SIU Desk Investigator

This is a fully remote position, open to applicants in Alabama, +40 more states.

📋 Description

• Investigate and evaluate intricate, multi-disciplinary coverage and claims referred to the Special Investigative Unit for potential fraud.

• Manage complex claims involving both attorney representation and unrepresented claims, as well as moderate to complex losses.

• Perform background checks, scene investigations, clinic evaluations, recorded statements, witness interviews, and social media assessments.

• Analyze medical records, invoices, and property damage reports.

• Conduct surveillance and create scene reconstructions as necessary.

• Assess whether fraud can be substantiated and assist in supporting lawsuits.

• Oversee claim review processes and decide when field investigations are warranted.

• Collaborate with vendors and provide recommendations to support claim resolutions.

• Input SIU claim information into various systems.

• Review fraud outcomes to confirm whether denial is justified.

• Update files with findings from investigations and return files to MCO when fraud is not verified or evidence is lacking.

• Execute complex online data searches, research, and evaluations.

• Validate information gathered through investigations and pursue leads effectively.

• Summarize documentation and maintain claim files with notes, evaluations, and decision-making processes.

• Utilize analytical tools and SIU field intelligence to identify complex claims and substantiate evidence of fraud and damages.

• Research and address complex customer communications, concerns, conflicts, or issues.

• No supervisory responsibilities are included.

⛳️ Requirements

• Licensed SIU Desk Investigator with relevant experience.

• Proven track record in conducting intricate fraud investigations across Auto, Homeowners, and Specialty Lines.

• Prior experience with Bodily Injury claims is preferred.

• Active insurance license holders must resign from all existing appointments prior to onboarding and may not hold external appointments during employment.

• Applicants with a resident producer license must relinquish that license as directed by the licensing team.

• A background investigation is mandatory.

• Must have a dedicated, private workspace that is free from distractions.

• Adequate desk and seating arrangement for remote work is required.

• Reliable internet connection with a minimum of 50 MB download and 5 MB upload speeds is necessary.

• Compliance with applicable insurance licensing regulations is required.

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

🏝️ Benefits

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

• Monthly connectivity reimbursement for eligible employees working from home.

• Flexible remote work arrangement.

• Incentive pay (commission, bonus, etc.) if applicable.