Siu Specialist

AF Group

United States
Base: $73,600 to $123,200; bonus/equity: not speci...
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California department of insurance compliance
Vendor management for field investigations
Medical provider fraud investigation oversight
** The SIU Specialist position at AF Group focuses on managing vendor-conducted investigations, specifically for California claims, ensuring compliance with relevant laws and regulations. The role includes conducting fraud investigations, overseeing quality assurance, and providing training and mentorship within the Special Investigations Unit. **

Job Summary

  • The primary focus of this role is the development and management of vendor-conducted Special Investigations Unit (SIU) investigations while ensuring strict adherence to California laws and regulations.
  • The specialist is responsible for analyzing intelligence, conducting desk investigations, managing external vendors for field work, and developing medical provider fraud investigations.
  • This position requires a minimum of seven years of law enforcement or insurance claims investigation experience with a strong emphasis on California-specific regulatory reporting and compliance.

Matching Summary

Match Score: 75

** The SIU Specialist position at AF Group focuses on managing vendor-conducted investigations, specifically for California claims, ensuring compliance with relevant laws and regulations. The role includes conducting fraud investigations, overseeing quality assurance, and providing training and mentorship within the Special Investigations Unit. **

Salary

Base: $73,600 to $123,200; Bonus/Equity: Not specified; Benefits: Not specified

Skills & Requirements

Must-have

  • California Department of Insurance compliance
  • Vendor management for field investigations
  • Medical provider fraud investigation oversight
  • Annual budget development and monitoring
  • Desk and field investigation execution

Nice-to-have

  • Workers' compensation experience preferred
  • Property/casualty insurance organization background
  • Certification in fraud investigation highly preferred
  • Leadership and mentoring capabilities
  • Advanced presentation skills

Key Requirements

  • Bachelor's degree required
  • Minimum 7 years law enforcement or insurance claims investigation experience
  • Valid driver's license with acceptable record
  • Knowledge of civil and criminal insurance fraud laws

Work Rights

Not specified

Tailored Resume

Cover Letter