SIU Compliance Coordinator

Description

Job Description:

Monitor account activity to detect possible fraud. Performs analysis to identify areas for process improvements and recommends to SIU Manager. This position works between the Compliance and the Special Investigation Unit (SIU). Incumbent will effectively manage the workload balancing SIU and Compliance functions.

Essential Duties and Responsibilities:

SIU/Fraud:

• FL 626 requests to and from other carriers.
• Complete DFS referral and maintains tracking of both state and client referrals.
• Requests documents from civil entities (police, fire, housing departments, experts, and court).
• Performs background/asset checks as requested.
• Complete error corrections as assigned.
• Answer phones, check voice mail regularly, and return calls as needed.
  
  

Compliance:

• Assists Compliance Department with Adjuster licensing verifications, reporting to all Unit Managers monthly.
• Assures required adjuster licenses are renewed timely.
• Process W-9’s and update the vendor table with approved vendors.
• Audits/verification of vendors submitted.
• Assist with Medicare and OFAC reporting/analysis.
• Completes and mails form letters as directed.
• Assists with compliance with state regulatory reporting requirements.
• Performs other assigned tasks or duties as required or directed.
  
  

Work Environment Requirements:

• This role requires extended periods of computer screen usage for tasks such as data entry, research, and virtual meetings.
• The ability to maintain focus and productivity while working for long hours in front of a screen is essential.
  
  

Qualification Requirements:

Education / Licensing:

• High School Diploma or GED required.
• FL Adjuster’s License preferred.
• 3 years superior customer service.
• Thorough knowledge of Claims 3 required.
• Bilingual abilities (Spanish) including translation a plus.
  
  

Technical Skills:

• Must possess excellent written and verbal communication skills.
• 2 years of data entry experience
• Must have a high level of interpersonal skills to handle sensitive and confidential situations and information.
• Advanced knowledge of a variety of computer software applications in word processing, spreadsheets, database, and presentation software. (Microsoft Office platform.)
• Superior phone skills
• Must be able to work independently and possess excellent written and verbal skills
  
  

Abilities:

• Reading Comprehension
• Basic Math and Accounting knowledge
• Familiar with claim files, commercial policies, and endorsements
• Position requires poise, tact, and diplomacy always.
• Must be able and agree to work overtime as needed, especially during a catastrophe.
• Must be able to communicate clearly and concisely with customers, claimants, and other involved parties.
• Requires long periods of sitting
• Requires consistent data entry / typing ability
• Repeated use of keyboard, mouse, and exposure to computer screen
• Requires working indoors in environmentally controlled conditions Requires lifting of files and boxes up to approximately 20 pounds