Job Description

The world isnt standing still, and neither is Allstate. Were moving quickly, looking across our businesses and brands and taking bold steps to better serve customers evolving needs. Thats why now is an exciting time to join our team. As a leader in a corporation with 83,000 employees and agency force members, youll have a hand in transforming not only Allstate but a dynamic industry. Youll have opportunities to take risks, challenge the status quo and shape the future for the greater good.

Youll do all this in an environment of excellence and the highest ethical standards a place where values such as integrity, inclusive diversity and accountability are paramount. We empower every employee to lead, drive change and give back where they work and live. Our people are our greatest strength, and we work as one team in service of our customers and communities.

Everything we do at Allstate is driven by a shared purpose: to protect people from lifes uncertainties so they can realize their hopes and dreams. For 89 years weve thrived by staying a step ahead of whatevers coming next to give customers peace of mind no matter what changes they face. We acted with conviction to advocate for seat belts, air bags and graduated driving laws. We help give survivors of domestic violence a voice through financial empowerment. Weve been an industry leader in pricing sophistication, telematics, digital photo claims and, more recently, device and identity protection. We are the Good Hands. We dont follow the trends. We set them.

Job Description

Allstate Insurance Company has an exciting opportunity for a Casualty PIP Adjuster in Farmington Hills, MI!

Under general supervision, this job is responsible for handling the medical portion of auto accident claims for the insured or other injured parties found to be eligible under a personal injury protection and/or medical payment benefits where the policy limits or exposure to the company is limited and occasionally when the policy limits or exposure to the company is moderate. This individual determines coverage and assesses medical claims, evaluates medical bills, and initiates or reviews potential fraud investigations as warranted. The individual explains coverage, negotiates and settles claims, and follows up with the customer on continuing treatments while delivering compassionate service that is fast, fair, and easy, to ensure customer retention. At this level, the individual typically negotiates and settles moderately complex claims, such as claims in less regulated and occasionally moderately regulated states (or in some situations more complex claims with guidance as needed). The individual is capable of working independently, prioritizing the individual's own responsibilities, and managing the individual's own workload. The individual also consistently meets band level behaviors, production, quality, and/or customer service goals.

The Adjusting Function is responsible for verifying policy coverage and limits. The Adjusting function investigates and evaluates damage and/or liability; estimates damages, losses, or total indemnity; sets and maintains reserves; and/or negotiates and settles claims. First party claims involve coverage determination, investigation, negotiation, and resolution of eligible injured parties' claims.

Key Responsibilities

Customer Service

* Makes and maintains a connection with the customer by understanding and meeting their needs; serves the customer with empathy; and follows up to ensure that customer needs have been met
* Researches and responds to moderately complex customer communications, concerns, conflicts or issues

File Documentation and Reporting

* Summarizes documents and enters into claim system notes
* Documents a claim file with notes, evaluations and decision making process
* Processes medical bills and recognizes medical management opportunities

Medical Management (1st Party)

* Assesses medical/physical condition and prior injuries of claimant, and obtains and analyzes medical bills, wage loss reviews, home service or attendant care, mileage payments, and other related claims to determine reasonableness of charges and relation of injuries to accident, and to ensure compliance with fee schedules, and detect duplicate billing
* Conducts first party file processing/fact gathering, including interviewing claimant, witnesses, medical providers, etc.
* Evaluates medical records and treatment plan of claimant and determines if continued treatment is reasonable
* Sets up IME and reviews results
* Investigates, reviews, and accepts or rejects moderately complex coverage and other potential coverage; and investigates coverage denial questions
* Determines appropriate benefit and negotiates and settles moderately complex claims, including resolution of moderately complex usual and customary billings
* Monitors treatment and benefit payments for excessive, unreasonable, or abusive claims
* Handles specialized claims

Other Projects and Responsibilities

* May participate in one or more moderately complex special assignments
* May serve as a committee team lead for smaller projects or as a committee team member on medium projects
* Reviews subpoenas and non-complex demands (e.g., Florida demands)
* May serve as an agent advocate
* May prepare and negotiate moderately complex subrogation issues or arbitrations

Compensation Data

The salary for this position will be based on experience but starts at $46,700.

Job Qualifications

The work hours for this role will be either 8am - 4:30pm or 9am - 5:30pm.

As a condition of employment, your office/area may require you to obtain an adjuster and/or an appraiser license. If required, the Hiring Manager will work with you along with the Centralized Licensing team to ensure that you are properly licensed.

* 3-5 years of PIP claims handling experience is preferred
* Litigation claims handling experience is preferred
* High School Diploma/GED is required
* Ability to interact effectively with internal or external customers and act with empathy
* Applies general knowledge of insurance policy, coverage, and regulation
* Applies general knowledge of claim processes, policies, procedures, claim systems, coverage, liability, damage estimating, and/or settlement, and adherence to applicable legal compliance standards
* Applies general industry knowledge to discipline practices, including best practices, to support the business unit
* Applies general knowledge of analytical procedures to reconcile, manipulate, and recognize patterns of data
* Applies general knowledge of standardized problem solving and preparation of basic reports for analysis
* Applies general ability to leverage learned technical skills in support of team objectives
* Applies general negotiation and/or arbitration skills
* Applies general conflict management and problem resolution skills in managing internal and external customer relationships
* Ability to investigate, evaluate negotiate and settle moderately complex claims
* Provides individual decision making within authority limits
* Has and maintains all appropriate licenses and registrations for the role per state requirements

The candidate(s) offered this position will be required to submit to a background investigation, which includes a drug screen.

Good Work. Good Life. Good Hands.

As a Fortune 100 company and industry leader, we provide a competitive salary but thats just the beginning. Our Total Rewards package also offers benefits like tuition assistance, medical and dental insurance, as well as a robust pension and 401(k). Plus, youll have access to a wide variety of programs to help you balance your work and personal life -- including a generous paid time off policy.

Learn more about life at Allstate. Connect with us on Twitter, Facebook, Instagram and LinkedIn or watch a video.

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.

It is the policy of Allstate to employ the best qualified individuals available for all jobs without regard to race, color, religion, sex, age, national origin, sexual orientation, gender identity/gender expression, disability, and citizenship status as a veteran with a disability or veteran of the Vietnam Era.