Allstate
SIU Medical Provider Fraud Investigator
Key aspects of the role:
- Drive sales growth by engaging with interested prospective customers- all while working remote
- No cold calling— Connect through inbound calls and proactive outbound calls with active insurance shoppers
- Enjoy competitive compensation with a base salary + uncapped performance-based incentives
- Sell reputable products from Allstate and our family of brands
Role overview
At Allstate, great things happen when our people work together to protect families and their belongings from life’s uncertainties. And for more than 90 years, our innovative drive has kept us a step ahead of our customers’ evolving needs. From advocating for seat belts, air bags and graduated driving laws, to being an industry leader in pricing sophistication, telematics, and, more recently, device and identity protection.
Job Description
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. This role typically handles bodily injury claim files, including both non-litigation and litigation matters.
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. The ideal candidate brings a strong investigative mindset with the ability to identify suspicious patterns, conduct complex medical provider fraud investigations, and thoroughly document findings. Success in this role requires exceptional organizational skills, attention to detail, analytical thinking, and the ability to manage multiple investigations effectively. Strong written and verbal communication skills are essential, along with the ability to collaborate with internal partners and present investigative findings in a clear, concise, and professional manner.
Key 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
Supervisory Responsibilities
-
This job does not have supervisory duties.
#LI-AS
Skills
Analytical Thinking, Complex Claims, Fraud Investigations, Healthcare Fraud Prevention, Insurance Claims Investigations, Insurance Fraud, Litigation, Medical Codes, Medical Malpractice, Medical Record Auditing, Witness Interviewing
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. Total compensation for this role may include additional components, such as incentive pay (for example, commission or bonus), if applicable.
Notice of Licensing Requirement: As a condition of employment, you are expected to satisfy licensing requirements. Failure to complete these requirements within the time frame designated by the hiring department may result in the recommendation to terminate your employment with National General Insurance, an Allstate Insurance Company. In addition, you must maintain all licensing required for your role. This includes any continuing education and/or other state-affiliated requirements for licensing renewal. Failure to retain appropriate licensing could lead to disciplinary action up to and including termination of your employment. In addition, you must agree to surrender any currently held resident license (producer or adjuster) that is inconsistent with your role at National General Insurance and terminate all non-Allstate appointments upon being hired for any role within Allstate Insurance Company.
The candidate(s) offered this position will be required to submit to a background investigation.
Joining our team isn’t just a job — it’s an opportunity. One that takes your skills and pushes them to the next level. One that encourages you to challenge the status quo. One where you can shape the future of protection while supporting causes that mean the most to you. Joining our team means being part of something bigger – a winning team making a meaningful impact.
Allstate generally does not sponsor individuals for employment-based visas for this position.
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.
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.
Keys to Success
At Allstate, it’s all about teamwork, flexibility, and thinking ahead. We all contribute to the bigger picture, combining unique ideas to design innovative, more affordable protection solutions for customers.
We look for candidates with these skills to help us achieve that goal:
Learning agility
Quickly adapt to new situations, continually build new skills, experiment, and embrace new ways of doing things
Customer centricity
Deliver exceptional experience with a customer-first mindset and human-centered design
Digital literacy
Discover and apply emerging digital technology tools, data and insights.
Results-oriented
Start with measurable outcomes and drive results with speed
Inclusive leadership
Integrate diverse viewpoints into decision-making processes to enhance creativity and innovation
Together, we’re all working toward Our Shared Purpose, using our strengths to make a real difference for our people, our customers, our company, and the world around us.
Working in Sales
What We Do:
As an expert on our products and services, you can give customers personalized attention and innovative solutions to make their lives easier.
How We Support You:
Starting day one, you’ll have access to resources and incentives to keep you feeling challenged and excited about your careers.
Make An Impact:
As a member of our sales team, you’ll bring a sense of ease and support to customers looking for a better understanding of their protection options. Whether in the field or talking to customers over the phone, you’ll continue to build trust in who we are and what we do.
Working together
You’re in Good Hands® is more than a promise we make to our customers. It’s a promise we make to our employees, too.
We want you to love where you work. That starts with the freedom to be yourself. Our workplace flexibility and focus on individuality means everyone is seen, heard and respected.
When you join us, you’ll have the opportunity to push your skills to the next level with access to development programs to support your career aspirations – whatever that means for you. Because as you learn and grow, so do we.
Working here also means getting the chance to make a real impact in your community. We have been driving change for over 90 years, but the mark we leave on the world can be even greater when we work together.
Role overview
At Allstate, great things happen when our people work together to protect families and their belongings from life’s uncertainties. And for more than 90 years, our innovative drive has kept us a step ahead of our customers’ evolving needs. From advocating for seat belts, air bags and graduated driving laws, to being an industry leader in pricing sophistication, telematics, and, more recently, device and identity protection.
Job Description
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. This role typically handles bodily injury claim files, including both non-litigation and litigation matters.
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. The ideal candidate brings a strong investigative mindset with the ability to identify suspicious patterns, conduct complex medical provider fraud investigations, and thoroughly document findings. Success in this role requires exceptional organizational skills, attention to detail, analytical thinking, and the ability to manage multiple investigations effectively. Strong written and verbal communication skills are essential, along with the ability to collaborate with internal partners and present investigative findings in a clear, concise, and professional manner.
Key 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
Supervisory Responsibilities
-
This job does not have supervisory duties.
#LI-AS
Skills
Analytical Thinking, Complex Claims, Fraud Investigations, Healthcare Fraud Prevention, Insurance Claims Investigations, Insurance Fraud, Litigation, Medical Codes, Medical Malpractice, Medical Record Auditing, Witness Interviewing
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. Total compensation for this role may include additional components, such as incentive pay (for example, commission or bonus), if applicable.
Notice of Licensing Requirement: As a condition of employment, you are expected to satisfy licensing requirements. Failure to complete these requirements within the time frame designated by the hiring department may result in the recommendation to terminate your employment with National General Insurance, an Allstate Insurance Company. In addition, you must maintain all licensing required for your role. This includes any continuing education and/or other state-affiliated requirements for licensing renewal. Failure to retain appropriate licensing could lead to disciplinary action up to and including termination of your employment. In addition, you must agree to surrender any currently held resident license (producer or adjuster) that is inconsistent with your role at National General Insurance and terminate all non-Allstate appointments upon being hired for any role within Allstate Insurance Company.
The candidate(s) offered this position will be required to submit to a background investigation.
Joining our team isn’t just a job — it’s an opportunity. One that takes your skills and pushes them to the next level. One that encourages you to challenge the status quo. One where you can shape the future of protection while supporting causes that mean the most to you. Joining our team means being part of something bigger – a winning team making a meaningful impact.
Allstate generally does not sponsor individuals for employment-based visas for this position.
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.
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.
Keys to Success
At Allstate, it’s all about teamwork, flexibility, and thinking ahead. We all contribute to the bigger picture, combining unique ideas to design innovative, more affordable protection solutions for customers.
We look for candidates with these skills to help us achieve that goal:
Learning agility
Quickly adapt to new situations, continually build new skills, experiment, and embrace new ways of doing things
Customer centricity
Deliver exceptional experience with a customer-first mindset and human-centered design
Digital literacy
Discover and apply emerging digital technology tools, data and insights.
Results-oriented
Start with measurable outcomes and drive results with speed
Inclusive leadership
Integrate diverse viewpoints into decision-making processes to enhance creativity and innovation
Together, we’re all working toward Our Shared Purpose, using our strengths to make a real difference for our people, our customers, our company, and the world around us.
Working in Claims
What We Do:
Your ability to quickly and calmly make smart decisions can make a huge difference in how confident customers feel throughout the claims process. And as you support our customers, we’re there to support you.
How We Support You:
We empower your success starting day one. You’ll have access to everything you need to grow professionally while helping our customers get their lives back on track.
Make An Impact:
Helping customers with their claims is about learning their stories, not just processing their paperwork. You can take pride in the fact that you’re providing invaluable guidance and helping to build continued trust in our company.
Working together
You’re in Good Hands® is more than a promise we make to our customers. It’s a promise we make to our employees, too.
We want you to love where you work. That starts with the freedom to be yourself. Our workplace flexibility and focus on individuality means everyone is seen, heard and respected.
When you join us, you’ll have the opportunity to push your skills to the next level with access to development programs to support your career aspirations – whatever that means for you. Because as you learn and grow, so do we.
Working here also means getting the chance to make a real impact in your community. We have been driving change for over 90 years, but the mark we leave on the world can be even greater when we work together.
Role overview
At Allstate, great things happen when our people work together to protect families and their belongings from life’s uncertainties. And for more than 90 years, our innovative drive has kept us a step ahead of our customers’ evolving needs. From advocating for seat belts, air bags and graduated driving laws, to being an industry leader in pricing sophistication, telematics, and, more recently, device and identity protection.
Job Description
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. This role typically handles bodily injury claim files, including both non-litigation and litigation matters.
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. The ideal candidate brings a strong investigative mindset with the ability to identify suspicious patterns, conduct complex medical provider fraud investigations, and thoroughly document findings. Success in this role requires exceptional organizational skills, attention to detail, analytical thinking, and the ability to manage multiple investigations effectively. Strong written and verbal communication skills are essential, along with the ability to collaborate with internal partners and present investigative findings in a clear, concise, and professional manner.
Key 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
Supervisory Responsibilities
-
This job does not have supervisory duties.
#LI-AS
Skills
Analytical Thinking, Complex Claims, Fraud Investigations, Healthcare Fraud Prevention, Insurance Claims Investigations, Insurance Fraud, Litigation, Medical Codes, Medical Malpractice, Medical Record Auditing, Witness Interviewing
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. Total compensation for this role may include additional components, such as incentive pay (for example, commission or bonus), if applicable.
Notice of Licensing Requirement: As a condition of employment, you are expected to satisfy licensing requirements. Failure to complete these requirements within the time frame designated by the hiring department may result in the recommendation to terminate your employment with National General Insurance, an Allstate Insurance Company. In addition, you must maintain all licensing required for your role. This includes any continuing education and/or other state-affiliated requirements for licensing renewal. Failure to retain appropriate licensing could lead to disciplinary action up to and including termination of your employment. In addition, you must agree to surrender any currently held resident license (producer or adjuster) that is inconsistent with your role at National General Insurance and terminate all non-Allstate appointments upon being hired for any role within Allstate Insurance Company.
The candidate(s) offered this position will be required to submit to a background investigation.
Joining our team isn’t just a job — it’s an opportunity. One that takes your skills and pushes them to the next level. One that encourages you to challenge the status quo. One where you can shape the future of protection while supporting causes that mean the most to you. Joining our team means being part of something bigger – a winning team making a meaningful impact.
Allstate generally does not sponsor individuals for employment-based visas for this position.
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.
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.
Keys to Success
At Allstate, it’s all about teamwork, flexibility, and thinking ahead. We all contribute to the bigger picture, combining unique ideas to design innovative, more affordable protection solutions for customers.
We look for candidates with these skills to help us achieve that goal:
Learning agility
Quickly adapt to new situations, continually build new skills, experiment, and embrace new ways of doing things
Customer centricity
Deliver exceptional experience with a customer-first mindset and human-centered design
Digital literacy
Discover and apply emerging digital technology tools, data and insights.
Results-oriented
Start with measurable outcomes and drive results with speed
Inclusive leadership
Integrate diverse viewpoints into decision-making processes to enhance creativity and innovation
Together, we’re all working toward Our Shared Purpose, using our strengths to make a real difference for our people, our customers, our company, and the world around us.
Working together
You’re in Good Hands® is more than a promise we make to our customers. It’s a promise we make to our employees, too.
We want you to love where you work. That starts with the freedom to be yourself. Our workplace flexibility and focus on individuality means everyone is seen, heard and respected.
When you join us, you’ll have the opportunity to push your skills to the next level with access to development programs to support your career aspirations – whatever that means for you. Because as you learn and grow, so do we.
Working here also means getting the chance to make a real impact in your community. We have been driving change for over 90 years, but the mark we leave on the world can be even greater when we work together.
Benefits
Experience the benefits that make Allstate a great place to work.
*Benefits vary based on position.
Health
- Medical, dental and vision coverage
- HSAs and FSAs
- Wellbeing programs
- Free therapy sessions
Retirement
- 401(k) plan
- Pension plan
- Free financial counseling
Work-life balance
- Paid time off
- Work flexibility
Career development
- Talent shares
- Tuition reimbursement
- Learning opportunities
For a full description of Allstate’s benefits visit our benefits page
Start making a difference
Realize your full potential by doing
work that matters.
Grow your career in meaningful ways.
We want to make sure you have every opportunity to grow, explore new horizons and follow your passion in a meaningful career. It’s an exciting time to join Allstate. Help us shape the future.
Ryan / 8 years with Allstate
Business Architect Lead Consultant
June 2025 – Present
Anthony / 11 years with Allstate
New Agent Leader- EA Channel
February 2026 – Present
Michael / 25 years with Allstate
Property Delivery Director
2023 – Present/Remote
Bree / 11 years with Allstate
Unrepresented Bodily Injury Adjuster
December 2022 – Present
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