Fraud Operations Analyst

About the Role

Equity Staffing Group is looking for a Temporary Fraud Operations Analyst to join a prominent healthcare organization remotely for around six months. The position focuses on supporting fraud prevention and verifying payment processes in a demanding, high-volume setting.

Key Responsibilities

• Investigate fraud-related cases concerning provider enrollment, account modifications, and payment activities.
• Examine transactional, enrollment, and payment data to detect suspicious behaviors and possible fraud indicators.
• Make outbound calls to providers and business partners to confirm information and collect evidence.
• Maintain detailed documentation of findings, keep precise case records, and escalate issues as needed.
• Manage an assigned case workload while adhering to service level goals and turnaround times.
• Compile case summaries, provide status reports, and observe trends for leadership and stakeholders.

Qualifications

• Minimum of two years' experience in fraud operations, payment operations, banking, audit, compliance, loss prevention, provider enrollment, or related investigative roles.
• Proven experience in making outbound verification calls and recording outcomes.
• Strong analytical, organizational, and problem-solving capabilities.
• Ability to work independently within a remote work setting.
• Proficient in Microsoft Office applications, particularly Excel.
• Experience with Salesforce or other case management platforms preferred.
• Additional experience in healthcare payment operations, provider onboarding, ACH, virtual card, or check payments is advantageous.