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Fraud Claims Operations Representative Jobs in Conley, GA

W. R. Berkley

SIU Manager

Atlanta, GA · On-site

This position requires a deep understanding of commercial and personal insurance operations ... claims staff on fraud indicators, red flags, and referral procedures. * Represent the company at ...

Georgia

Investigator - Medicaid Fraud

Atlanta, GA

$50/hr

... legal representation of the highest quality to the agencies, officers and employees of state ... Demonstrates knowledge of court system operations and methods of presenting testimony.

BENNETT MOTOR EXPRESS

Claims Adjuster I

Mcdonough, GA · On-site

Identify subrogation, salvage, and fraud indicators, and refer files appropriately. * Communicate ... Active adjuster license(s) as required by state(s) of operation, or ability to obtain within a ...

BENNETT MOTOR EXPRESS

Claims Adjuster I

Mcdonough, GA · On-site

Identify subrogation, salvage, and fraud indicators, and refer files appropriately. * Communicate ... Active adjuster license(s) as required by state(s) of operation, or ability to obtain within a ...

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All JobsFraud Claims Operations Representative JobsFraud Claims Operations Representative Jobs in Conley, GA

Fraud Claims Operations Representative information

See Conley, GA salary details

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$28

How much do fraud claims operations representative jobs pay per hour?

As of Aug 18, 2026, the average hourly pay for fraud claims operations representative in Conley, GA is $19.09, according to ZipRecruiter salary data. Most workers in this role earn between $16.20 and $20.82 per hour, depending on experience, location, and employer.

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.

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 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.

What cities near Conley, GA are hiring for Fraud Claims Operations Representative jobs?

Cities near Conley, GA 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 Conley, GA as of August 2026, with employment types broken down into 82% Full Time, 15% Part Time, 1% Temporary, and 2% Contract. Highlights an 94% Physical, 2% Hybrid, and 4% Remote job distribution, with an average salary of $39,697 per year, or $19.1 per hour.

Senior Account Manager - Claims LTC (Remote USA)

Munich Re

Atlanta, GA • On-site, Remote

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Posted 20 days ago

Job description

***This is a fully remote position in the United States.***
Position Overview
This is a senior position for a highly experienced Long-Term Care (LTC) claim professional. The role is primarily client-facing and requires deep LTC claim and medical impairment knowledge, strong relationship management skills, and the ability to serve as an industry resource to clients and internal leadership. The Sr Account Manager will assess and manage complex and high-liability LTC claims, assess whether ceding companies are following applicable claim guidelines and best practices, and provide well-supported recommendations to leadership. This position will lead or participate in external claim audits, prepare audit reports, identify training opportunities, potential fraud and process gaps, deliver client training, present at industry meetings, engage with LTCI Consortium, evaluate and propose strategic initiatives for clients and Munich Re, lead projects, monitor performance, analyze production reports, and develop practical claim tools and resources for clients. The role requires the ability to travel as needed to support client engagements, audits, training, and industry-related activities.
Your Role:
  • Serve as a client-facing LTC claim leader, providing industry and medical impairment expertise, claim guidance, and consultative support to clients and internal stakeholders.
  • Manage and review complex, high-liability, high-dollar, and contestable LTC claim matters, including claims requiring advanced clinical, contractual, legal, or administrative analysis.
  • Assess whether ceding companies are following applicable claim guidelines, policy provisions, treaty requirements, and sound LTC claim management practices.
  • Evaluate Munich Re's claim exposure and liability, identify potential risks, fraud or emerging issues, and provide well-supported recommendations to leadership.
  • Lead or participate in external claim audits, including audit planning, claim file review, client discussions, audit report preparation, findings validation, and follow-up on recommendations.
  • Identify client training needs, develop training content and claim tools, and deliver training to support consistent, effective LTC claim practices.
  • Manage client relationships from the claim perspective, including responding to claim questions, resolving claim-related issues, and supporting client account management activities.
  • Conduct claim trend analysis, identify operational or adjudication patterns, and produce analytical business reports with recommendations for appropriate action plans.
  • Lead or contribute to special projects, process improvement initiatives, and development of client-facing resources that support the LTC claim function.
  • Represent Munich Re in client meetings, audit discussions, training sessions, and industry meetings, including presenting LTC claim insights and best practices as needed.
  • Travel as needed to support client engagements, external audits, training, industry meetings, and other business-related activities.

Your Profile:
  • Bachelor's Degree
  • Industry related designations (ICA, LOMA)
  • 8+ years of progressive responsibility in Long-Term Care claim adjudication experience.
  • Demonstrated experience managing client-facing claim responsibilities, including client consultation, claim issue resolution, relationship management, and presentation of claim recommendations or findings to clients and internal leadership.
  • Experience leading or participating in external claim audits, preparing audit reports, identifying training opportunities, and supporting follow-up on audit recommendations.
  • Experience developing or delivering claim training, presenting at client or industry meetings, conducting claim trend analysis, preparing analytical business reports, and leading or supporting claim-related projects preferred.
  • In-depth knowledge of direct insurance company claims operations
  • Strong communication skills, written and oral
  • Proven ability to apply knowledge and creativity to improve processes and procedures or to resolve problems.

About Munich Re
Together, we engage with everything we have and are, to help humankind act braver and better.
As the world's leading reinsurance company with more than 40,000 employees in over 50 locations around the globe, Munich Re introduces a paradigm shift in the way you think about insurance. By turning uncertainty into manageable risk, we enable fundamental change. We recognize Diversity, Inclusion, and Belonging as a key priority with a culture that welcomes different thoughts and opinions. We dare to think big and are continuously innovating on behalf of our clients.
Our data, our technology, and our teams place us in a unique position to drive transformative change in the life insurance industry. We invest strategically in our world class talent, offering our employees a work experience that promotes professional development, innovation, and rewards high performance.
For New York City based employees, the base salary range anticipated for this position is $125,000 to $140,000, plus an opportunity for an annual company bonus based upon a percentage of eligible pay.
The salary estimate displayed represents the typical salary range for candidates hired in this position. Factors that may be used to determine your actual salary include your specific skills, how many years of experience you have and comparison to other employees already in this role.
What Can We Offer You?
We are proud to offer our employees, their domestic partners, and their children, a wide range of insurance benefits:
  • Two options for your health insurance plan (PPO or High Deductible).
  • Prescription drug coverage (included in your health insurance plan).
  • Vision and dental insurance plans.
  • Additional insurance coverages provided at no cost to you, such as basic life insurance equal to 1x annual salary and AD&D coverage that is equal to 1x annual salary.
  • Short and Long-Term Disability coverage.
  • Supplemental Life and AD&D plans that you can purchase for yourself and dependents (includes Spouse/domestic partner and children).
  • Voluntary Benefit plans that supplement your health and life insurance plans (Accident, Critical Illness and Hospital Indemnity).

In addition to the above insurance offerings, our employees also enjoy:
  • A robust 401k plan with up to a 6% employer match
  • Paid time off that begins with 24 days each year, with more days added when you celebrate milestone service anniversaries.
  • Eligibility to receive a yearly bonus as a Munich Re employee.
  • A variety of health and wellness programs provided at no cost, including a gym fitness reimbursement.
  • Paid time off for eligible family care needs.
  • Tuition assistance and educational achievement bonuses.
  • A corporate matching gifts program that further enhances your charitable donation.
  • Paid time off to volunteer in your community.

Please note that only candidates who are selected for interview will be contacted directly. We thank all candidates for their interest.
At Munich Re US, we see Diversity and Inclusion as a solution to the challenges and opportunities all around us. Our goal is to foster an inclusive culture and build a workforce that reflects the customers we serve and the communities in which we live and work. We strive to provide a workplace where all of our colleagues feel respected, valued and empowered to achieve their very best every day. We recruit and develop talent with a focus on providing our customers the most innovative products and services. We are an equal opportunity employer. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

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