Insurance Investigator - Fraud Detection

Placements24; Queenstown; Vor Ort; NZD 39.000 - 58.000; Vollzeit

Benefits dieser Stelle

Competitive salary package

Medical aid plan

Retirement fund contributions

Training and certifications in fraud

Professional development opportunities

Zusammenfassung

Placements24 is seeking an Insurance Investigator to join a dedicated fraud detection unit in Queenstown. The role focuses on identifying, investigating and preventing fraudulent insurance claims, with responsibilities spanning interviews, data analysis, evidence collection, and reporting.

The ideal candidate has strong deductive reasoning, attention to detail, and knowledge of claim processes and fraud schemes.

Qualifikationen

• Matriculation certificate required; tertiary qualification in Criminal Justice/Law/Forensic Science advantageous.
• Minimum of 3 years in insurance claims investigation, fraud detection, or related law enforcement role.
• Knowledge of insurance claims processes and common fraud schemes.
• Excellent observational, analytical, and deductive reasoning skills.
• Strong interviewing and interrogation techniques and excellent report writing.

Aufgaben

• Investigate suspicious insurance claims across lines of business to detect fraud.
• Conduct interviews with claimants, witnesses, and other parties to gather information.
• Analyze claim data, policy information, and financial records to identify irregularities.
• Collect and preserve evidence in line with legal and company standards.
• Prepare comprehensive investigation reports with findings, evidence, and recommendations.
• Collaborate with law enforcement, legal counsel, and internal stakeholders to pursue fraud cases.
• Develop and implement proactive strategies to prevent insurance fraud.
• Stay updated on emerging fraud trends, typologies, and investigation techniques.
• Testify in legal proceedings when required.

Kenntnisse

Observational

Analytical

Deductive reasoning

Interviewing techniques

Report writing

Integrity

Independence

Multi-tasking

Ausbildung

Matriculation certificate

Tertiary qualification in Criminal Justice/Law/Forensic Science (advantageous)

Tools

Investigation tools and databases

Jobbeschreibung

About the Role

Our client, a leading provider of specialized insurance services, is seeking a meticulous and analytical Insurance Investigator to join their dedicated fraud detection unit in Queenstown, Eastern Cape . This role is crucial in safeguarding the company's assets by identifying, investigating, and preventing fraudulent insurance claims. The successful candidate will be responsible for conducting thorough investigations, gathering evidence, and preparing detailed reports to support legal and recovery actions. The ideal candidate possesses strong deductive reasoning skills, a keen eye for detail, and a thorough understanding of insurance claim processes and common fraud schemes. This is an excellent opportunity to contribute to maintaining the integrity of the insurance industry.

Key Responsibilities

Investigate suspicious insurance claims across various lines of business to detect potential fraud. Conduct interviews with claimants, witnesses, and other relevant parties to gather information. Analyze claim data, policy information, and financial records to identify irregularities and inconsistencies. Collect and preserve evidence in accordance with legal and company standards. Prepare comprehensive investigation reports, documenting findings, evidence, and recommendations. Collaborate with law enforcement agencies, legal counsel, and internal stakeholders to pursue fraudulent cases. Develop and implement proactive strategies to prevent insurance fraud. Stay updated on emerging fraud trends, typologies, and investigation techniques. Maintain strict confidentiality and adherence to ethical standards throughout investigations. Testify in legal proceedings when required.

Requirements

• A Matriculation certificate is required; a tertiary qualification in Criminal Justice, Law, Forensic Science, or a related field is advantageous.
• A minimum of 3 years of experience in insurance claims investigation, fraud detection, or a related law enforcement role.
• Demonstrated knowledge of insurance claims processes and common fraud schemes.
• Excellent observational, analytical, and deductive reasoning skills.
• Strong interviewing and interrogation techniques.
• Exceptional report writing and documentation abilities.
• Proficiency in using investigation tools and databases.
• High level of integrity, discretion, and professionalism.
• Ability to work independently and manage multiple investigations simultaneously.
• Must be based in or willing to relocate to Queenstown, Eastern Cape.

Benefits

Our client offers a competitive salary with potential for performance-based bonuses related to successful fraud recovery. A comprehensive medical aid plan and retirement fund contributions are provided. Opportunities for specialized training in fraud investigation techniques and relevant certifications are available. The company fosters a supportive work environment dedicated to upholding ethical standards and promoting professional development. Join our team in Queenstown and play a vital role in combating insurance fraud.