SIU Desk Investigator

Job Description
The Special Investigative Unit Consultant II is responsible for investigating and analyzing complex, multi-discipline coverage and claims that have been referred to the Special Investigative Unit (SIU) for potential fraud. The 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.

We are seeking an experienced licensed SIU Desk Investigator to conduct complex fraud investigations across Auto, Homeowners, and Specialty Lines. This remote desk-based role manages multiple aspects of the investigative process, including claim review, determining when field investigation is needed, coordinating with vendors, and providing recommendations to support claim decisions. A significant portion of the caseload may involve injury claims, prior Bodily Injury claims experience is preferred.

Key Responsibilities

• Enters SIU claim data information into multiple SIU systems
• 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
• Conducts complex online data application searches, research, and evaluation
• Conducts complex site inspections, including body shops, medical clinics, loss locations etc.
• 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
• 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
• Researches and responds to complex customer communications, concerns, conflicts or issues

Supervisory Responsibilities

• This job does not have supervisory duties.

As a requirement of employment, individuals who currently hold an active insurance license must terminate all existing appointments prior to onboarding and must not hold any outside appointments at any point during employment. Applicants seeking an adjuster role who also hold a resident producer license must formally surrender that license when instructed to by the licensing team. By proceeding with the application process, applicants acknowledge and accept these licensing requirements and agree to comply.

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Skills
Analytical Thinking, Bodily Injury Claims, Claims Processing, Complex Claims, Critical Thinking, Documentations, Empathy, Evidence Gathering, Fraud Investigations, Information Collection, Insurance Claims Investigations, Insurance Investigation, Investigative Skills, Personal Injury Claims, Soft Tissue, Special Investigations, Surveillance, Witness Interviewing

Compensation
Base compensation offered for this role is:

Special Investigative Unit Consultant I: $60,000 - $98,450
Special Investigative Unit Consultant II: $62,100 - $105,300
Special Investigative Unit Sr Consultant I: $68,500- $117,700

Annually and is based on experience and qualifications. Total compensation for this role is comprised of several factors, including the base compensation outlined above, plus incentive pay (i.e. commission, bonus, etc.) if applicable for the role.

The candidate(s) offered this position will be required to submit to a background investigation.

Allstate provides a comprehensive technology setup, including a laptop, monitors, headset, keyboard, and mouse. Employees eligible to work from home also receive a monthly connectivity reimbursement to help offset internet costs.

When working from home, you must have a dedicated, private workspace free from distractions, along with appropriate desk and seating. Reliable internet is required, with minimum speeds of 50 MB download and 5 MB upload.

To help create a more personal and engaging experience, we ask that you join with your camera on if your interview is virtual. Please also have a Valid Photo Identification available at the start of your interview. If you require any accommodations or have questions ahead of your interview please reach out to your recruiter.

Note: Internal candidates are only asked to join on video; a Valid Photo Identification is not needed for the interview.