Evaluation Consultant

Description :

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Think that working in the insurance field can’t be exciting, rewarding and challenging? Think again. You’ll help us reinvent protection and retirement to improve customers’ lives. We’ll help you make an impact with our training and mentoring offerings. Here, you’ll have the opportunity to expand and apply your skills in ways you never thought possible. And you’ll have fun doing it. Join a company of individuals with hopes, plans and passions, all using and developing our talents for good, at work and in life.

Job Description

Allstate Insurance Company has an exceptional career opportunity for an Evaluation Consultant in Farmington Hills, MI!

Do you enjoy helping in leading a team and providing beneficial knowledge that will take their jobs to the next level? This is a specialized position within the Michigan Personal Injury Protection (MI PIP) MCO that will be responsible for oversight of the MCO file review process that includes, but is not limited to: completing oversight reviews, Reviewing Catastrophic PIP and other complex claims, MCCA process compliance reviews and coaching adjusters for improvement.

As an Evaluation Consultant in the MI PIP MCO, your job will be to support leadership in operational improvements through the development and completion of compliance and file reviews. You will analyze and review results to determine underlying root casues of operational pressures, communicate findings to leadership and will use employee coaching and action planning. In this role, you will practice operational policies and procedures and effectively convey your knowledge to the leadership staff. Compliance and SOX reviews are a very integral part of the work we do, due to our interaction with the Michigan Assigned Claims Association. Thus accuracy is a critical component of the work and reviews that need to be completed. The ideal candidate will be proficient in first party benefits, Legacy, Mitchell, Decision Point, have an understanding of the MCCA process which includes billed and unbilled aging dollars, the MMS platform and reporting, and other claim handling processes as it relates to PIP.

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
  • Manages, researches and resolves complex and occasionally highly complex customer communications, concerns, conflicts or issues
  • Reviews customer satisfaction results; recommends, designs and implements personal and business unit action plan

Training – Develop and Deliver

  • Ability to coordinate, facilitate and deliver education and unit needs via-stand up instruction, webcasts, and teleconferencing
  • Instructional design experience preferred
  • Must be willing to travel for business needs
  • Microsoft Office profieciency required (Excel, PowerPoint, and Outlook)
  • With inpurt from more experienced Team Leads and/or CSLs, provides coaching/mentoring and feedback
  • Documents a claim file with notes, evaluations and decision making process

Other Projects and Responsibilities

  • May participate in one or more complex special assignments
  • May serve as a committee team lead for medium-sized projects or as a committee team member on large projects
  • May serve as a subrogation or arbitration panelist
  • May participate in Horizontal, Vertical, or Targeted Reviews
  • Researches, responds to, or participates in Department of Insurance complaints or investigations
  • Participates in or leads Telephone Alert Conferences regarding complex claims referred to Home Office
  • Reviews files and makes recommendations to refer files to Home Office for escalation
  • May lead roundtable and/or calibration discussions

Job Qualifications

Job Requirements:

  • Bachelor’s degree in related field preferred or equivalent experience
  • 3 to 5 years of Personal Injury Protection experience
  • Ability to interact effectively, and coach others on interacting effectively, with internal or external customers and act with empathy
  • Applies broad knowledge of insurance policy, coverage, regulation, and MCCA processes and information
  • Applies broad knowledge of claim processes, policies, procedures, claim systems, coverage, liability, damage estimating, and/or settlement, and adherence to applicable legal compliance standards
  • Applies broad industry knowledge to discipline practices, including best practices, to support the business units
  • Applies broad knowledge of analytical procedures to reconcile, manipulate, and recognize patterns of data as it relates to the MCCA work completed in the MCO
  • Applies broad knowledge of problem solving and preparation of reports for analysis
  • Applies broad ability to leverage learned technical skills in support of team objectives
  • Applies broad negotiation and/or arbitration skills
  • Applies broad conflict management and problem resolution skills in managing internal and external customer relationships
  • Applies broad problem solving skills to continuously improve business outcomes
  • Applies broad knowledge of training facilitation and coaching skills
  • Ability to investigate, evaluate and settle complex claims
  • Provides broad individual decision making within authority limits

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 that’s 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, you’ll 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 see the notice regarding the San Francisco Fair Chance 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.


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