SIU PIP Investigator

Allstate

23h • $60,000 - $92,700

About The Position

At Allstate, great things happen when our people work together to protect families and their belongings from life’s uncertainties. And for more than 90 years, our innovative drive has kept us a step ahead of our customers’ evolving needs. From advocating for seat belts, air bags and graduated driving laws, to being an industry leader in pricing sophistication, telematics, and, more recently, device and identity protection. This job is responsible for investigating and analyzing complex Michigan PIP claims that have been referred to the special investigation unit (SIU) for potential fraud. This role typically handles a combination of complex attorney represented and unrepresented claims and moderate to complex 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 conducts surveillance on property and/or creates scene reconstructions on some investigations and reviews whether fraud can be substantiated and supports a lawsuit. The individual provides work guidance and direction to less senior employees and provides mentoring and coaching to the team. The ideal candidate is detail‑oriented, proactive, and adaptable, with the ability to manage multiple priorities in a fast‑paced environment. You bring a strong understanding of PIP regulations, demonstrate sound judgment, and consistently apply a thorough, analytical approach to claim investigations.

Requirements

• Detail-oriented
• Proactive
• Adaptable
• Ability to manage multiple priorities in a fast-paced environment
• Strong understanding of PIP regulations
• Demonstrate sound judgment
• Consistently apply a thorough, analytical approach to claim investigations
• Analytical Thinking
• Auto Insurance Claims
• Evidence Gathering
• Fraud Investigations
• Insurance Claims Investigations
• Personal Injury Protection
• Ability to submit to a background investigation

Nice To Haves

• Experience handling Michigan state PIP claims is highly desirable

Responsibilities

• Enters SIU claim data information into multiple SIU systems
• 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
• Conducts complex online data application searches, research, and evaluation
• Conducts complex site inspections, including body shops, medical clinics, loss locations etc.
• Conducts thorough investigations of complex that are potentially fraudulent to determine if payment is warranted, including scene investigations and surveillance as needed
• Validates that the information provided and obtained through investigation is true and accurate and follows up on all possible leads
• 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
• Researches and responds to complex customer communications, concerns, conflicts or issues

Benefits

• Total compensation for this role may include additional components, such as incentive pay (for example, commission or bonus)
• An environment that fosters innovative thinking where you’ll be able to explore your ideas and feel proud of the work you do
• Opportunity to find meaning and value in work

What This Job Offers

• Job Type: Full-time
• Career Level: Senior
• Education Level: No Education Listed