SIU Investigation Senior Adjuster

Jacksonville 1776senior

Other

0 views0 saves0 applied

Apply Now

Quick Summary

Key Responsibilities

SIU Field Adjuster Sr Cons II: $70,000 - $138,600 and is based on experience and

Technical Tools

Other

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.

This job is responsible for investigating and analyzing highly complex, multi-discipline coverage and 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 large or significant losses and claims involving highly complex extra-contractual liability, large fire and property losses where 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; (4) and conducting witness interviews and social media searches. The individual reviews whether fraud can be substantiated and supports a lawsuit. At this level, the individual is expected to handle the most complex or specialized claims or claims involving significant dollar exposure or customers.

Responsibilities

~1 min read

• Oversees file quality Investigative Consultant

• Makes claim decisions regarding highly complex investigations, and pursues restitution

• Manages vendor relationship and oversees vendor performance

• Conducts highly complex online data application searches, research, and evaluation

• Conducts thorough investigations of highly complex, multi-discipline claims and Excess Coverage Liability (ECL) claims that are potentially fraudulent to determine if payment is warranted

• Reviews investigations with fraud outcomes to validate whether denial is appropriate

• Conducts highly complex site inspections, including body shops, medical clinics, loss locations etc.

• Manages, researches, and resolves highly complex customer communications, concerns, conflicts or issues

• Utilizes analytic tools or SIU field intelligence to identify highly complex claims for investigation and/or for support in the evidence of the fraud and damages

• Summarizes documents and enters into claim system notes, documenting a claim file with notes, evaluations and decision making process

• This job does not have supervisory duties.

• 4 year Bachelors Degree (Preferred)

• 3 or more years of experience (Preferred)

Claims Processing, Critical Thinking, Fraud Investigations, Information Collection, Insurance Investigation

What We Offer

~2 min read

Base compensation offered for this role is:
SIU Field Adjuster Sr Cons II: $70,000 - $138,600 and is based on experience and qualifications. Total compensation for this role is comprised of several factors, including the base compensation outlined above, plus incentive pay (i.e. commission, bonus, etc.) if applicable for the role.
As a requirement of employment, individuals who currently hold an active insurance license must terminate all existing appointments prior to onboarding and must not hold any outside appointments at any point during employment. Applicants seeking an adjuster role who also hold a resident producer license must formally surrender that license when instructed to by the licensing team. By proceeding with the application process, applicants acknowledge and accept these licensing requirements and agree to comply.

Direct General Auto & Life, Personal Express Insurance, Century-National Insurance, ABC Insurance Agencies, NatGen Preferred, NatGen Premier, Seattle Specialty, National General Lender Services, ARS, RAC Insurance Partners, Mountain Valley Indemnity, New Jersey Skylands, Adirondack Insurance Exchange, VelaPoint, Quotit, HealthCompare, AHCP, NHIC, Healthcare Solutions Team, North Star Marketing, Euro Accident.

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. 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.

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.

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.

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.