Fraud & Claims Operations Representative Job at Wells Fargo (Hyderabad)

New

Lead Fraud & Claims Operations Representative

Wells Fargo is seeking a Lead Fraud & Claims Operations Representative.

Location

India , Bengaluru

Salary:

Not provided

Wells Fargo

Expiration Date

February 24, 2026

Requirements

2+ years of customer service, financial services, fraud, or investigations experience, or equivalent demonstrated through one or a combination of the following: work experience, training, military experience, education.

Job Responsibility

Support performance and overall effectiveness of team as well as cross-group operational tasks
Proactively provide feedback and present ideas for improving or implementing processes and tools with efficient flow of fraud and claims operations
Perform or guide others on complex account activity and claims that can include high risk and high dollar transactions requiring research that involves multiple transaction channels and products
Independently prioritize work and provide day-to-day work leadership and mentorship for fraud and claims team
Contribute in resolving control deficiencies in bank processes, procedures, customer, or team decisions that require coordination among cross-functional teams
Provide guidance and subject matter expertise to less experienced staff in complex situations on wide range of information related to fraud and claims

Fulltime

Associate Fraud & Claims Operations Representative

Wells Fargo is seeking a Fraud & Claims Operations Representative for one of the...

Location

Philippines , Taguig City

Salary:

Not provided

Wells Fargo

Expiration Date

Until further notice

Requirements

At least 6 months of Customer Service experience in BPO Industry.

Job Responsibility

Support fraud and claims functional area by proactively identifying opportunities to improve customer experience, and offer ideas to mitigate risks through effective authentication of customers in order to prevent fraudulent activity
Perform moderately complex customer support tasks by utilizing solid communication, and verbal and written skills to establish rapport with customer and to deescalate difficult, as well as sensitive information as a part of resolving a claim
Oversee multiple claim types, take appropriate action to decision the case using multiple systems and applications, and may contact third parties for research, as needed
Receive direction from supervisor and escalate questions or issues
Interact with immediate team and functional area on wider range of information, plus internal or external customers

Fulltime

Fraud & Claims Operations Representative

Wells Fargo is seeking a Fraud & Claims Operations Representative to review acco...

Location

Philippines , Taguig City

Salary:

Not provided

Wells Fargo

Expiration Date

March 15, 2026

Requirements

6+ months of customer service experience, or equivalent demonstrated through one or a combination of the following: work experience, training, military experience, education

Job Responsibility

Support and capture all pertinent information from customers about their claims
Conduct research and provide updates on status of new and existing claims
Identify opportunities to improve customer experience after thorough research of complex account activity, and take appropriate actions to handle the claim
Perform routine customer support tasks by maintaining balance between exceptional customer service and solid investigative research while answering incoming calls in a call center environment
Receive direction from team lead and escalate questions and issues to more experienced roles
Interact with colleagues on basic day-to-day issues, and network with supporting functional areas to create a seamless experience for the customers

Fulltime

Director, Payment Integrity

The Director, Payment Integrity provides strategic leadership and oversight for ...

Location

United States , Phoenix

Salary:

Not provided

Blue Cross Blue Shield of Arizona

Expiration Date

Until further notice

Requirements

10 years of experience in Payment Integrity, Special Investigation Unit, or healthcare anti-fraud
7+ years of experience in management role
2+ years of experience in Vendor Partner Oversight
contracting and vendor management of external payment vendors and/or audit firms
Demonstrated success in developing and executing enterprise-wide strategies
Bachelor's Degree in business, statistics, healthcare administration or related field of study
Intermediate PC proficiency
Intermediate skill in use of office equipment
Basic skill in word processing and presentation software
Intermediate proficiency in spreadsheet, statistical analysis, query / data mining, and business intelligence software

Job Responsibility

Develop and execute enterprise-wide Payment Integrity strategy aligned with organizational objectives and cost of care targets
Lead the design, implementation, and continuous improvement of payment integrity programs, including pre- and post-payment audits, recovery, and investigative functions
Establish and maintain governance structures, including cross-functional committees, to oversee payment integrity controls and policy development
Representing the organization in internal and external forums, collaborating with industry peers, regulatory bodies, and vendor partners to share best practices and drive innovation
Stay abreast of emerging trends, technologies, and regulatory shifts in the healthcare payment integrity space
Oversee day-to-day operations, ensuring timely, accurate, and compliant claims payment and recovery activities
Direct vendor management, including contracting, performance oversight, and strategic partnerships for payment integrity solutions
Drive automation and technology adoption to enhance payment integrity processes and reporting capabilities
Lead cost-benefit analyses to determine optimal resource allocation (internal vs. outsourced functions)
Set and monitor KPIs, SMART goals, and financial targets for payment integrity initiatives

Fulltime

Director, Payment Integrity

The Director, Payment Integrity provides strategic leadership and oversight for ...

Location

United States , Phoenix

Salary:

Not provided

Blue Cross Blue Shield of Arizona

Expiration Date

Until further notice

Requirements

10 years of experience in Payment Integrity, Special Investigation Unit, or healthcare anti-fraud
7+ years of experience in management role
2+ years of experience in Vendor Partner Oversight
contracting and vendor management of external payment vendors and/or audit firms
Demonstrated success in developing and executing enterprise-wide strategies
Bachelor's Degree in business, statistics, healthcare administration or related field of study
Intermediate PC proficiency
Intermediate skill in use of office equipment
Basic skill in word processing and presentation software
Intermediate proficiency in spreadsheet, statistical analysis, query / data mining, and business intelligence software

Job Responsibility

Develop and execute enterprise-wide Payment Integrity strategy aligned with organizational objectives and cost of care targets
Lead the design, implementation, and continuous improvement of payment integrity programs, including pre- and post-payment audits, recovery, and investigative functions
Establish and maintain governance structures, including cross-functional committees, to oversee payment integrity controls and policy development
Representing the organization in internal and external forums, collaborating with industry peers, regulatory bodies, and vendor partners to share best practices and drive innovation
Stay abreast of emerging trends, technologies, and regulatory shifts in the healthcare payment integrity space
Oversee day-to-day operations, ensuring timely, accurate, and compliant claims payment and recovery activities
Direct vendor management, including contracting, performance oversight, and strategic partnerships for payment integrity solutions
Drive automation and technology adoption to enhance payment integrity processes and reporting capabilities
Lead cost-benefit analyses to determine optimal resource allocation (internal vs. outsourced functions)
Set and monitor KPIs, SMART goals, and financial targets for payment integrity initiatives

Fulltime

Risk, Control & Compliance Manager

The Risk, Control & Compliance Manager will lead and inspire the centre team, co...

Location

Malaysia , Johor Bahru

Salary:

Not provided

IKEA

Expiration Date

Until further notice

Requirements

Bachelor's or master's degree in occupational health/safety, Environmental Engineering or a related field
10+ years of experience in a similar or compliance role in retail or related industries
Minimum 3+ years in managerial level
Experience with incident reporting and claims handling process with insurance company
Experience in managing FCC and security guards
Experience dealing with fire drills, system testing, and crisis management
Experience investigating fraud and unethical behaviours
Experience in setting and implementing long-term strategic plans, setting budgets, and following up goals

Job Responsibility

Lead and inspire the centre team, co-workers, and external security guard service to optimize safety, security, and compliance
Ensure business process compliance and standard operating procedures compliance
Identify safety & security hazards, process gaps and incorporate preventive, protective, and control measures
Define, establish, and implement operating procedures and standards
Ensure safety and security operating systems meet Ikano requirements and local legislation
Develop and implement operations guidelines, standards and procedures
Provide expertise on development of training materials for co-workers and external partners
Responsible for performance of outsourced security service providers
Ensure company standards are fulfilled in fire prevention, intrusion alarm, access control, video surveillance, safety systems
Lead risk topics regarding potential operational challenges

Fulltime

New

In-Home Nurse Practitioner or Physician Assistant

We’re building a world of health around every individual — shaping a more connec...

Location

United States , Harrisburg

Salary:

87035.00 - 187460.00 USD / Year

CVS Health

Expiration Date

December 31, 2026

Requirements

Active, unrestricted license(s) in coverage area(s)
Board certification (required)
Multi-state licenses (preferred)
Able to cover the following primary locations:

Job Responsibility

Provide In-Home Health Evaluations
Engage with people in the comfort of their own homes and help bridge gaps in care
Build trusted relationships to make people healthier
Bring flexible, comprehensive and personalized health evaluations right to people’s front doors
Conduct visits lasting about 45 minutes, including a medication and medical history review, a physical evaluation, and, if ordered, additional diagnostic tests (i.e., diabetic eye exams, spirometry, etc.)
Use an iPad and an intuitive clinical workflow for each evaluation
Be flexible to travel locally and within licensed states, as needed
Conduct virtual visits as needed
Provide all Signify Health services as indicated including Diagnostic & Preventive Services products (i.e., spirometry, DEE, bone density screening, etc.)

What we offer

Health, dental and vision insurance
Paid time off
Annual CEU allowance
401K
Supplies and other perks
Malpractice coverage
Affordable medical plan options, a 401(k) plan (including matching company contributions), and an employee stock purchase plan
No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching
Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility

Fulltime

New

Shift Supervisor

A Shift Supervisor is a key leader supporting the CVS Store Management team in d...

Location

United States , Sumter

Salary:

16.00 - 23.00 USD / Hour

CVS Health

Expiration Date

April 09, 2026

Requirements

Deductive reasoning ability, analytical skills and computer skills
Advanced communication skills and supervision skills
Ability to work a flexible schedule, including some early morning, overnight and weekend shifts, to work overtime as needed, and to respond to urgent issues at the store when they arise

Job Responsibility

Work effectively with store management and store crews
Supervise the store’s crew through assigning, directing and following up of all activities
Effectively communicate information both to and from store management and crews
Assist customers with their questions, problems and complaints
Promote CVS customer service culture. (Greet, offer help, and thank)
Handle all customer relations issues in accordance with company policy and promote a positive shopping experience for all CVS customers
Maintain customer/patient confidentiality
Price merchandise
Stock shelves
Execute the displays, sign and inventory of weekly, promotional, and seasonal merchandise

What we offer

Affordable medical plan options
401(k) plan (including matching company contributions)
Employee stock purchase plan
No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching
Paid time off
Flexible work schedules
Family leave
Dependent care resources
Colleague assistance programs
Tuition assistance

Parttime

Fraud & Claims Operations Representative

Wells Fargo

Location:
India , Hyderabad

Category:
Customer Service

Contract Type:
Not provided

Salary:

Job Description:

Job Responsibility:

Requirements:

Additional Information:

Job Posted:
February 23, 2026

Expiration:
February 24, 2026

Looking for more opportunities? Search for other job offers that match your skills and interests.

Similar Jobs for Fraud & Claims Operations Representative

Lead Fraud & Claims Operations Representative