#JOB_POSTING-3-15203
tions (2) taking recorded statements; (3) reviewing and analyzing medical notes, bills, and property damage; and (4) conducting witness interviews and social media searches.
Key Responsibilities:
Researches and responds to complex customer communications, concerns, conflicts or issues
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
Conducts thorough investigations of complex that are potentially fraudulent to determine if payment is warranted
Validates that the information provided and obtained through investigation is true and accurate and follows up on all possible leads
Conducts complex online data application searches, research, and evaluation
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
Enters SIU claim data information into multiple SIU systems
Makes claim decisions regarding complex investigations, and pursues restitution
This role handles claims in New York and New England
Preferred Qualifications:
Bachelor's Degree or equivalent preferred
SIU experience preferred
3 years NY or NY/NE claims handling experience required
PIP and MED PAY experience is a plus
Licensing in NY and/or NE states preferred
Certificates, Licenses, Registrations:
For the NY/NE position, New England licenses in CT, MA and RI are preferred
For the NY position, NY licensing is preferred
Notes:
The preceding description is not designed to be a complete list of all duties and responsibilities. May be required to perform other related duties as assigned. Regular, predictable attendance is an essential function of this job.
#LI-AC3
Skills
Analytical Thinking, Casualty Insurance, Communication, Customer Interactions, Customer Service, Evidence Gathering, Insurance Fraud Investigations, Negotiation, Researching, Special Investigations
Compensation
Compensation offered for this role is $56,500.00 - 99,962.50 annually and is based on experience and qualifications.
The candidate(s) offered this position will be required to submit to a background investigation.
Joining our team isn't just a job - it's an opportunity. One that takes your skills and pushes them to the next level. One that encourages you to challenge the status quo. And one where you can impact the future for the greater good.
You'll do all this in a flexible environment that embraces connection and belonging. And with the recognition of several inclusivity and diversity awards, we've proven that Allstate empowers everyone to lead, drive change and give back where they work and live.
Good Hands. Greater Together.
Allstate generally does not sponsor individuals for employment-based visas for this position.
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