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About the Role
As an SIU Field Investigator, you’ll conduct detailed investigations, analyze claim information, identify potential fraud indicators, and gather the information needed to reach well-supported conclusions. You’ll use critical thinking, effective interviewing, research, and analytical skills to connect details and resolve questions that may not have an obvious answer. Whether analyzing information or conducting investigative work in the field, you’ll play an important role in helping ensure claims are handled appropriately while protecting customers and the business from potential fraud.
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
Requirements
- 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 (336) 435-2000.
- 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.
Skills
- Analytical Thinking
- Critical Thinking
- Decision Making
- Documentations
- Evidence Gathering
- Fraud Investigations
- Insurance Claims Investigations
- Interviewing
- Investigative Skills
- Problem Analysis
- Special Investigations
- Time Management
Location
- Northern California
- San Francisco
- Oakland
- San Jose
- Sacramento
Work Type
- Field-based
Experience Level
- Based on experience and qualifications
Salary/Compensations
- SIU Cons I: $60,000 - $87,400
- SIU Cons II: $62,100 - $92,700
Benefits
- 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.
About the Company
- 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.
- 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.
Equal Opportunity
- 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.
- 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.