SIU Field Investigator - National General

National General; Chicago (IL); In loco; USD 69.000 - 118.000; Tempo pieno

Descrizione del lavoro

National General is seeking an experienced Special Investigative Unit Senior Consultant I to investigate and analyze complex fraud in Auto, Homeowners, and Specialty Lines. This field-based role covers a territory within approximately a three-hour radius of Chicago, IL.

Prior SIU experience is preferred and candidates should demonstrate a proven track record in identifying and resolving suspicious claims. The role involves conducting background checks, scene inspections, statements, medical and

Competenze

• Experience in investigative work or fraud detection is required.
• Ability to handle complex, multi-discipline investigations across multiple lines of business.

Mansioni

• Makes claim decisions regarding complex investigations and pursues restitution.
• Manages customer communications and resolves issues.
• Validates information gathered during investigations and follows up on leads.
• Conducts thorough investigations of complex claims to determine if payment is warranted.
• Uses SIU tools to identify claims for investigation and support evidence of fraud.

Conoscenze

Analytical Thinking

Claims Processing

Fraud Investigations

Witness Interviewing

Time Management

Descrizione del lavoro

National General is a part of The Allstate Corporation, which means we have the same innovative drive that keeps us a step ahead of our customers’ evolving needs. We offer home, auto and accident and health insurance, as well as other specialty niche insurance products, through a large network of independent insurance agents, as well as directly to consumers.

Job Description

The Special Investigative Unit Senior Consultant I is responsible for investigating and analyzing complex and occasionally highly 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 complex losses and claims involving extra-contractual liability, large fire and property 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 reviews whether fraud can be substantiated and supports a lawsuit.

We are seeking an experienced SIU Investigator to join our growing team! This role is responsible for conducting complex fraud investigations across multiple lines of business, including Auto, Homeowners, and Specialty Lines. This is a field-based position supporting a territory within approximately a three-hour radius of Chicago, IL. Prior investigative experience is required, with a strong preference for candidates who have a Special Investigations Unit (SIU) background and a proven track record of identifying, investigating, and resolving suspicious claims.

Key Responsibilities

• Makes claim decisions regarding complex and occasionally highly complex investigations, and pursues restitution
• Manages, researches, and resolves complex and occasionally highly complex customer communications, concerns, conflicts or issues
• Validates that the information provided and obtained through investigation is true and accurate and follows up on all possible leads
• Conducts thorough investigations of complex and occasionally highly complex multi-discipline claims and ECL claims that are potentially fraudulent to determine if payment is warranted
• Utilizes analytic tools or SIU field intelligence to identify complex and occasionally 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
• Enters SIU claim data information into multiple SIU systems
• Updates files with investigation outcome, and when no fraud, or if insufficient evidence is found, returns file to MCO for further handling and settlement
• Reviews investigations with fraud outcomes to validate whether denial is appropriate
• Conducts complex and occasionally highly complex online data application searches, research, and evaluation

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.

Skills

Analytical Thinking, Claims Processing, Collision Investigations, Collision Reconstruction, Critical Thinking, Decision Making, Evidence Gathering, Fraud Investigations, Information Collection, Insurance Claims Investigations, Insurance Investigation, Researching, Special Investigations, Surveillance Operations, Surveillance Techniques, Time Management, Witness Interviewing

Compensation

Base compensation offered for this role is:

Special Investigative Unit Consultant II: $62,100 - $105,300

Special Investigative Unit Sr Consultant I: $68,500- $117,700

Special Investigative Unit Sr Consultant II: $70,100 - $124,500

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.

Companies & Partners

Direct General Auto & Life, Personal Express Insurance, Century-National Insurance, ABC Insurance Agencies, NatGen Preferred, NatGen Premier, Seattle Specialty, National General Lender Services, ARS, RAC Insurance Partners, Mountain Valley Indemnity, New Jersey Skylands, Adirondack Insurance Exchange, VelaPoint, Quotit, HealthCompare, AHCP, NHIC, Healthcare Solutions Team, North Star Marketing, Euro Accident.

Benefits

National General Holdings Corp. is an Equal Opportunity (EO) employer – Veterans/Disabled and other protected categories. All qualified applicants will receive consideration for employment regardless of any characteristic protected by law. Candidates must possess authorization to work in the United States, as it is not our practice to sponsor individuals for work visas. In the event you need assistance or accommodation in completing your online application, please contact NGIC main office by phone at [phone].

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.

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.

For jobs in San Francisco, please click “here” for information regarding the San Francisco Fair Chance Ordinance.

For jobs in Los Angeles, please click “here” for information regarding the Los Angeles Fair Chance Initiative for Hiring Ordinance.

To view the “EEO Know Your Rights” poster click “here”. This poster provides information concerning the laws and procedures for filing complaints of violations of the laws with the Office of Federal Contract Compliance Programs.

To view the FMLA poster, click “here”. This poster summarizing the major provisions of the Family and Medical Leave Act (FMLA) and telling employees how to file a complaint.

It is the Company’s policy to employ the best qualified individuals available for all jobs. Therefore, any discriminatory action taken on account of an employee’s ancestry, age, color, disability, genetic information, gender, gender identity, gender expression, sexual and reproductive health decision, marital status, medical condition, military or veteran status, national origin, race (include traits historically associated with race, including, but not limited to, hair texture and protective hairstyles), religion (including religious dress), sex, or sexual orientation that adversely affects an employee's terms or conditions of employment is prohibited. This policy applies to all aspects of the employment relationship, including, but not limited to, hiring, training, salary administration, promotion, job assignment, benefits, discipline, and separation of employment.

National General Holdings Corp., a member of the Allstate family of companies, is headquartered in New York City. National General traces its roots to 1939, has a financial strength rating of A– (excellent) from A.M. Best, and provides personal and commercial automobile, homeowners, umbrella, recreational vehicle, motorcycle, supplemental health, and other niche insurance products. We are a specialty personal lines insurance holding company. Through our subsidiaries, we provide a variety of insurance products, including personal and commercial automobile, homeowners, umbrella, recreational vehicle, supplemental health, lender-placed and other niche insurance products.