The world isn’t standing still, and neither is allstateWe’re moving quickly, looking across our businesses and brands and taking bold steps to better serve customers’ evolving needsThat’s why now is an exciting time to join our teamYou’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 paramountWe empower every employee to lead, drive change and give back where they work and liveOur 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 dreamsFor 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 faceWe acted with conviction to advocate for seat belts, air bags and graduated driving lawsWe help give survivors of domestic violence a voice through financial empowermentWe’ve been an industry leader in pricing sophistication, telematics, digital photo claims and, more recently, device and identity protectionWe are the good handsWe don’t follow the trendsWe set them.
Job description
The adjusting function is responsible for verifying policy coverage and limitsThe adjusting function investigates and evaluates damage and/or liability; estimates damages, losses, or total indemnity; sets and maintains reserves; and/or negotiates and settles claimsSpecial investigative unit (siu) work is performed by a specialized unit that proactively utilizes analytical tools to handle the most complex or specialized claims possibly in litigation and works with specialized counsel and law enforcement to detect, investigate, prosecute and deter fraud.
This is a b1 openingIf you are currently a b1, this move would be lateral.
Under limited supervision, this job is responsible for investigating and analyzing moderately complex and occasionally complex, multi-discipline coverage and claims that have been referred to the special investigation unit (siu) for potential fraudThis role typically handles moderately complex and occasionally complex unrepresented and occasionally attorney represented claims and small losses (property)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 analysis; and (4) conducting witness interviews and social media searchesThe individual conducts surveillance on property and/or creates scene reconstructions on some investigationsThe individual reviews whether fraud can be substantiated and supports a lawsuitThe individual provides work guidance and direction to less senior employeesThe individual also delivers compassionate service that is fast, fair, and easy, to ensure customer retentionThe individual works independently, prioritizing the individual`s own responsibilities, and managing the individual`s own workloadThe individual also consistently meets band level behaviors, production, quality, and/or customer service goals.
Key responsibilities
Customer service
Makes and maintains a connection with the customer by understanding and meeting their needs; serves the customer with empathy; and follows up to ensure that customer needs have been met
Researches and responds to moderately complex and occasionally complex customer communications, concerns, conflicts or issues
Reviews customer satisfaction results; works independently to create personal action plans
File documentation and reporting
Summarizes documents and enters into claim system notes
Documents a claim file with notes, evaluations and decision making process
Siu (post-referral)
Verifies loss facts and coverage
Utilizes analytic tools or siu field intelligence to identify moderately complex and occasionally complex claims for investigation and/or for support in the evidence of the fraud and damages
Attends industry, law enforcement and nicb meetings to obtain information on latest fraud schemes
Conducts thorough investigations of moderately complex and occasionally complex, multi-discipline claims 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
Has frequent customer interaction of a moderately complex and occasionally complex nature, including taking statements, responding to document requests and handling complaints
Conducts moderately complex and occasionally complex online data application searches, research, and evaluation
Conducts moderately complex and occasionally complex site inspections, including body shops, medical clinics, loss locations etc.
Collaborates with retained and staff counsel to develop strategies for advancing the investigation
Reviews investigations with fraud outcomes to validate whether denial is appropriate
Works in conjunction with law enforcement, as needed, on moderately complex and occasionally complex matters to pursue criminal charges if warranted
Updates files with investigation outcome, and when no fraud, or if insufficient evidence is found, returns file to mco for further handling and settlement
Enters siu claim data information into multiple siu systems
Notifies appropriate state agencies, industry databases, and underwriting regarding fraud outcomes
Makes claim decisions regarding moderately complex and occasionally complex investigations, and pursues restitution
Utilizes applications/tools to analyze claim information and other data to reveal hidden patterns of activity across multiple claims
Key responsibilities
Legal bill reviewer
Applies legal billing guidelines
Achieves acceptable legal bill review variance to re-reviews
Achieves acceptable turn-around time compared to the country-wide average
Other projects and responsibilities
May participate in one or more moderately complex or occasionally complex special assignments
May serve as a committee team lead for medium-sized projects or as a committee team member on medium to large projects involving complex case work
Manages vendor relationship and oversees vendor performance
May serve as mco liaison
Facilitates training on fraud awareness for mcos and industry personnel
Knowledge/skills/abilities/experience
Bachelors degree in related field preferred or equivalent experience
Ability to interact effectively with internal or external customers and act with empathy
Applies general and occasionally broad knowledge of insurance policy, coverage, and regulation
Applies general and occasionally broad knowledge of claim processes, policies, procedures, claim systems, coverage, liability, damage estimating, and/or settlement, and adherence to applicable legal compliance standards
Applies general and occasionally broad industry knowledge to discipline practices, including best practices, to support the business unit
Applies general and occasionally broad knowledge of analytical procedures to reconcile, manipulate, and recognize patterns of data
Applies general and occasionally broad knowledge of problem solving and preparation of reports for analysis
Applies general and occasionally broad ability to leverage learned technical skills in support of team objectives
Applies general and occasionally broad negotiation and/or arbitration skills
Applies general and occasionally broad conflict management and problem resolution skills in managing internal and external customer relationships
Applies general and occasionally broad problem solving skills to continuously improve business outcomes
Ability to investigate, evaluate, negotiate and settle moderately complex and occasionally complex claims
Provides individual decision making within authority limits
Has and maintains all appropriate licenses and registrations for the role per state requirements
The candidate(s) offered this position will be required to submit to a background investigation, which includes a drug screen.
Good workGood lifeGood hands®.
As a fortune 100 company and industry leader, we provide a competitive salary – but that’s just the beginningOur 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 policyFor a full description of allstate’s benefits, visit allstate.jobs/benefits/
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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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