Allstate
SIU Medical Provider Fraud Investigator
USA - TX (Remote)
No sponsorship$60k-$87kDetected 36 days ago
AuditingResearchCommunicationProblem SolvingOrganizational Skills
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odds of building a lasting career here
33Risky
Cap-exempt (no lottery)0
Sponsors this role65
Entry-level history0
PERM / green-card track0
Lottery odds (Level I)39
Fits your clock70
Thin sponsorship signal and lottery-bound (~15% per draw). A low-probability bet with your clock running. Prioritize cap-exempt roles and proven entry-level sponsors first.
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About the role
- This role is responsible for identifying suspicious medical provider businesses, attorneys, and law firms that may be connected for the purpose of generating fraudulent payments.
- The individual will conduct thorough investigations by identifying injured parties, billing trends, treatment sequences, attorney relationships, and claim reporting patterns.
- Responsibilities include conducting database searches, performing data mining, taking recorded statements, attending virtual depositions and mediations, and leading case investigation meetings.
Responsibilities
- Reviews investigations with fraud outcomes to validate whether denial is appropriate
- 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
- Failure to retain appropriate licensing could lead to disciplinary action up to and including termination of your employment.
Requirements
- In addition, you must maintain all licensing required for your role.
- The candidate(s) offered this position will be required to submit to a background investigation.
Skills
- Compensation
- Base compensation offered for this role is:
- SIU Cons I: $60,000.00 - $87,400.00/salary
- SIU Cons II: $62,100.00 - $92,700.00/salary
- Compensation is based on experience and qualifications.
- This includes any continuing education and/or other state-affiliated requirements for licensing renewal.
Compensation
- $60,000.00 - $87,400.00/salary
- $62,100.00 - $92,700.00/salary
- Total compensation for this role may include additional components, such as incentive pay (for example, commission or bonus), if applicable.
- Compensation is based on experience and qualifications.
- 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.
Benefits
- This poster summarizing the major provisions of the Family and Medical Leave Act (FMLA) and telling employees how to file a complaint.
- Conducts complex site inspections, including body shops, medical clinics, loss locations etc.
Company info
- We are seeking an experienced SIU Medical Provider Fraud Investigator, preferably located within the Central Time Zone, who holds an active Texas All-Lines Adjuster License or a reciprocal state license.
- Joining our team means being part of something bigger - a winning team making a meaningful impact.
- And for more than 90 years, our innovative drive has kept us a step ahead of our customers' evolving needs.
Equal opportunity
- To view the "EEO Know Your Rights" poster click " here ".
Visa & Work Authorization
- Allstate generally does not sponsor individuals for employment-based visas for this position
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This listing is sourced directly from Allstate's careers page and normalized into a canonical job model.