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Fraud Operations Analyst

Equity Staffing Group -
Remote

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Job Details

Full-time
4 days ago

Qualifications

Trend analysis
Investigative data analysis
Client interaction via phone calls

Full Job Description

Equity Staffing Group is seeking a Fraud Operations Analyst to support one of our premier healthcare clients. This fully remote opportunity is ideal for professionals with experience in fraud operations, commercial payments, banking, payment processing, or case investigations who enjoy analyzing data, solving problems, and protecting organizations from fraudulent activity.
In this role, you'll review and investigate payment-related fraud cases, validate account and enrollment information, communicate with providers and stakeholders, and maintain accurate case documentation while working in a fast-paced, high-volume environment.

Responsibilities

Review assigned fraud cases involving commercial enrollment, account changes, provider validation, and payment activity across ACH, virtual card, and check payment workflows.
Manage and prioritize a high-volume case inventory while meeting turnaround times and service level expectations.
Analyze transactional data, payment records, enrollment information, validation results, and supporting documentation to identify suspicious activity.
Conduct outbound calls with providers, customers, clients, payers, and internal business partners to verify enrollment, payment, and account information.
Identify fraud indicators, payment anomalies, account discrepancies, and potential financial risks.
Document investigation findings, case summaries, assumptions, and supporting evidence in accordance with company standards.
Escalate suspected fraud, ownership concerns, payment exceptions, or unresolved issues through established procedures.
Utilize case management systems, validation tools, reporting platforms, and Microsoft 365 applications to maintain organized and audit-ready documentation.
Prepare status updates, operational reports, inventory summaries, and trend observations for leadership and stakeholders.
Ensure compliance with company policies, privacy regulations, audit requirements, and healthcare, banking, and payment industry standards.
Handle confidential information with professionalism and maintain accurate documentation throughout the investigation process.

Required Qualifications

2+ years of experience in one or more of the following:
- Fraud operations
- Commercial payments
- Banking operations
- Payment processing
- Transaction review
- Enrollment operations
- Loss prevention
- Audit support
- High-volume case review environments
Experience conducting outbound calls to gather information, validate records, and document findings.
Strong analytical and critical thinking skills with the ability to identify trends and anomalies.
Excellent written and verbal communication skills.
Ability to work independently in a fully remote environment while managing multiple priorities.
Intermediate proficiency with Microsoft 365, including:
- Excel
- Word
- Outlook
- Teams
- PowerPoint
- SharePoint
Experience working with payment platforms, banking systems, identity validation tools, case management systems, or research databases.
Ability to adapt quickly in a fast-paced environment with changing priorities and evolving fraud trends.

Preferred Qualifications

Experience supporting commercial payments, provider enrollment, healthcare payment operations, or banking operations.
Experience with ACH, virtual card, and check payment workflows.
Salesforce experience strongly preferred.
Experience reviewing fraud indicators, payment exceptions, enrollment activity, or account changes.
Knowledge of reporting and analytics tools such as Excel, Tableau, or Power BI.
Exposure to regulatory compliance, audit requirements, legal documentation, or client-facing operational processes.

If you're a detail-oriented professional with experience in fraud investigations, banking, payment operations, or case management, apply today with Equity Staffing Group!

#indnitca

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