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Fraud Triage Specialist (Mobile)
$43,596–$71,947 year
Remote · United States
Job Summary
Fraud Triage Specialist (Mobile) processes claims with risk issues and researches fraud indicators within the Connected Living Organization. Responsibilities include processing claims with risk issues, identifying risk through analysis and use of off-system data, collaborating with SIU investigators, performing suspected fraud referrals and callbacks, responding to inquiries from internal clients, documenting claim files for accurate customer communication, meeting productivity and quality standards, assisting in identifying risk, fraud, and compliance issues, and participating in implementing tools and processes to minimize issues. The role involves routine post-decision tasks (e.g., BOLOs, updating negative lists), and requires attendance on a Mon–Fri shift from 1:00pm–10:00pm EST. Emphasis on risk detection, fraud prevention, data analysis, and clear communication in a multi-system environment, with a focus on compliance and continuous improvement. The posting notes a remote work arrangement (LI-remote) and an emphasis on belonging to a leading global services company offering confidential identity verification and AI usage guidelines.
Required Qualifications
- High School diploma, GED or higher
- 3+ years of experience in a customer service environment
- Ability to attend and pass Insurance Adjuster License courses
- Ability to maintain continuing education requirements necessary to maintain required Licenses
- Analytical skills including experience with data and statistical analysis
- Proficient in Microsoft Word, Excel, and other Office applications
- Ability to work in multi system/functional environment requiring the use of various systems and tools
- Excellent verbal and written communication skills
- Demonstrates strong internal and external communication to drive improved performance
- Ability to effectively relay accurate and detailed information via telephone, written communication, in team meetings, and training sessions
- Ability to apply problem solving skills on complex issues for researching and resolving cases initiated via various channels
- Ability to analyze problems and make recommendations that impact the team and business
- 2-year degree or equivalent experience
- Current Insurance Adjuster License
- Experience with ePrism and Assurant Mobile Claims
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