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Fraud Claims Operations Representative Jobs in Virginia

USAA

Sr. Injury Claims Adjuster

Chesapeake, VA · On-site +1

$63K - $121K/yr

Supports workload surges and/or Catastrophe Operations as needed. * May act as an informal resource ... represented third party injury claims. * 4 or more years auto liability/casualty adjusting ...

USAA

Sr. Injury Claims Adjuster

Chesapeake, VA · On-site +1

$63K - $121K/yr

Supports workload surges and/or Catastrophe Operations as needed. * May act as an informal resource ... represented third party injury claims. * 4 or more years auto liability/casualty adjusting ...

USAA Careers

Sr. Injury Claims Adjuster

Chesapeake, VA · On-site +1

$63K - $121K/yr

Supports workload surges and/or Catastrophe Operations as needed. * May act as an informal resource ... represented third party injury claims. * 4 or more years auto liability/casualty adjusting ...

New

Chubb

Casualty Claim Examiner

Chesapeake, VA · On-site

$53K - $77K/yr

Dive deep into all aspects of reported claims, including the identification of potential fraud ... With operations in 54 countries, Chubb provides commercial and personal property and casualty ...

Chubb

Casualty Claim Examiner

Chesapeake, VA

$53K - $77K/yr

Dive deep into all aspects of reported claims, including the identification of potential fraud ... With operations in 54 countries, Chubb provides commercial and personal property and casualty ...

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Fraud Claims Operations Representative information

What are the key skills and qualifications needed to thrive as a fraud claims operations representative, and why are they important?

To thrive as a Fraud Claims Operations Representative, you need strong analytical skills, attention to detail, and experience in financial services or fraud investigation, often supported by a relevant associate's or bachelor's degree. Familiarity with fraud detection software, case management systems, and banking platforms is typically required. Excellent communication, problem-solving, and customer service skills help you resolve claims efficiently and reassure affected clients. These skills are essential for accurately identifying fraudulent activity, mitigating losses, and maintaining customer trust in financial institutions.

How does a fraud claims operations representative typically collaborate with other departments during an investigation?

Fraud Claims Operations Representatives regularly work with teams such as Customer Service, Risk Management, and IT Security to thoroughly investigate and resolve fraud cases. Collaboration often involves sharing detailed case information, coordinating on account holds or restrictions, and ensuring that customers are kept informed throughout the process. Effective communication and teamwork are essential, as representatives must often escalate complex cases or seek specialized expertise from other departments to reach a resolution promptly.

What does a fraud claims operations representative do?

A Fraud Claims Operations Representative is responsible for investigating and resolving claims related to fraudulent activities on customer accounts. They review transaction details, communicate with customers to gather information, and determine the validity of reported fraud. Their work helps protect both the financial institution and its customers from financial losses due to unauthorized or suspicious activity. They also ensure compliance with company policies and legal regulations during the claims process.
What are popular job titles related to Fraud Claims Operations Representative jobs in Virginia? For Fraud Claims Operations Representative jobs in Virginia, the most frequently searched job titles are:
What job categories do people searching Fraud Claims Operations Representative jobs in Virginia look for? The top searched job categories for Fraud Claims Operations Representative jobs in Virginia are:
What cities in Virginia are hiring for Fraud Claims Operations Representative jobs? Cities in Virginia with the most Fraud Claims Operations Representative job openings:
Fraud Claims Operations Representative jobs near you
Infographic showing various Fraud Claims Operations Representative job openings in Virginia as of August 2026, with employment types broken down into 86% Full Time, 11% Part Time, 1% Temporary, and 2% Contract. Highlights an 94% Physical, 2% Hybrid, and 4% Remote job distribution.

Executive Vice President, AFBA and 5Star Life

Armed Forces Benefits Assoc.

Alexandria, VA • On-site

$200K - $250K/yr

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Posted 11 days ago

Job description

GENERAL DESCRIPTION:

The Executive Vice President, AFBA and 5Star Life Insurance serves as a senior executive leader supporting both the Armed Forces Benefit Association and 5Star Life Insurance Company. This position acts as deputy to the President of AFBA and 5Star Life Insurance, providing executive leadership, strategic support, operational oversight, and cross-functional coordination to advance AFBA’s mission and ensure alignment across AFBA and 5Star Life. The role also serves as a knowledgeable resource on life insurance, supplemental health, worksite voluntary benefits, policy administration, claims support, and insurance-related customer and broker service. The position requires strong executive judgment, insurance knowledge, relationship management, attention to detail, and the ability to explain complex policy, benefit, operational, and organizational matters clearly and professionally.

ESSENTIAL DUTIES AND RESPONSIBILITIES:

  • Serve as Executive Vice President for AFBA and 5Star Life Insurance, providing senior leadership, strategic guidance, and enterprise-wide coordination in support of the President and organizational priorities.
  • Act as deputy to the President of AFBA, representing the President as requested, supporting executive decision-making, coordinating key initiatives, and helping ensure effective follow-through across departments and leadership teams.
  • Support AFBA governance, board, committee, member, partner, and stakeholder activities by helping prepare information, coordinate responses, elevate issues, and advance priorities on behalf of executive leadership.
  • Serve as a subject matter resource for 5Star Life insurance products, including life insurance, supplemental health, group, and worksite voluntary benefit offerings.
  • Explain policy provisions, benefit schedules, eligibility rules, coverage limits, exclusions, continuation options, portability provisions, premium requirements, and claims procedures in clear, practical language.
  • Support internal business partners, brokers, employer groups, policyholders, insureds, and beneficiaries, as needed with insurance-related questions and service needs.
  • Coordinate across AFBA and 5Star Life functions to ensure communication, execution, and operational decisions are aligned with the President’s direction, board priorities, member service expectations, and business objectives.
  • Review policy, certificate, rider, enrollment, claims, and administrative documentation for accuracy, completeness, and consistency with contract provisions and company policies and procedures.
  • Assist with claims-related inquiries by helping clarify documentation requirements, coverage provisions, claim status, and next steps while coordinating with claims, operations, compliance, and other internal teams as needed.
  • Partner with Worksite, Distribution, Operations, Claims, Compliance, Legal, Actuarial, Product, and Sales teams to resolve issues and support a strong client and customer experience.
  • Identify trends, recurring service issues, process gaps, or training needs and recommend improvements that strengthen service quality, compliance, and operational efficiency.
  • Maintain accurate and timely records of communications, policy reviews, service requests, claims support, and related follow-up activity.
  • Assist with new product implementation, policy administration updates, process improvements, audits, regulatory inquiries, and quality assurance activities as requested.
  • Demonstrate complete adherence to privacy laws, company privacy guidelines, confidentiality requirements, and standards for safeguarding customer, employee, and business information.
  • Travel to other offices, conferences, meetings, and other events as necessary to accomplish business goals.

EDUCATION AND EXPERIENCE:

  • Bachelor’s degree in business, insurance, finance, association management, public administration, or a related field required. Advanced degree preferred.
  • Minimum of 15 years of progressively responsible leadership experience in life insurance, supplemental health, group benefits, worksite benefits, claims, policy administration, customer operations, account management, underwriting, compliance, association management, nonprofit leadership, or a related executive function, including significant executive-level responsibility with a life insurance carrier, association, or member-based organization.
  • Experience in association executive management, including governance support, board and committee relations, member services, strategic planning, executive communications, stakeholder engagement, and implementation of association priorities.
  • Demonstrated experience working with or reporting to Boards of Directors, executive committees, senior officers, or governance bodies in a mission-driven, member-based, nonprofit, association, insurance, or financial services environment.
  • Professional insurance designation or coursework such as ALMI, ACS, FLMI, AINS, CLU, or similar credential.
  • Experience with life, accident, hospital indemnity, critical illness, cancer, disability, or other supplemental health insurance products.
  • Experience supporting brokers, employer groups, worksite voluntary benefit programs, or member-based insurance programs.
  • Experience with LifePRO, Salesforce, enrollment platforms, imaging systems, or other insurance administration tools preferred.
  • Proficiency with Microsoft Office and ability to learn insurance administration, imaging, workflow, CRM, enrollment, or claims systems.


KNOWLEDGE, SKILLS, ABILITIES & COMPETENCIES:

  • Executive presence, discretion, and judgment necessary to serve as deputy to the President of AFBA and to help lead enterprise priorities across AFBA and 5Star Life.
  • Strong understanding of life insurance and supplemental health products, policy language, benefit provisions, claims requirements, and insurance administration processes.
  • Ability to read, interpret, and explain group policies, certificates, riders, benefit schedules, forms, and related insurance documents.
  • Ability to build effective relationships with Boards of Directors, AFBA members, regulators, distribution partners, vendors, executive leadership, and internal teams, and to represent the President and organization with professionalism and sound judgment.
  • Strong written and verbal communication skills, including the ability to communicate professionally with brokers, employer groups, insureds, beneficiaries, vendors, and internal stakeholders.
  • Excellent attention to detail, organizational skills, follow-through, and ability to manage multiple priorities in a fast-paced environment.
  • Knowledge of insurance compliance, privacy, regulatory requirements, quality assurance, market conduct, or audit support.
  • Ability to foster a culture of integrity, accountability, service excellence, collaboration, innovation, and continuous improvement.
  • Exceptional analytical thinking and practical problem-solving. Attention to detail, accuracy, and documentation discipline. Professional discretion and confidentiality.


WORK ENVIRONMENT:

This position will be based in Alexandria, Virginia. The role requires regular collaboration with AFBA and 5Star Life leadership, internal departments, boards, committees, brokers, employer groups, policyholders, insureds, beneficiaries, vendors, and service partners. The position may be asked to represent or act on behalf of the President of AFBA in meetings, communications, initiatives, and follow-up activities. Occasional travel or extended hours may be required during board and committee activities, product launches, renewals, audits, major service initiatives, claims escalations, executive priorities, or project deadlines.

About AFBA and 5Star Life Insurance Company:

The Armed Forces Benefit Association serves members and their families through benefits, services, and support designed for those connected to military, government, and public service communities. 5Star Life Insurance Company is the primary underwriter of AFBA member policies and is also a provider of group and worksite voluntary products. Together, AFBA and 5Star Life serve individuals, organizations, employer groups, and broker partners through products and services designed to support financial protection, customer service, trusted partnership, and mission-driven member support.

Benefits we offer:

  • health insurance (medical, dental, and vision)
  • flexible spending accounts (medical and dependent care)
  • 401k plan with generous employer match
  • paid time off
  • paid holidays (12)
  • life insurance
  • short- and long-term disability insurance
  • employee assistance program
  • professional development & tuition reimbursement
  • career growth opportunities
  • on-site gym and locker rooms (Alexandria, VA office only)
  • friendly, collaborative culture

Qualified people of all races, ethnicities, ages, sex, genders, sexual orientations, national origins, gender identities, marital status, religions, veterans' statuses, disabilities, and any other protected classes are strongly encouraged to apply. As an equal opportunity workplace, we are committed to creating an inclusive environment for all employees. AFBA and 5Star Life Insurance Company endeavors to make reasonable accommodations to the known physical or mental limitations of qualified applicants with a disability unless the accommodation would impose an undue hardship on the operation of our business. If an applicant believes they require such assistance to complete the application or to participate in an interview, or has any questions or concerns, they should contact Human Resources (hr@afba.com). EEO is the Law (Link to external DOL site). AFBA and 5Star Life Insurance Company is an Equal Opportunity Employer and an E-Verify Employer.