Senior SIU Consultant

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. 

Job Description

The Senior Consultant II – Fraud Analyst analyzes highly complex fraud patterns and the organization’s exposure to fraudulent claims, identifying patterns of suspected fraud and recommending appropriate cases for prosecution. The role leverages investigative data, analytical tools, and industry intelligence to identify emerging fraud risks and trends across multiple claims and entities. Once patterns are identified, the individual determines the appropriate course of action and oversees investigations and related litigation activities.

National General is seeking a Senior Consultant II – Fraud Analyst to join our Special Investigations Unit (SIU) and play a key role in detecting and disrupting complex fraud schemes. In this role, you will analyze large volumes of investigative data, leverage data mining, and link analysis tools to identify suspicious activity and evaluate potential fraud risks across claims.

Conducts in-depth reviews—including medical provider analysis—monitoring industry alerts to identify potential exposure and producing detailed reports and presentations that communicate investigative findings and recommendations.

Collaborates closely with claims teams, investigators, management, fraud bureaus, law enforcement, and industry anti-fraud organizations, while also building strong partnerships with SIU investigators within your territory.

Additionally, you will help evaluate business practices and workflows, providing data-driven recommendations to improve operational efficiency and reduce organizational risk, all while maintaining the highest standards of confidentiality and professional integrity.

Key Responsibilities

• May serve as MCO liaison

• Summarizes documents and enters into claim system notes

• Analyzes legal bills to assess appropriateness of charges and detect duplicate billing

• Interacts and exchanges information with claim personnel, investigators, management, fraud bureaus, law enforcement, and industry anti-fraud groups

• Analyzes highly complex investigation data involving multiple claims and multiple entities participating in the fraudulent schemes

• Documents a claim file with notes, evaluations, and decision-making process

• Acts as a resource to management on highly complex analyses of claim fraud data and activity

• Works with counsel and Corporate Lit Counsel on discovery and interrogatory responses

• Directs and facilitates with litigation counsel consistent handling on the underlying claims along with the global case

• Designated as the Corporate Representative 30 (b) (6) both as to the person with the most knowledge and responsible for articulating damage calculation to include but not limited to case specific policy, practices, and procedures

Supervisory Responsibilities

• This job does not have supervisory duties.

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Skills

Claims Documentation, Claims Evaluation, Claims Management System, Claims Review, Fraud Analysis, Fraud Analytics, Fraud Auditing, Fraud Detection, Fraud Investigation, Fraud Investigations, Fraud Litigation, Fraud Monitoring, Insurance Claims, Insurance Fraud

 

Compensation

Base compensation offered for this role is: 

SIU Sr Cons I: $62,100-92,700

SIU Sr Cons II: $65,600-98,200

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.

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.

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 re