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

The Medicare Adjuster role supports the Medicare Mail Adjusting Team, and is responsible for handling the medical portion of auto accident claims under personal injury protection (PIP) and/or medical payment benefits (and some liability claims), where policy limits or company exposure are limited. The adjuster determines coverage, assesses medical claims and bills, investigates potential fraud, explains coverage, and follows up on ongoing treatments.

The role typically involves handling minor to moderate claims independently, with occasional guidance on more complex cases. The adjuster applies best practice processes to Medicare mail handling, lien resolution, and related correspondence involving Medicare, Medicare Advantage Plans, Medicaid, and other entities. Responsibilities also include verifying policy coverage and limits, determining reserves, and resolving eligible claims. The position involves managing Medicare lien letters, open debt cases, and participating in special projects related to governmental lien resolution.

The adjuster is expected to maintain and update Medicare Section 111 Electronic Reporting and contribute to continuous improvement of Medicare processes. This individual works independently, prioritizes responsibilities, manages workload, and consistently meets performance, quality, and customer service goals, delivering compassionate service that is fast, fair, and easy to ensure customer retention.

Candidates should be comfortable with the possibility of phone communication as part of their duties.

Key Responsibilities

• Determines claim value

• Sets initial reserve, updates reserve, documents rationale and claim summary notes

• Summarizes documents and enters into claim system notes, documenting a claim file with notes, evaluations and decision-making process

• Takes recorded statements from claimants, insureds, witnesses, medical providers, etc., conducts investigations into minor and moderate auto accidents, determines liability, and prepares summaries

• Negotiates and settles claims in accordance with business unit best practices

Education

• 4 year Bachelors Degree (Preferred)

Experience

• 0-2 years experience (Preferred)

Supervisory Responsibilities

• This job does not have supervisory duties.

Education & Experience (in lieu)

• In lieu of the above education requirements, an equivalent combination of education and experience may be considered.

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Skills

Analytical Decision Making, Business Communications, Claims Negotiations, Critical Thinking, Customer Satisfaction, Fraud Investigations, Information Collection, Medicare Claims, Medicare Regulations, Self-Starter, Time Management

Compensation

Compensation offered for this role is $44,000.00 - 67,227.50 annually and is based on experience and qualifications.

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.

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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.