Remote SIU Desk Investigator: Fraud & Claims Analysis

Allstate Corporation; Texas; Hybrid; USD 62,000 - 105,000; Full time

Job summary

Allstate Corporation is seeking a Special Investigative Unit Desk Investigator II to analyze and investigate complex, multi-discipline coverage and claims for potential fraud. This remote, desk-based role involves review of medical notes, demand packages, and coordination with vendors to support claim decisions.

Ideal candidates have Bodily Injury claims experience and strong analytical and investigative skills, with the ability to conduct surveillance and site inspections as needed.

Qualifications

• Experience investigating complex fraud in multi-discipline coverage and claims.
• Ability to conduct background searches, scene investigations, and interviews.
• Proficiency with SIU data systems and documentation practices.

Responsibilities

• Enters SIU claim data information into multiple SIU systems.
• Reviews investigations with fraud outcomes to validate denial appropriateness.
• Updates files with investigation outcomes and returns files if no fraud is found.
• Conducts complex online data searches, research, and evaluation.
• Conducts complex site inspections, including body shops and clinics.
• Investigates potentially fraudulent cases to assess payment validity.
• Summarizes documents and records notes in claim systems.
• Uses SIU tools to identify complex claims for investigation.
• Responds to complex customer communications and concerns.

Skills

Analytical Thinking

Bodily Injury Claims

Claims Processing

Complex Claims

Critical Thinking

Evidence Gathering

Fraud Investigations

Investigative Skills

Surveillance

Witness Interviewing

Job description

Allstate Corporation is seeking a Special Investigative Unit Desk Investigator II to analyze and investigate complex, multi-discipline coverage and claims for potential fraud. This remote, desk-based role involves review of medical notes, demand packages, and coordination with vendors to support claim decisions.

Ideal candidates have Bodily Injury claims experience and strong analytical and investigative skills, with the ability to conduct surveillance and site inspections as needed.