIU claim information into various SIU systems.

• Update files with outcomes of investigations and return files to MCO when necessary.

• Review investigations resulting in fraud outcomes to confirm whether denial is warranted.

⛳️ Requirements

• A minimum of 3 years of investigative experience (Preferred).

• Background investigation is essential.

• A dedicated, distraction-free workspace is required when working from home.

• Suitable desk and seating arrangements are necessary for remote work.

• Dependable internet connection with at least 50 MB download and 5 MB upload speeds.

• Allstate typically does not sponsor individuals for employment-based visas for this role.

🏝️ Benefits

• Comprehensive technology setup that includes a laptop, monitors, headset, keyboard, and mouse.

• Monthly connectivity reimbursement to assist with internet costs.