Senior Investigator Consultant

2 weeks ago


Orlando, Florida, United States Allstate Insurance Company Full time
Job Description

Job Title: Senior Investigator Consultant

Job Summary:

We are seeking a highly skilled and experienced Senior Investigator Consultant to join our team at Allstate Insurance Company. As a Senior Investigator Consultant, you will be responsible for investigating and analyzing complex and occasionally highly complex, multi-discipline coverage and claims that have been referred to the special investigation unit (SIU) for potential fraud.

Key Responsibilities:

  • Conduct thorough investigations of complex and occasionally highly complex multi-discipline claims and ECL claims that are potentially fraudulent to determine if payment is warranted.
  • Utilize 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.
  • Makes claim decisions regarding complex and occasionally highly complex investigations, and pursues restitution.
  • 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.

Requirements:

  • 4 year Bachelors Degree (Preferred).
  • 3 or more years of experience (Preferred).

Compensation: $62,050.00 annually and is based on experience and qualifications.



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