Fraud & Claims Call Monitoring Lead
Citizens Bank
Description The Fraud & Claims Call Monitoring Lead is responsible for leading quality assurance and control activities while driving business outcomes, supporting team performance, and acting as a key liaison between frontline QC staff and leadership. This role requires strong leadership presence, independent decision-making, and the ability to influence business processes and outcomes. The Call Monitoring Lead operates with minimal oversight, leads critical initiatives, and ensures alignment between QC activities and broader business, risk, and customer impact objectives. Primary responsibilities include Advanced understanding of QC methodologies, controls, and business processes Strong analytical skills with the ability to interpret trends and drive business insights Demonstrated leadership capability without direct authority (influence-based leadership) Experience leading meetings, presentations, and cross-functional discussions independently Strong communication skills (written and verbal), especially in translating data into business impact Proven ability to manage competing priorities and drive outcomes Proficiency in reporting tools, dashboards, and data analysis (e.g., Excel, reporting platforms) Core Qualifications & Skills Advanced understanding of QC methodologies, controls, and business processes Strong analytical skills with the ability to interpret trends and drive business insights Demonstrated leadership capability without direct authority (influence-based leadership) Experience leading meetings, presentations, and cross-functional discussions independently Strong communication skills (written and verbal), especially in translating data into business impact Proven ability to manage competing priorities and drive outcomes Proficiency in reporting tools, dashboards, and data analysis (e.g., Excel, reporting platforms) Functional Leadership Operates independently, presenting findings, insights, and recommendations with minimal leadership support Serves as a subject matter leader in meetings, reviews, and cross‑functional engagements Ensures consistency, accuracy, and alignment in QC practices and outputs Business & Strategic Impact Champions corporate and business-line initiatives impacting QC, including AI and process modernization Leads Business Line Reviews (BLRs) and stakeholder meetings independently Drives closed‑loop resolution of identified issues impacting customers or business outcomes Translates QC findings into actionable insights that influence business decisions Team Leadership & Development Develops and delivers training plans and materials for new and existing colleagues Supports hiring and onboarding activities (e.g., interviews, access setup coordination) Acts as a primary escalation point and buffer between team members (S3, S4, P1) and leadership Conducts spot checks and peer reviews to ensure quality and consistency Coaches team members using findings to improve performance and capability Owns performance management administrative activities, including tracking key metrics Leads by example, reinforcing professionalism, accountability, and positive team behaviors Problem Solving & Decision Support Identifies trends, themes, and complex issues across QC results Performs fact‑based analysis to develop and recommend solutions to leadership Ensures issues are fully resolved, not just documented Leads decision support efforts for escalations, exceptions, and disputes Provides input into business decisions related to corrective actions and risk mitigation Operational Impact Drives team outcomes and ensures timely completion of work across all levels (S3, S4, P1) Maintains limited individual QC workload, focusing primarily on leadership and oversight responsibilities Leads walkthroughs and supports audits, risk reviews, and GenAI‑related initiatives Ensures readiness for internal and external audits through strong documentation and execution Interpersonal & Influence Skills Models strong professionalism, sound judgment, and collaboration Builds trust as a reliable escalation and advisory resource Effectively navigates sensitive or complex conversations with business partners and stakeholders Acts as a bridge between QC teams and leadership, ensuring clarity and alignment Qualifications, Education, Certifications and/or Other Professional Credentials Required Qualifications 1-2 years experience in Fraud or Claims operations or; 1-2 years QC experience within a financial services environment Advanced understanding of QC methodologies, controls, and business processes Strong analytical skills with the ability to interpret trends and drive business insights Demonstrated leadership capability without direct authority (influence‑based leadership) Experience leading meetings, presentations, and cross‑functional discussions independently Strong communication skills (written and verbal), especially in translating data into business impact Proven ability to manage competing priorities and drive outcomes Proficiency in reporting tools, dashboards, and data analysis (e.g., Excel, reporting platforms) Hours & Work Schedule Hours per Week: 40 Work Schedule: Hybrid 4 Days in Office - Monday- Friday 8:00am-5:00pm Equal Employment Opportunity Citizens, its parent, subsidiaries, and related companies (Citizens) provide equal employment and advancement opportunities to all colleagues and applicants for employment without regard to age, ancestry, color, citizenship, physical or mental disability, perceived disability or history or record of a disability, ethnicity, gender, gender identity or expression, genetic information, genetic characteristic, marital or domestic partner status, victim of domestic violence, family status/parenthood, medical condition, military or veteran status, national origin, pregnancy/childbirth/lactation, colleague’s or a dependent’s reproductive health decision making, race, religion, sex, sexual orientation, or any other category protected by federal, state and/or local laws. At Citizens, we are committed to fostering an inclusive culture that enables all colleagues to bring their best selves to work every day and everyone is expected to be treated with respect and professionalism. Employment decisions are based solely on merit, qualifications, performance and capability. #J-18808-Ljbffr Citizens Bank
- Description The Fraud & Claims Call Monitoring analyst independently executes call monitoring reviews across the fraud & claims call center colleagues, ensuring accuracy, compliance, and operational adherence during customer interactions. This role applies established...ClaimsFraudWork at officeLocal areaMonday to Friday
- Citizens Bank seeks a Fraud & Claims Call Monitoring analyst to ensure accuracy and compliance in customer interactions. This role requires strong analytical and communication skills, with a focus on process improvement. The ideal candidate will have 3-5 years of operations...ClaimsFraud
- Citizens Bank is looking for a Fraud & Claims Call Monitoring analyst to conduct independent monitoring reviews in a hybrid work environment. This role requires attention to detail to ensure compliance and operational effectiveness during customer interactions. Ideal candidates...ClaimsFraud
- A leading financial institution is seeking a Call Monitoring Manager to oversee the call monitoring quality assurance program. This role requires strong leadership to manage a team and foster quality excellence while collaborating with operations and compliance teams....SuggestedWork at officeMonday to Friday
$249.97k - $388.13k
...Director, Global Value Evidence Lead, is a strategic leader... ...Statement Regarding Job Recruiting Fraud Scams At Otsuka we take security... ...processing fee, even if claimed you will be reimbursed, this is... ...fraudulent, please contact Otsuka's call center at: (***) ***-****. If...ClaimsFraudTemporary workLocal areaFlexible hours- ...Description Queue Manager in the Fraud Department Manager Call Notes ~ Looking for a... ...detection systems and claims systems ~ they manage an... ...similar work and he would be the lead candidate right now, this... ...creation and maintenance, monitors workflow progression to meet...ClaimsFraudInternshipWork at office
- The Call Monitoring Manager is responsible for leading and overseeing the call monitoring (quality assurance) program to ensure consistent, accurate, and risk‑aware evaluation of customer interactions. This role partners closely with business leaders, operations, compliance...Work experience placementWork at officeLocal areaMonday to Friday
$249.97k - $388.13k
...the clinical strategy, leading cross-functional study... ...documents including medical monitoring plans, asset... ...Regarding Job Recruiting Fraud Scams At Otsuka we take... ...processing fee, even if claimed you will be reimbursed,... ...please contact Otsuka’s call center at: (***) ***-****...ClaimsFraudTemporary workLocal areaFlexible hours$230.72k - $345k
...therapeutic areas. This role leads and develops a high-... ..., ongoing performance monitoring, and course correction... ...Job Recruiting Fraud Scams At Otsuka we take... ...processing fee, even if claimed you will be reimbursed,... ...please contact Otsuka's call center at: (***) ***-****...ClaimsFraudTemporary workLocal areaFlexible hours- ...seeking a Senior Clinical Research Associate (Sr. CRA) in Providence, Rhode Island. The Sr. CRA is responsible for site management and monitoring of clinical trials, ensuring quality execution and compliance with GCP standards. The ideal candidate will have extensive...
- ...collaboration with investigators and ensures compliance with ICH-GCP standards. The ideal candidate will have over 5 years of CRA experience, including oncology, and will be responsible for site management, study monitoring, and data quality assurance. #J-18808-Ljbffr ParexelLocal area
$86.3k - $118.7k
...in outstanding dental cases. Within this position the Dental Fraud and Waste Lead for the Humana Dental SIU Team will complete dental clinical... ...of investigative or auditing experience of dental related claims ~ Knowledge of Medicare regulations ~ Knowledge of Medicaid...ClaimsFraudFull timeTemporary workFor contractorsRemote workWork from homeHome officeMonday to Friday- Syneos Health/ inVentiv Health Commercial LLC is seeking a Clinical Research Associate to manage site activities ensuring compliance with regulations and quality standards. You will perform site qualifications, manage recruitment strategies, and evaluate site performance...Flexible hours
- A financial services organization in Johnston is seeking a Call Monitoring Manager to oversee the call monitoring program. You will lead a team focused on quality assurance, develop processes to align with business needs, and collaborate with operations and training teams...
- ...Club values. The Finance Manager leads the preparation and analysis... ..., budgeting cycles, and claims‑related financial processes will... ...entries. Tracks monthly accruals, monitoring for accuracy/trends, and... ...procedural gaps that could lead to fraud and recommends safeguards....ClaimsFraudFull timeWork at officeRemote work
$92.7k - $203.94k
...actionable product direction, monitoring shifts to identify emerging opportunities and risks Lead a cross-functional squad of data... ...Payment Integrity, with a focus on Fraud, Waste, & Abuse (FWA) Strong... ...knowledge of healthcare claims processing, including end‑to‑end...ClaimsFraudHourly payFull timeTemporary workWork experience placementLocal areaShift work$27.88 - $37.02 per hour
...AUV operations. ABOUT THE ROLE We are seeking a Lead Manufacturing Test Technician to join our team... ...clicking on links. What to Do If You Suspect Fraud: Should you encounter any questionable or fraudulent outreach claiming to be from Anduril, please report it immediately...ClaimsFraudHourly payFull timeWork experience placementImmediate startRelocation packageFlexible hours- ...involving cases, documents, and claims. Due to client requirements... ...and GitHub or Bitbucket. Lead deployments across Development... ...delivery and release efficiency. Monitor and support the application... ...activity, please contact fraud@eliassen.com . About...ClaimsFraudHourly payContract workLocal areaRemote work
- ...Union is seeking a Compliance Specialist II to support its Compliance Management System with responsibilities that include leading compliance monitoring, managing compliance functions, and providing guidance to business units. The ideal candidate will have 3-6 years of...
- ...Our goal is always to deliver optimal results at the best possible value. The Consulting Group provides risk management and claims monitoring services and strategic advice to architects and engineers and their professional liability insurers. The Consulting Group is...ClaimsContract workLocal areaRemote work
- ...Description Citizens Fraud & Claims Operations is seeking a seasoned leader to own the end-to... ...products. This role is responsible for leading chargeback processing, recovery operations... ...across onshore and offshore teams. Monitor and maintain compliance with Mastercard...ClaimsFraudWork at officeLocal areaMonday to Friday
$169.4k - $279.6k
...capabilities and paving the way for best-in-class solutions. As a Lead Architect, you will collaborate with senior Technology and... ...selection and routing, RAG pipelines, memory systems, and tool/function-calling patterns — while promoting reusability, interoperability, and...ClaimsTemporary workWork experience placementLocal area$19.01 - $23.72 per hour
...A health services organization is seeking a Pharmacy Call Center Technician to ensure effective delivery of pharmacy services. This... ...guidance to front line staff, responding to inquiries regarding drug claims and authorizations. The position needs someone experienced in...ClaimsHourly pay$186.49k - $278.88k
...PD and regulatory submissions. Leads study design, execution and... ...Statement Regarding Job Recruiting Fraud Scams At Otsuka we take... ...processing fee, even if claimed you will be reimbursed, this is... ...fraudulent, please contact Otsuka's call center at: (***) ***-****. If...ClaimsFraudContract workTemporary workLocal areaFlexible hours$19 per hour
...Overview Allied Universal®, North America’s leading security and facility services company,... ...As a Security Officer Patrol Monitor in Providence, RI , you will serve and... ...for you and explore new roles using our Claim a Shift platform. Learn more: aus.com/earnmore...ClaimsPart timeWork at officeLocal areaShift work$209.6k - $313.38k
...The Director will lead activities related to Early... ...investigator brochures; monitor safety and contribute to... ...Job Recruiting Fraud Scams At Otsuka we take... ...processing fee, even if claimed you will be reimbursed,... ...please contact Otsuka’s call center at: (***) ***-****...ClaimsFraudTemporary workLocal areaFlexible hours$71.2k - $166.1k
...to the member, provider, and claim Create novel and standard insightful... ...for financial evaluations and fraud vulnerabilities Communicate... ...your potential at a company leading the way in AI and cloud... ...****@*****.*** or by calling (***) ***-**** in the United...ClaimsFraudTemporary workWork experience placementFlexible hours$186.49k - $278.88k
...roles/experience ~3+ years leading and translating an integrated... ...Statement Regarding Job Recruiting Fraud Scams At Otsuka we take... ...application processing fee, even if claimed you will be reimbursed, this... ..., please contact Otsuka’s call center at: (***) ***-****. If you...ClaimsFraudTemporary workLocal areaFlexible hoursShift work- A leading IT staffing company in Rhode Island is seeking a Call Center Representative to handle inbound calls regarding claims and billing for MetLife insurance products. The role requires strong communication and organizational skills, as well as the ability to work various...ClaimsShift work
- ...Job Title: Fraud operations specialist Location: Johnston, RI Duration: 6 Months Contract Pay Rate: $23/hr W2 Job Description... ...consists of 16 members handling multiple fraud detection and claims processing streams, email inbox management, and fraud case...ClaimsFraudContract workMonday to FridayFlexible hours
Do you want to receive more vacancies?
Subscribe and receive similar vacancies to Fraud & Claims Call Monitoring Lead. Be the first to apply!


