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At American Family Insurance Claims Services, Inc. we believe people are an organization?s most valuable asset, and their ideas and experiences matter. From our CEO to our agency force, we?re committed to growing a diverse and inclusive culture that empowers innovation that will inspire, protect, and restore our customers? dreams in ways never imagined.

American Family Insurance Claims Services, Inc is driven by our customers and employees. That?s why we provide more than just a job ? we provide opportunity. Whether you?re already part of our team in search of a new challenge or new to our company and ready for what?s next, you?re in the right place. Every dream is a journey that starts with a single step. Start your journey right here. Join our team. Bring your dreams.

Job ID:

Compensation may vary based on the job level and your geographic work location.

Compensation Minimum:$90,200

Compensation Maximum:$144,500

Summary:

Responsible for implementing effective insurance fraud control strategies and tactics in assigned territory that align with SIU?s mission and support its departmental strategic and operational goals. Leads and manages a team of investigators and vendor resources to ensure investigations are consistently performed in accordance with SIU guidelines and quality standards. Identifies developmental opportunities for direct reports and collaborates with them to create and implement appropriate action plans. Arranges effective fraud awareness / detection training that address current and emerging insurance fraud trends and schemes.

Job Description:

Primary Accountabilities

First Line Management / Leadership for Individual Unit (40%)

• Manages direct reports, systems, and projects to achieve unit goals in accordance with company policies and practices.
• Prepares and analyzes unit plans and reports.
• Provides leadership by exhibiting influence and expertise, thus affecting the results of the operating area.
• Creates an effective work environment by developing a common vision, setting clear objectives, expecting teamwork, recognizing outstanding performance, and maintaining open communications.
• Develops staff through coaching, providing performance feedback, providing effective performance reviews, and establishing development plans.

Investigation Operations (40%)

• Assesses investigator resource capabilities and capacity to determine resource needs.
• Identifies external expert and investigative resources, as needed, to supplement company resources and support the requirements of investigations.
• Monitors and reviews vendor investigation resources? work product for quality and timeliness.
• Implements and improves investigation guidelines.
• Works with investigators to ensure delivery of high quality investigations.
• Assists investigators in determining course and extent of investigative activity required for resolution of the case.

Anti-Fraud Program Development & Implementation (10%)

• Collaborates with SIU and business partners to develop and implement effective anit-fraud plans and strategies to identify, prevent and mitigated fraudulent claim losses.
• Communicates anti-fraud programs to appropriate business partners.
• Serves as anti-fraud expert to staff and internal / external business partners.
• Identifies and monitors fraud trends in the insurance industry.
• Collaborates with SIU fraud forensic analysts, examiners and business partners to proactively identify insurance fraud activity.
• Develops and maintains meaningful relationships with members of the insurance industry, law enforcement agencies, and anti-fraud organizations to gather and share information regarding fraud.
• Acts as anti-fraud subject matter expert and collaborates with appropriate training and educational resources to develop and deliver effective and appropriate anti-fraud training to SIU staff, internal / external business partners and customers.

Strategies Linked to the Division's Business Goals / Results (10%)

• Establishes, communicates, and implements departmental plans, objectives, and strategies.
• Participates as a member of the management team.
• Maintains an active awareness of American Family's business environments, corporate culture, and structure to support key decision making.

Certifications

• Acquired or working towards one or more related industry certifications (e.g. CIFI, CPCU, SCLA, AIC).

Specialized Knowledge and Skills Requirements

• Demonstrated experience providing customer-driven solutions, support or service
• Solid knowledge of P&C claims operations including claims processes, procedures, best practices, and service levels.
• Solid knowledge of P&C SIU operations to include processes, performance measures, strategies, insurance fraud schemes and associated indicators.
• Demonstrated experience investigating suspected insurance fraud activity involving P&C multi-line (Personal and Commercial) auto and property claims.
• Demonstrated experience developing and delivering anti-fraud detection training to internal (e.g. Claims) and external (e.g. Agents) business partners.
• Basic experience actively participating in SIU industry associations and collaborating with SIU industry peers to combat insurance fraud activity.
• Solid knowledge of appropriate federal, state and local laws, regulations and practices pertaining to states within designated operating territory.

Travel Requirements

• May be required to travel up to 5% of the time.
• Travel may be required to perform field related activities and attend job related meetings, seminars and training events

Additional Job Information:

The SIU Triage Manager is responsible for leading a multi-functional business unit responsible for utilizing data analytics and research investigation techniques to assess suspected questionable claims submitted by a variety of sources such as our Claims partners, predictive modeling tools, NICB, law enforcement, and agents.

The SIU Triage Manager actively participates in departmental strategy and tactical planning and decision making while collaborating with internal and external business partners to ensure optimization of our fraud detection systems. The desired candidate will possess the skills to lead people inclusively, lead as an intrapreneur and lead innovation.

When you work at American Family Insurance Claims Services you can expect benefits that support your physical, emotional, and financial wellbeing. You will have access to comprehensive medical, dental, vision and wellbeing benefits that enable you to take care of your health. We also offer a competitive 401(k) contribution, a pension plan, an annual incentive, and a paid-time off program. In addition, our student loan repayment program and paid-family leave are available to support our employees and their families. Interns and contingent workers are not eligible for American Family Enterprise benefits.

We also consider qualified applicants with criminal histories, consistent with applicable federal, state and local law.

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