SIU Operations Specialist
About The Position
The SIU Operations Specialist supports Special Investigations Unit (SIU) operations by managing daily investigative workflows, reviewing and triaging claim alerts, and ensuring timely identification and assignment of items requiring SIU involvement. The position also supports Claims leadership by coordinating administrative activities, managing system access, assisting with calls, and organizing team events. The role performs investigations as directed, using resources such as ISO, NICB, TLO, internet searches, and similar tools. It requires research, analysis, and decision-making to process non-routine claims data, along with effective collaboration with Claims, other departments, and external customers.
Requirements
- Typically requires at least two years of professional experience demonstrating competence and organization in managing projects, programs, and interactions with others.
- Demonstrate proficiency with Microsoft Word, Excel, Outlook, and Teams.
- Demonstrate the ability to research, analyze, and make decisions to process non-routine claims data.
- Exhibit superior interpersonal skills to develop and maintain effective working relationships with Claims, other departments, and external customers.
- Demonstrate analytical, decision-making, negotiation, and customer service skills.
- Work independently, manage time effectively, maintain schedules, and meet deadlines.
- Ability to perform essential functions of the job, with or without a reasonable accommodation.
Nice To Haves
- Claims department experience with detailed knowledge of department policies, procedures, and operations is typically preferred.
Responsibilities
- Manage daily investigative workflows supporting SIU operations.
- Review and triage claim alerts, identifying and assigning items requiring SIU involvement in a timely manner.
- Coordinate administrative activities for Claims leadership.
- Manage system access and assist with calls.
- Organize team events.
- Perform investigations as directed, including ISO, NICB, TLO, internet, and similar searches.
- Research, analyze, and make decisions to process non-routine claims data.
Benefits
- Health, dental, voluntary vision, and prescription drug insurance
- Savings and profit sharing 401(k)
- Paid time off for sick and personal leave, vacation, and holidays
- Vitality Wellness Program
- “Dress for Your Day” dress code
- Flexible scheduling
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Education Level
No Education Listed
