Senior Investigator Consultant
2 weeks ago
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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