Fraud Triage Specialist (Mobile)

This position is listed on behalf of a partner company, who manages all applications and next steps. Our partner is looking for a Fraud Triage Specialist (Mobile) based in the United States.

This role offers an opportunity to play a key part in safeguarding the integrity and profitability of insurance, warranty, and mobile protection programs by identifying and analyzing potential fraud and risk indicators. You will work within a fast-paced operational environment where attention to detail, analytical thinking, and investigative skills are essential. The position involves reviewing claims, detecting suspicious patterns, and collaborating with specialized investigation teams to ensure accurate and compliant outcomes. You will also leverage data insights and system tools to support fraud prevention efforts and enhance operational controls. This is a highly collaborative role where your findings directly contribute to risk mitigation strategies and process improvements. Ideal candidates are detail-oriented professionals who thrive in data-driven environments and enjoy solving complex, high-impact problems.

• Review and process claims with identified risk indicators, conducting detailed analysis to detect potential fraud patterns and anomalies.
• Collaborate with Special Investigations Unit (SIU) investigators and support fraud referrals, callbacks, and escalation processes when necessary.
• Research and respond to internal inquiries, ensuring accurate documentation and timely communication across stakeholders and customers.
• Analyze data and off-system information sources to identify trends, emerging risks, and fraud indicators.
• Maintain compliance with fraud detection protocols, reporting standards, and risk management policies across all assigned work queues.
• Identify recurring issue patterns and escalate findings to leadership for further action and process improvement.
• Support the development and implementation of fraud detection tools, workflows, and preventive measures.
• Participate in operational meetings to provide feedback, align on performance, and contribute to process enhancements.
• Provide guidance to team members on fraud detection best practices and case handling procedures.
• Complete post-decision tasks such as updating BOLOs, risk flags, and negative lists in system databases.
• Ensure adherence to productivity, quality, and accuracy standards across all claim reviews and fraud assessments.

Requirements

• High school diploma or GED required; additional education (associate degree or higher) preferred.
• 3+ years of experience in a customer service, claims, insurance, or risk-related environment.
• Strong analytical and problem-solving skills, with experience working with data or statistical analysis.
• Ability to obtain and maintain an Insurance Adjuster License, including completion of required coursework and continuing education.
• Proficiency in Microsoft Office applications (Word, Excel, Outlook) and ability to work across multiple systems and platforms.
• Strong written and verbal communication skills with the ability to clearly document and present findings.
• Ability to analyze complex issues and provide recommendations that impact team and business outcomes.
• Experience working with multiple systems, databases, or risk management tools is highly beneficial.
• Strong attention to detail, organizational skills, and ability to manage competing priorities in a fast-paced environment.
• Ability to collaborate effectively with internal teams and external stakeholders, including investigators and operational leaders.
• Familiarity with insurance claims, fraud detection processes, or risk management practices is a plus.
• Current insurance adjuster license and experience with mobile claims systems are advantageous.

Benefits

• Hourly pay range of $20.96 to $34.59, based on experience and location.
• Fully remote work opportunity within the United States.
• Opportunity to contribute directly to fraud prevention and risk management initiatives.
• Exposure to advanced claims systems, analytics tools, and investigative processes.
• Career development within insurance, fraud detection, and risk operations.
• Comprehensive benefits package including healthcare, retirement, and paid time off (subject to eligibility and employer policies).
• Structured training and ongoing professional development opportunities.
• Collaborative and mission-driven work environment focused on operational excellence and integrity.