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Fraud Claims Operations Representative Jobs (NOW HIRING)

MLabs

Head of Claims

New York, NY

$150K - $200K/yr

Extensive experience leading claims operations, managing technical governance, and leading Team Leads or Claims Managers. * Strong understanding of leakage control, fraud detection, litigation ...

MLabs

Head of Claims

New York, NY · On-site

$150K - $200K/yr

Extensive experience leading claims operations, managing technical governance, and leading Team Leads or Claims Managers. * Strong understanding of leakage control, fraud detection, litigation ...

SECURITY FIRST BANK

Fraud Specialist

Rapid City, SD · On-site

... operations succeed since 1898. As a locally owned financial services organization, we're committed ... Process fraud claims and disputes in accordance with bank policies and regulatory requirements.

Security First Bank

Fraud Specialist

Rapid City, SD

... operations succeed since 1898. As a locally owned financial services organization, we're committed ... Process fraud claims and disputes in accordance with bank policies and regulatory requirements.

ClaimSorted Inc

Head of Claims

New York, NY · On-site

$150K - $200K/yr

Experience leading claims operations and technical governance * Experience managing Team Leads and Claims Managers * Strong understanding of leakage, fraud, litigation exposure, recoveries, and QA ...

EVERENCE SERVICES,

Fraud Manager

Lancaster, PA · On-site

... operations, compliance, information security, and law enforcement to mitigate fraud risk while ... Ensure timely investigation and resolution of fraud alerts and members' claims. * Maintain and ...

Chubb

Claim Center Representative

Phoenix, AZ

We are currently seeking a Claim Center Operations Representative to join our North America Claim ... This position will report directly to the Claims Operations Manager and will be responsible for ...

Citizens Bank

Fraud Operations Professional

Irving, TX · On-site

As the Fraud Operations Professional , you will support the Fraud and Claims Operations teams through the Command Center. The Command Center is the centralized workforce orchestration and management ...

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Fraud Claims Operations Representative information

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

As of Jul 22, 2026, the average hourly pay for fraud claims operations representative in the United States is $19.85, according to ZipRecruiter salary data. Most workers in this role earn between $16.83 and $21.63 per hour, depending on experience, location, and employer.

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 is the highest paying job at Wells Fargo?

At Wells Fargo, executive roles such as Chief Executive Officer (CEO), Chief Financial Officer (CFO), and Chief Risk Officer tend to be the highest paying positions. These roles require extensive experience, leadership skills, and often involve overseeing large teams and strategic decision-making.

What is the salary of fraud and claims operations representative?

The salary for a fraud and claims operations representative typically ranges from $40,000 to $60,000 annually, depending on experience, location, and company size. Entry-level positions may start lower, while experienced professionals or those with specialized skills can earn higher wages. Benefits often include health insurance, paid time off, and opportunities for advancement.

What is fraud and claims operations?

Fraud and claims operations involve detecting, investigating, and resolving fraudulent activities related to financial transactions or insurance claims. A Fraud Claims Operations Representative typically reviews reports, uses specialized tools, and follows procedures to prevent losses and ensure accurate claim processing.

What qualifications do I need to be a fraud investigator?

To become a fraud investigator, candidates typically need a bachelor's degree in criminal justice, finance, or a related field. Relevant skills include attention to detail, analytical thinking, and proficiency with investigative tools or software; certifications such as Certified Fraud Examiner (CFE) can also enhance qualifications. Experience in law enforcement, accounting, or banking is often preferred.

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.
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What cities are hiring for Fraud Claims Operations Representative jobs? Cities with the most Fraud Claims Operations Representative job openings:
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What job categories do people searching Fraud Claims Operations Representative jobs look for? The top searched job categories for Fraud Claims Operations Representative jobs are:
Fraud Claims Operations Representative jobs near you
Infographic showing various Fraud Claims Operations Representative job openings in the United States as of July 2026, with employment types broken down into 90% Full Time, 8% Part Time, and 2% Contract. Highlights an 87% Physical, 4% Hybrid, and 9% Remote job distribution, with an average salary of $41,287 per year, or $19.8 per hour.

Head of Claims

MLabs

New York, NY

$150K - $200K/yr

Other

Medical, Retirement, PTO

Posted 7 days ago

Job description

Location: London; New York or Remote U.S

On-Site/Remote | Full-time

Compensation: $150K - $200K Offers Equity 110K - 150K

Our client is an AI-native Third-Party Administrator (TPA) that is redefining how claims operations are managed globally. Backed by some of the world's most prestigious investment funds-including Y Combinator, Atomico, and Eurazeo-our client manages claims operations across the US, UK, and Europe for leading MGAs, publicly traded companies, and household insurer names.

By combining elite claims talent with proprietary AI systems, our client delivers drastically faster resolutions, lower leakage, and a fundamentally superior, empathetic customer experience across multiple lines of business (including auto, property, travel, gadget, pet, renters, and liability).

Our client is seeking an ambitious, hands-on Head of Claims to lead, redesign, and scale their global claims function. This is not a traditional insurance leadership role. This position is designed for an operational and technical strategist who views claims as a product, technical, and operational challenge rather than just a people-management task. The successful candidate will rebuild claims processes from first principles, establish global standards, and work closely with the founding, product, and engineering teams to integrate cutting-edge AI workflows.

  • Location: This is a full-time, in-person (5 days a week) role based out of our client's office in London (UK), New York (US), or their upcoming Dallas (US) location.

Key Responsibilities

Rebuild Claims Operations from First Principles

  • Redesign workflows, escalation structures, QA systems, and claims governance to eliminate unnecessary complexity and operational bottlenecks.
  • Build highly scalable claims standards across multiple lines of business and diverse geographic regions.
  • Collaborate directly with product and engineering teams to automate workflows and continuously improve operations using AI.

Own Technical Claims Excellence

  • Define and maintain technical claims handling standards across auto, property, liability, travel, renters, and other specialized products.
  • Establish and oversee governance frameworks for complex, high-risk, litigated, or precedent-setting claims.
  • Personally review difficult or high-value cases, making final technical decisions where required.
  • Drive continuous improvement across core metrics, including leakage, fraud prevention, recoveries, and audit performance.

Build and Scale Elite Claims Teams

  • Recruit, develop, and mentor exceptional Claims Handlers, Team Leads, and QA specialists.
  • Elevate the organization's technical capabilities by creating coaching systems, calibration frameworks, and structured technical training.
  • Foster an internal culture centered on high standards, extreme ownership, and urgency.

Manage Key Partner and Customer Relationships

  • Serve as the senior claims subject matter expert during strategic partner, customer, and carrier meetings.
  • Support client launches, external audits, high-level escalations, and executive-level insurer discussions.
  • Cultivate deep trust with carriers, MGAs, brokers, and key enterprise partners.

Core Outcomes You Will Own

  • Overall claims quality, technical accuracy, and claims governance across all active client accounts.
  • Leakage reduction, fraud detection, and litigation outcomes.
  • SLA performance, backlog management, and low complaint rates.
  • QA and external audit scores, as well as recovery performance.
  • Team quality, talent development, and high retention rates.

Requirements

Professional Experience & Background

  • 7 to 15 years of claims experience with deep technical expertise across auto, property, and liability lines of business.
  • Proven track record of working within a fast-paced startup or scale-up environment.
  • Extensive experience leading claims operations, managing technical governance, and leading Team Leads or Claims Managers.
  • Strong understanding of leakage control, fraud detection, litigation exposure, recoveries, and robust QA frameworks.
  • Solid knowledge of regulatory and compliance requirements, with a demonstrated ability to integrate these smoothly into daily operational workflows.
  • A legal background is strongly preferred.

Ideal Profile & Cultural Fit

  • Driven by a desire to rebuild inefficient, legacy systems rather than managing them from a distance.
  • Deeply committed to operational excellence and comfortable making difficult decisions under pressure.
  • Enthusiastic about staying close to the day-to-day work, including personally reviewing claims when necessary.
  • Operates with high intensity, speed, and a strong sense of urgency.
  • Prefers clear ownership and action over administrative bureaucracy.

Benefits

Our client offers a competitive package designed to attract top-tier talent:

  • Compensation: Competitive salary positioned beyond the standard industry average.
  • Equity: Generous and transparent equity participation, allowing you to share in the company's long-term success.
  • Visa Support: Skilled Worker visa sponsorship is available for qualified candidates in the UK.
  • Paid Time Off: 28 days of annual leave plus bank holidays in the UK (20 days of annual leave in the US).
  • Flexibility: 30 days of remote work permitted annually.
  • Health & Wellness: Comprehensive private health insurance.
  • Retirement: Pension contributions provided in line with UK auto-enrolment requirements (or regional equivalents).
  • Culture: Regular company offsites and the opportunity to build a category-defining company alongside exceptional colleagues.


Due to the high volume of applications we anticipate, we regret that we are unable to provide individual feedback to all candidates. If you do not hear back from us within 4 weeks of your application, please assume that you have not been successful on this occasion. We genuinely appreciate your interest and wish you the best in your job search.

Commitment to Equality and Accessibility:

At MLabs, we are committed to offer equal opportunities to all candidates. We ensure no discrimination, accessible job adverts, and providing information in accessible formats. Our goal is to foster a diverse, inclusive workplace with equal opportunities for all. If you need any reasonable adjustments during any part of the hiring process or you would like to see the job-advert in an accessible format please let us know at the earliest opportunity by emailing human-resources@mlabs.city.

MLabs Ltd collects and processes the personal information you provide such as your contact details, work history, resume, and other relevant data for recruitment purposes only. This information is managed securely in accordance with MLabs Ltd's Privacy Policy and Information Security Policy, and in compliance with applicable data protection laws. Your data may be shared only with clients and trusted partners where necessary for recruitment purposes. You may request the deletion of your data or withdraw your consent at any time by contacting legal@mlabs.city.

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