Internal Claims Fraud Discovery Unit Manager

Description :

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Job Description

The Internal Claims Fraud Discovery Unit is responsible for detecting instances of improper claim handling and improving the system of preventative and detective controls related to internal fraud.

The role oversees the program to audit Allstate national claims operations to identify improper claim handling and payment activity. The individual maintains a comprehensive risk assessment and oversees development and delivery of the annual engagement plan. This role ensures that the audit plan is delivered on schedule, that all audit engagements meet quality standards, all stakeholders are informed timely of status and findings, and all issues are properly handled. On a regular basis, this role applies their knowledge, insights and objectivity to help the claims organization evaluate the design and effectiveness of controls and strategies for fraud prevention, detection, and response.

Risk Management and Compliance

  • Oversees a team of auditors focused on identifying and measuring risks and performing audit procedures to detect instances of improper claim handling practices.
  • Ensures engagements are properly scoped based on a well-informed understanding of risks, the claims organization, and claim handling practices.
  • Independently develops annual audit plan based on advanced knowledge of risks and changes in the enterprise and industry
  • Ensures the annual audit plan is delivered and any changes are communicated timely
  • Coordinates extensively with parnters throughout the organization to obtain informed perspectives on priorities and risks and to ensure all stakeholders are well informed of plans, activities, findings, and risks
  • Drives response and escalates findings and risks to proper levels of leadership as deemed necessary to protect company interests
  • Reviews engagement plans, testing workpapers, engagement findings, engagement reports, and other work products for quality and ensures deadlines are met
  • Provides regular reporting on risk assessment developments, engagement planning and status, engagement outcomes, tracking of open issues, themes, etc.
  • Demonstrates excellent verbal and written communication and exhibits strong partnering skills and ability to interact with various levels of management and stakeholders
  • Acts as a subject matter expert on internal fraud, auditing, claim handling practices and documentation, and Allstate fraud and compliance issue handling best practices
  • Trains staff and partners on skills that support key capabilities such as risk assessment, substantive and analytical audit testing, control design best practices, professional/technical writing, influencing, etc.

Job Qualifications

  • Bachelor's degree and advanced training in related field preferred
  • Three to seven years of experience leading teams in a claims or audit role, or related experience
  • Prior experience conducting meetings and preparing and delivering presentations to line, middle and senior management
  • CFE designation a plus, or willingness to obtain CFE certification
  • Strong written and verbal communication skills
  • Flexible, adaptable and comfortable with the unknown
  • Highly advanced skill in motivation, organization, training, coaching and facilitation of teamwork
  • Highly advanced knowledge of problem solving and preparation of complex reports for analysis
  • Highly advanced ability to leverage learned technical skills in support of team objectives

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.

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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.

For jobs in Los Angeles, please seethe notice regarding the Los Angeles 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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