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Core Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates expertise in conducting complex fraud investigations, particularly in Auto, Homeowners, and Specialty Lines, while utilizing analytic tools and SIU field intelligence to substantiate claims. Proficient in managing claim reviews, coordinating with vendors, and validating investigation outcomes to support decision-making processes.
Highest-signal resume keywords
Licensed SIU Desk InvestigatorComplex Fraud InvestigationsBodily Injury Claims ExperienceAnalytic Tools ProficiencyInsurance Licensing Compliance
ATS Keywords
Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills
Fraud InvestigationClaims AnalysisBackground SearchesScene InvestigationsMedical Notes ReviewSurveillance TechniquesData EvaluationDocument SummarizationClaim Data EntryField Investigation Management
Soft Skills
Attention to DetailProblem-SolvingCommunication SkillsConflict ResolutionResearch Skills
Certifications & Qualifications
Active Insurance License
Industry Keywords
Special Investigative UnitAuto InsuranceHomeowners InsuranceSpecialty LinesClaims Management
About the role
Key responsibilities & impact- Investigate and analyze complex, multi-discipline coverage and claims referred to the Special Investigative Unit for potential fraud
- Handle complex attorney-represented and unrepresented claims and moderate to complex losses
- Conduct background searches, scene investigations, clinic inspections, recorded statements, witness interviews, and social media searches
- Review and analyze medical notes, bills, and property damage
- Conduct surveillance and create scene reconstructions as needed
- Determine whether fraud can be substantiated and support lawsuits
- Manage claim review and determine when field investigation is needed
- Coordinate with vendors and provide recommendations supporting claim decisions
- Enter SIU claim data into multiple systems
- Review fraud outcomes to validate whether denial is appropriate
- Update files with investigation outcomes and return files to MCO when fraud is not established or evidence is insufficient
- Conduct complex online data searches, research, and evaluation
- Validate information obtained through investigations and follow up on leads
- Summarize documents and document claim files with notes, evaluations, and decision-making processes
- Use analytic tools and SIU field intelligence to identify complex claims and support evidence of fraud and damages
- Research and respond to complex customer communications, concerns, conflicts, or issues
- No supervisory duties
Requirements
What you’ll need- Experienced licensed SIU Desk Investigator
- Experience conducting complex fraud investigations across Auto, Homeowners, and Specialty Lines
- Prior Bodily Injury claims experience preferred
- Active insurance license holders must terminate all existing appointments before onboarding and must not hold outside appointments during employment
- Applicants with a resident producer license must surrender that license when instructed by the licensing team
- Background investigation required
- Dedicated, private workspace free from distractions
- Appropriate desk and seating for working from home
- Reliable internet with minimum speeds of 50 MB download and 5 MB upload
- Must comply with applicable insurance licensing requirements
- Allstate generally does not sponsor individuals for employment-based visas for this position
Benefits
Comp & perks- Comprehensive technology setup including a laptop, monitors, headset, keyboard, and mouse
- Monthly connectivity reimbursement for employees eligible to work from home
- Remote work arrangement
- Incentive pay (commission, bonus, etc.) if applicable
