Manages special investigation unit and appraisal claims functions, including claim oversight, reserves, payments, litigated claim investigations, fraud compliance, reporting, vendor programs, expenses, training, and staff leadership. Develops operational plans, coaches employees, conducts performance reviews, recommends employment actions, and may lead cross-functional projects.
Summary: Under limited supervision and with significant independent judgment, supervises and coordinates the activities of the special investigation unit and the appraisers by performing the following duties:
Essential Duties and Responsibilities:
- Directs and manages the investigation and appraisal claims functions including:
- Oversees the management of all claims as assigned by function
- Approves reserves and payments within authority level
- Manages investigations of a litigated SIU claim and best practice/quality review
- Manage adjusting vendor programs that provide claims services as assigned, such as direct repair programs, ISO, independent adjusters, and desk audit.
- Manages Special Investigation Unit monthly reporting, compliance, anti-fraud plan, vendor management and expenses. Also oversees the following:
- Department Fraud Education
- New Hire SIU training
- Manages Appraiser monthly reporting, vendor management and expenses.
- Functions as a Supervisor of a business unit, either directly or through subordinate leaders, including but not limited to:
- Recommends and communicates goals. Directs operations to ensure the achievement of required results
- Develops, recommends, and implements operational plans and procedures
- Trains, coaches, and leads staff
- Prepares and/or reviews performance appraisals. Conducts performance review meetings
- May recommend and/or implement employment actions, including employment/termination, corrective action, promotions/demotions, salary changes, etc.
- May serve as a contributing member of project team(s), or leader of project team(s), coordinating resources to ensure achievement of project activities
- Performs other duties as assigned
Qualifications: To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
Education/Experience: Level 5: Bachelor’s degree (B.A.) from four-year college or university; or four to six years related experience and/or training; or equivalent combination of education and experience.
A minimum requirement for this position is the ability to work legally in the United States. No visa sponsorship/support is available for this position, including for any type of U.S. permanent residency (green card) process.
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