The Claims Supervisor, SIU will oversee the operation of a unit of SIU Investigators and Analysts with varying levels of experience who handle investigations on suspect claim and underwriting matters. The ideal candidate will be experienced in Supervising and handling complex SIU investigative activities across all claim coverage types in accordance with current state and federal regulatory laws.
Essential Duties and Responsibilities
Direct and control the work of remote SIU Investigators and Analysts.
Establish and monitor unit goals for service, production and work quality.
Plan unit workflow and monitor assignment of cases to unit members based on complexity, severity, and volume.
Promote teamwork through effective leadership.
Review active and closed files in compliance with Quality Assurance program to identify trends, provide direction, and provide feedback to unit.
Facilitate effective anti-fraud training to meet established internal and regulatory annual requirements
Analyze data and trends for emerging issues and enhanced referral opportunities.
Assist in the preparation of mandatory state SIU filings.
Conduct performance reviews and counseling sessions.
Monitor attendance and write performance appraisals.
Make recommendations for promotions, staff changes, and salary.
Effectively partner with claim and underwriting staff to achieve established fraud detection, prevention and awareness goals.
Qualifications and Education
A Bachelor's Degree (B.A.) from a four year college or university and/or 3-4 years related experience and/or training which must include PIP, Casualty and prior supervision of an SIU team
Experience in NY, NJ and PA jurisdictions preferred
SIU affiliated professional designation preferred (FCLS,SCLA, CFE, CIFI)
Major case and litigation experience preferred
Able to work in a fast paced environment and multi-task.
Strong critical thinking and problem solving skills
Able to exercise independent judgement
Must have strong verbal and written communication skills, experience with presentations and public speaking a must
Have a working knowledge of claim applications, including Image Right, Stream, and the Microsoft Office Suite of products