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Fraud & Claims Operations Representative Jobs

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Director, Payment Integrity
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United States , Phoenix
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Not provided
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Blue Cross Blue Shield of Arizona
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Until further notice
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Risk, Control & Compliance Manager
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Malaysia , Johor Bahru
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IKEA
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Until further notice
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Explore a career on the front lines of financial security with Fraud & Claims Operations Representative jobs. This critical profession serves as a vital shield for financial institutions and their customers, dedicated to preventing loss and resolving disputes. Professionals in this role are analytical problem-solvers who thrive in a fast-paced environment, balancing meticulous investigation with empathetic customer interaction. If you are seeking a career that combines detective work with customer service, where every day presents a new challenge, this could be the perfect path for you. A Fraud & Claims Operations Representative is primarily responsible for overseeing and resolving customer claims related to fraudulent activity, billing errors, and unauthorized transactions. Their day-to-day work involves a rigorous process of investigation and analysis. Common responsibilities include reviewing and decisioning various claim types, from unauthorized debit card purchases to complex account takeovers. They utilize multiple internal systems and applications to scrutinize transaction details, identify patterns of suspicious behavior, and determine the validity of a claim based on established protocols and regulations. A key part of their role involves effective customer authentication, using their communication skills to verify identities while being vigilant for social engineering attempts and potential fraudsters. Beyond investigation, this role is deeply rooted in customer support. Representatives are often the first point of contact for distressed customers who have been victims of fraud. They must establish rapport quickly, demonstrate empathy, and expertly de-escalate tense or difficult situations. Communicating clearly and sensitively, they guide customers through the claims process, explain complex information in understandable terms, and provide updates on the status of their case. This requires a unique blend of technical acumen and interpersonal skill. Furthermore, these professionals may contact third parties, such as merchants or other financial institutions, to gather additional evidence and research transactions. The typical skills and requirements for these jobs are centered around analytical thinking, resilience, and communication. Employers generally seek candidates with a background in customer service, call center operations, or the financial services industry. Strong verbal and written communication skills are non-negotiable, as is the ability to navigate multiple software systems simultaneously. A keen eye for detail is crucial for spotting inconsistencies that indicate fraud. Candidates should be able to work both independently, managing a queue of cases, and collaboratively as part of a larger team, escalating complex issues to supervisors as needed. This role is ideal for those who are naturally inquisitive, calm under pressure, and driven by a sense of purpose in protecting customers' financial well-being. Discover rewarding Fraud & Claims Operations Representative jobs and embark on a career that makes a tangible difference.

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