Job Description
This job is responsible for investigating and analyzing 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 large or significant losses and claims involving highly complex extra-contractual liability, large fire and property losses where 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; (4) and conducting witness interviews and social media searches. The individual reviews whether fraud can be substantiated and supports a lawsuit. At this level, the individual is expected to handle the most complex or specialized claims or claims involving significant dollar exposure or customers.

We are seeking an experienced SIU Investigator to join our team! This territory covers Northeast Florida, with a strong preference for candidates located near Jacksonville, FL. Candidates residing in Jacksonville or within a reasonable daily commuting distance will be well-positioned to support the assigned region.
Key Responsibilities
• Oversees file quality Investigative Consultant
• Makes claim decisions regarding highly complex investigations, and pursues restitution
• Manages vendor relationship and oversees vendor performance
• Conducts highly complex online data application searches, research, and evaluation
• Conducts thorough investigations of highly complex, multi-discipline claims and Excess Coverage Liability (ECL) claims that are potentially fraudulent to determine if payment is warranted
• Reviews investigations with fraud outcomes to validate whether denial is appropriate
• Conducts highly complex site inspections, including body shops, medical clinics, loss locations etc.
• Manages, researches, and resolves highly complex customer communications, concerns, conflicts or issues
• Utilizes analytic tools or SIU field intelligence to identify highly complex claims for investigation and/or for support in the evidence of the fraud and damages
• Summarizes documents and enters into claim system notes, documenting a claim file with notes, evaluations and decision making process

Education
• 4 year Bachelors Degree (Preferred)

Experience
• 3 or more years of experience (Preferred)

Supervisory Responsibilities
• This job does not have supervisory duties.

Skills
Claims Processing, Critical Thinking, Fraud Investigations, Information Collection, Insurance Investigation

Compensation
Base compensation offered for this role is:
SIU Field Adjuster Sr Cons II: $70,000 - $138,600 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.
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.

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.