... SIU resources for further investigation. * Achieves quality standards by appropriately managing ... Reporting Relationship Typically Director or above Skills, Knowledge & Abilities * Thorough ...
... SIU resources for further investigation. * Achieves quality standards by appropriately managing ... Reporting Relationship Typically Director or above Skills, Knowledge & Abilities * Thorough ...
Identify losses which should be reported to SIU. * Participates in special projects or assists ... Ability to influence claims stakeholders and to effectively direct claims strategy * Strong vendor ...
Identify losses which should be reported to SIU. * Participates in special projects or assists ... Ability to influence claims stakeholders and to effectively direct claims strategy * Strong vendor ...
Siu Director information
What are the key skills and qualifications needed to thrive in the Siu Director position, and why are they important?
To thrive as a SIU Director (Special Investigations Unit Director), you need a deep understanding of insurance claims processes, fraud detection methodologies, and a relevant bachelor's degree—often in criminal justice, finance, or a related field. Familiarity with fraud analytics software, case management systems, and certifications such as Certified Fraud Examiner (CFE) or Accredited Healthcare Fraud Investigator (AHFI) are commonly required. Strong leadership, analytical thinking, effective communication, and decision-making skills set exceptional SIU Directors apart. These skills ensure the effective management of complex investigations, compliance with legal standards, and the protection of company assets.
What is a SIU Director job?
A SIU (Special Investigations Unit) Director oversees and manages an organization's fraud detection and investigative functions, typically within insurance companies or healthcare organizations. They develop strategies to identify, investigate, and prevent fraudulent activities while ensuring compliance with regulations. The role involves leading a team of investigators, coordinating with law enforcement, and implementing policies to mitigate risks. Strong analytical, leadership, and regulatory knowledge are essential for success in this position.
What are some typical challenges faced by an SIU Director, and how can I succeed in managing them?
SIU Directors often handle complex, high-profile investigations involving insurance fraud, which can require balancing thorough analysis with timely decision-making under pressure. Managing a team of investigators, coordinating with law enforcement, and ensuring all investigations comply with evolving regulatory standards are frequent challenges in this role. Success comes from maintaining up-to-date knowledge of industry trends, fostering a collaborative team environment, and employing advanced analytical tools to detect and prevent potential fraud. SIU Directors who excel at cross-departmental communication and proactive problem-solving are better positioned to lead effective investigations and support organizational integrity.
Job description
You have a clear vision of where your career can go. And we have the leadership to help you get there.At CNA, we strive to create a culture in which people know they matter and are part of something important, ensuring the abilities of all employees are used to their fullest potential.
This individual contributor position works under general direction, and within broad authority limits, to manage commercial claims with high complexity and exposure for a specific line of business. Responsibilities include the coordination of all claim resolution activities in accordance with company protocols, while achieving quality and customer service standards. Position requires regular communication with customers and insureds and may be dedicated to specific account(s).Ideal candidates have strong familiarity with the claims litigation process and are experienced with catastrophic injuries in commercial auto/trucking, general liability and/or construction lines of business.
This position enjoys a flexible, hybrid work schedule and can work from any CNA office location.
JOB DESCRIPTION:
Essential Duties & Responsibilities
Performs a combination of duties in accordance with departmental guidelines:
Manages an inventory of highly complex commercial claims with large exposures that require a high degree of technical expertise and coordination, by following company protocols to verify policy coverage, conduct investigations, develop and employ resolution strategies, and authorize disbursements within authority limits.
Ensures exceptional customer service by managing all aspects of the claim, interacting professionally and effectively with insureds, claimants and business partners, achieving quality and cycle time standards, providing timely updates and responding promptly to inquiries and requests for information.
Verifies coverage and establishes timely and adequate reserves by reviewing and interpreting policy language and partnering with coverage counsel on more complex matters, estimating potential claim valuation, and following company's claim handling protocols.
Leads focused investigation to determine compensability, liability and covered damages by gathering pertinent information, such as contracts or other documents, taking recorded statements from customers, claimants, injured workers, witnesses, and working with experts, or other parties, as necessary to verify the facts of the claim.
Resolves claims by collaborating with internal and external business partners to develop, own and execute a claim resolution strategy, that includes management of timely and adequate reserves, collaborating with coverage experts, negotiating complex settlements, partnering with counsel to complex manage litigation and authorizing payments within scope of authority.
Establishes and manages claim budgets by achieving timely claim resolution, selecting and actively overseeing appropriate resources, authorizing expense payments and delivering high quality service in an efficient manner.
Realizes and addresses subrogation/salvage opportunities or potential fraud occurrences by evaluating the facts of the claim and making referrals to appropriate Claim, Recovery or SIU resources for further investigation.
Achieves quality standards by appropriately managing each claim to ensure that all company protocols are followed, work is accurate and timely, all files are properly documented and claims are resolved and paid timely.
Keeps leadership informed of significant risks and losses by completing loss summaries, identifying claims to include on oversight/watch lists, and preparing and presenting succinct case summaries to senior management.
Maintains subject matter expertise and ensures compliance with state/local regulatory requirements by following company guidelines, and staying current on commercial insurance laws, regulations or trends for line of business.
Mentors, guides, develops and delivers training to less experienced Claim Professionals.
May perform additional duties as assigned.
Reporting Relationship
Typically Director or above
Skills, Knowledge & Abilities
Thorough knowledge of the commercial insurance industry, products, policy language, coverage, and claim practices.
Strong communication and presentation skills both verbal and written, including the ability to communicate business and technical information clearly.
Demonstrated analytical and investigative mindset with critical thinking skills and ability to make sound business decisions, and to effectively evaluate and resolve ambiguous, complex and challenging business problems.
Strong work ethic, with demonstrated time management and organizational skills.
Ability to work in a fast-paced environment at high levels of productivity on complex matters.
Demonstrated ability to negotiate complex settlements.
Experience interpreting complex commercial insurance policies and coverage.
Ability to manage multiple and shifting priorities in a fast-paced and challenging environment.
Knowledge of Microsoft Office Suite and ability to learn business-related software.
Demonstrated ability to value diverse opinions and ideas
Education & Experience
Bachelor's Degree or equivalent experience
Typically a minimum six years of relevant experience, preferably in claim handling
Must have or be able to obtain and maintain an Insurance Adjuster License within 90 days of hire where applicable
Prior negotiation experience
Professional designations preferred (e.g. CPCU)
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In certain jurisdictions, CNA is legally required to include a reasonable estimate of the compensation for this role. In District of Columbia, California, Colorado, Connecticut, Illinois, Maryland, Massachusetts, New York and Washington, the national base pay range for this job level is $72,000 to $141,000 annually.Salary determinations are based on various factors, including but not limited to, relevant work experience, skills, certifications and location. CNA offers a comprehensive and competitive benefits package to help our employees - and their family members - achieve their physical, financial, emotional and social wellbeing goals. For a detailed look at CNA's benefits, please visitcnabenefits.com.
CNAutilizesAI-enabled technology during the recruiting process. For more information, please visitourcareers page.
CNA is committed to providing reasonable accommodations to qualified individuals with disabilities in the recruitment process. To request an accommodation, please contactleaveadministration@cna.com