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Remote Fraud Claims Jobs in California (NOW HIRING)

$150K - $165K/yr

In this fully remote position, you'll use your clinical judgment to review claims and prior ... fraud, waste, and abuse), and supporting workflow improvements You'll start your day by logging in ...

USAA roles may offer remote or hybrid flexibility for active-duty military spouses consistent with ... Reviews claims/suppliers for fraud indicators and refers to Special Investigations Unit for ...

USAA roles may offer remote or hybrid flexibility for active-duty military spouses consistent with ... Reviews claims/suppliers for fraud indicators and refers to Special Investigations Unit for ...

REMOTE MUST HAVES: * 5+ years of experience as an Operational Data Steward with Pharmacy Services ... Ensuring the accuracy of pharmacy claims data to facilitate timely reimbursement and reduce fraud.

New

REMOTE MUST HAVES: * 5+ years of experience as an Operational Data Steward with Pharmacy Services ... Ensuring the accuracy of pharmacy claims data to facilitate timely reimbursement and reduce fraud.

New

Certified Industrial Hygienist

Rocklin, CA · On-site +1

$39.50 - $52/hr

... fraud and arson cases and providing expert witness testimony, into a recognized global leader in ... Environmental claims management experience is desired. * Provide expert witness support in ...

Certified Industrial Hygienist

Sacramento, CA · On-site +1

$40.50 - $53.25/hr

... fraud and arson cases and providing expert witness testimony, into a recognized global leader in ... Environmental claims management experience is desired. * Provide expert witness support in ...

This position is remote, but may occasionally travel to visit our communities. Candidates should be ... Identifies and escalates healthcare regulatory, fraud-and-abuse, licensing, privacy and other ...

Certified Industrial Hygienist

Los Angeles, CA · On-site +1

$41 - $54/hr

... fraud and arson cases and providing expert witness testimony, into a recognized global leader in ... Environmental claims management experience is desired. * Provide expert witness support in ...

This position is remote, but may occasionally travel to visit our communities. Candidates should be ... Identifies and escalates healthcare regulatory, fraud-and-abuse, licensing, privacy and other ...

Certified Industrial Hygienist

San Diego, CA · On-site +1

$40.25 - $53/hr

... fraud and arson cases and providing expert witness testimony, into a recognized global leader in ... Environmental claims management experience is desired. * Provide expert witness support in ...

This position is remote, but may occasionally travel to visit our communities. Candidates should be ... Identifies and escalates healthcare regulatory, fraud-and-abuse, licensing, privacy and other ...

This position is remote, but may occasionally travel to visit our communities. Candidates should be ... Identifies and escalates healthcare regulatory, fraud-and-abuse, licensing, privacy and other ...

Certified Industrial Hygienist

Pasadena, CA · On-site +1

$41.50 - $54.50/hr

... fraud and arson cases and providing expert witness testimony, into a recognized global leader in ... Environmental claims management experience is desired. * Provide expert witness support in ...

Showing results 21-38

Remote Fraud Claims information

What is the difference between Remote Fraud Claims vs Remote Fraud Analysts?

AspectRemote Fraud ClaimsRemote Fraud Analysts
CredentialsTypically requires claims processing or insurance certificationsUsually requires analytical or investigative certifications
Work EnvironmentCustomer service and claims processing platformsData analysis and fraud detection tools
Industry UsageInsurance, finance, e-commerceBanking, finance, e-commerce
Job FocusHandling claims related to fraud incidentsIdentifying and investigating fraudulent activities

Remote Fraud Claims roles focus on processing and managing claims related to fraud, often requiring claims or insurance certifications. Remote Fraud Analysts concentrate on analyzing data to detect and prevent fraud, needing analytical skills and certifications. Both roles operate remotely within finance and e-commerce sectors but differ in their core responsibilities and required credentials.

What cities in California are hiring for Remote Fraud Claims jobs?

Cities in California with the most Remote Fraud Claims job openings:

Infographic showing various Remote Fraud Claims job openings in California as of August 2026, with employment types broken down into 88% Full Time, 10% Part Time, and 2% Contract. Highlights an 85% Physical, 4% Hybrid, and 11% Remote job distribution.

Product Manager/Owner AI

York Risk Services

Los Angeles, CA • On-site, Remote

Full-time

Re-posted 28 days ago


Job description

By joining Sedgwick, you'll be part of something truly meaningful. It's what our 33,000 colleagues do every day for people around the world who are facing the unexpected. We invite you to grow your career with us, experience our caring culture, and enjoy work-life balance. Here, there's no limit to what you can achieve.

Newsweek Recognizes Sedgwick as America's Greatest Workplaces National Top Companies

Certified as a Great Place to Work

Fortune Best Workplaces in Financial Services & Insurance

Product Manager/Owner AI

End-to-End AI Product Owner - Line of Business or Platform Aligned

Role Overview

The Product Manager / Product Owner - AI is responsible for end-to-end ownership of AI initiatives for a specific Line of Business or claims domain. This role partners directly with business stakeholders to define AI-enabled improvements to claims operations, cost control, and client service performance, and translates those objectives into structured, sprint-ready execution plans.

This role combines strategic initiative shaping with hands-on backlog ownership and daily collaboration with AI engineers and data scientists. It ensures that AI development is grounded in real operational pain points and that delivered solutions are practical, compliant, and measurable in impact.

Key Responsibilities

The Product Manager/Owner works directly with claims leadership, operational managers, and Business Transformation Leads to understand workflow bottlenecks, leakage drivers, customer friction points, regulatory risks, and client performance commitments. They translate these insights into clearly defined AI use cases with measurable operational objectives such as reduced claim cycle time, improved reserving accuracy, enhanced fraud detection rates, or improved document processing speed.

They decompose initiatives into epics and features that reflect real-world operational workflows, ensuring requirements account for system integrations, adjuster behavior, client reporting requirements, and compliance obligations. They collaborate with AI engineers and data scientists to validate feasibility, data availability, model explainability considerations, and downstream operational impact.

They own and continuously refine the product backlog, ensuring it remains prioritized according to business value and aligned with enterprise AI portfolio constraints. They prepare stories with detailed acceptance criteria that reflect actual claims scenarios and operational realities, not abstract technical requirements.

During sprint execution, they remain closely engaged with the delivery team, clarifying nuances of claims processes, regulatory rules, and client-specific variations. They validate that developed models, automation features, or decision-support tools function appropriately within the claims workflow and align with user expectations.

They communicate progress, risks, and trade-offs to LOB stakeholders transparently, ensuring expectations are managed around sequencing and delivery timelines. Following deployment, they monitor adoption, operational metrics, and user feedback, adjusting backlog priorities based on real-world performance and measurable impact.

This role requires balancing operational urgency with disciplined backlog governance, particularly in environments where client escalations or regulatory deadlines may introduce pressure for rapid change.

Qualifications

  • 6-10 years of experience in Product Management or Business-Technology roles within insurance, claims, or managed services
  • Strong understanding of claims operations, adjuster workflows, or insurance servicing models
  • Experience working in Agile delivery environments
  • Ability to translate operational pain points into structured technical requirements
  • Strong stakeholder communication skills across business and technical audiences

#LI-TS1 #remote

Sedgwickis an Equal Opportunity Employer and a Drug-Free Workplace.

If you're excited about this role but your experience doesn't align perfectly with every qualification in the job description, consider applying for it anyway! Sedgwick is building a diverse, equitable, and inclusive workplace and recognizes that each person possesses a unique combination of skills, knowledge, and experience. You may be just the right candidate for this or other roles.