Investigator Jobs in Chicago, IL

About The Position

Requirements

• Prior investigative experience.
• Individuals who currently hold an active insurance license must terminate all existing appointments before onboarding and must not hold outside appointments during employment.
• Applicants seeking an adjuster role who hold a resident producer license must formally surrender that license when instructed by the licensing team.

Nice To Haves

• Special Investigations Unit (SIU) background.
• A proven track record of identifying, investigating, and resolving suspicious claims.

Responsibilities

• Make claim decisions regarding complex and occasionally highly complex investigations, and pursue restitution.
• Manage, research, and resolve complex customer communications, concerns, conflicts, and issues.
• Validate information obtained through investigations and follow up on all possible leads.
• Conduct thorough investigations of potentially fraudulent multi-discipline and extra-contractual liability claims to determine whether payment is warranted.
• Use analytic tools or SIU field intelligence to identify claims for investigation and support evidence of fraud and damages.
• Summarize documents and document claim files with notes, evaluations, and the decision-making process.
• Enter SIU claim data into multiple SIU systems.
• Update files with investigation outcomes and return files to MCO for further handling and settlement when no fraud or insufficient evidence is found.
• Review investigations with fraud outcomes to validate whether denial is appropriate.
• Conduct complex online data application searches, research, and evaluation.
• Conduct background and scene investigations, clinic inspections, recorded statements, witness interviews, and social media searches.
• Review and analyze medical notes, bills, and property damage.

Benefits

• Eligible employees who work from home receive a monthly connectivity reimbursement to help offset internet costs.
• Allstate provides a technology setup that includes a laptop, monitors, headset, keyboard, and mouse.