ESIS Supervisor, SIU

JOB DESCRIPTION

The SIU Supervisor is responsible for overseeing the daily operations of the Special Investigations Unit (SIU), ensuring the delivery of high-quality fraud investigation services across all lines of business.

This role provides technical leadership, manages vendor partner relationships, ensures compliance with state regulatory requirements and SIU best practices, and drives revenue and quality performance results.

The SIU Supervisor reports to the SIU SVP and serves as a key liaison between internal claims operations, external clients, account executives, and vendor partners.

Quality & Technical Performance



* Achieve and maintain quality results that consistently meet or exceed established SIU Best Practices.


* Contribute to achieving the annual SIU revenue goal by driving effective fraud detection and cost containment outcomes.


* Ensure SIU compliance with Best Practices and applicable controls.


* Maintain an aged job queue and diary where no item exceeds 7 days from the current date; apply appropriate diary cycles to each case based on its development.


* Ensure accurate and timely management of the OFAC screening process and provide guidance as required.


* Proactively identify trends impacting quality and workflows and recommend process improvements to leadership.


* Harbor and coordinate relationships with the Department of Insurance, District Attorneys and the Attorney General agencies to include gathering claim request for copies of documents which include coordination with our internal counsel.

Reporting & Analytics



* Review all carrier and client data call reports in a timely manner (annual, quarterly, monthly, and weekly).


* Distribute accurate and timely audit metrics to carriers, clients, and internal customers.


* Provide monthly performance and trend reports to the SIU SVP, summarizing results, positive and negative findings, and recommended next steps.


* Responsible for weekly, monthly, and quarterly financial reporting to both internal and external stakeholders.

Vendor Management



* Cultivate strong relationships with SIU vendor partners to ensure accountability to account Service Level Agreements (SLAs).


* Perform vendor Quality Reviews and develop action plans as required, conduct follow-up calls with any vendor.


* Evaluate monthly data provided by vendor partners for accuracy and identify opportunities for improvement in reporting and quality.


* Review vendor invoices and reports for quality and accuracy to ensure work product meets client and claims handler expectations.


* Continue to identify new revenue-generating products available through internal and external SIU resources (e.g., SSN death indicator research, social media research tools).

Stakeholder Relations & Customer Service



* Maintain solid business relationships with key internal and external contacts, including ESIS claims offices, Sales staff, clients, and A...