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Job Details

SIU Manager

Location
Los Angeles, CA

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Profile

APEX Investigation is a leader in Insurance, Workers' Compensation, Liability and Human Resource Investigations. Our experience investigating thousands of cases, and our ability to adapt to the ever-changing laws impacting our clients gives APEX the leading edge in defending frivolous, exaggerated or fraudulent claims. We are currently seeking qualified candidates for the following full-time position:
The SIU Director will lead the company’s SIU division. This position is responsible for the oversight and management of all aspects within the department. Responsibilities include management of SIU investigators, evaluating and updating processes and procedures to improve efficiency, conducting SIU investigations, completing and submitting suspected fraudulent claim forms to appropriate agencies, assisting law enforcement on suspected fraudulent claims, updating clients on status of cases, conducting ongoing anti-fraud training with contracted clients, attending client meetings, conducting in person SIU evaluations at client offices, completing quarterly statistical reporting, invoicing, and reviewing reports for accuracy and content. The SIU Director will work closely with other department directors including surveillance, claims, sales and background to evaluate existing cases for suspected fraud.
Job Duties
Provide on-going training to all Investigators
Assign new cases to Investigators
Consistently monitor SIU investigations
Implement investigation best practices
Administer verbal and written write-ups when necessary
Continually update the training manual to improve efficiency and effectiveness of investigations.
Complete 90 day and yearly reviews
Review all final reports
Invoice cases
Establish goals for staff based KPIs
Attend client meetings
Conduct anti-fraud training for clients
Conduct in person SIU file reviews at client sites
Develop investigative action plans
Interfacing with clients, insureds, claimants, defense attorneys and law enforcement
Conduct continuing education training with clients (when required)
Providing testimony (when required)
SIU Packaging
FD-1 Submission
Traveling in local region up to 10%
Other duties as assigned
Requirements and Qualifications
Minimum 3 years SIU experience in the areas of Workers’ Compensation
Bachelor’s degree preferred, but substantial insurance carrier, technical claim, or criminal detective experience may be substituted in lieu of formal education
Prior law enforcement experience is preferred
Experience in identifying and validating red flags within a claim, fraud schemes, and legal indicators of fraud within a claim during file review or field investigation.
Understanding of insurance policies to include terms, conditions, exclusions, limits of liability, and subrogation
Experience discussing investigative findings and making recommendations to clients, defense attorneys, departments of insurance fraud divisions, etc.
Strong computer skills using Word, Excel, Power Point and Outlook. Ability to learn new software operating systems.
Strong presentation and speaking skills
The ideal candidate possesses the following:
· Strong work ethic
· Detail oriented and organized
· Excellent verbal and written communication skills
· Strong problem solving skills
· Ability to multi-task
· Use of effective time management and organization skills
· Ability to take initiative and work independently
· Proficient in Microsoft Word
· Bilingual (Spanish) is a plus
Benefits:
Medical
Dental
Vision
Chiropractic
PTO
FSA
Simple IRA Plan
After making a conditional offer of employment, the company will conduct a job-related background check. A comprehensive background check may consist of prior employment verification, motor vehicle records, professional reference checks, education confirmation and/ or criminal record and credit checks. Third-party services will be hired to perform these checks.
**After an offer is made and accepted, E-verify will be utilized to establish your identity and employment eligibility as required by the U.S. Department of Homeland Security.
Company Description
APEX Investigation is a leader in Insurance, Workers' Compensation, Liability and Human Resource Investigations. Our experience investigating thousands of cases, and our ability to adapt to the ever-changing laws impacting our clients gives APEX the leading edge in defending frivolous, exaggerated or fraudulent claims.
Location/Region: Los Angeles, CA (US)
Posted on
ZipRecruiter Prime
2018-08-11

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