Claims Investigator

Placements24; East London; Hybrid; ZAR 420,000 - 560,000; Full time

Benefits offered by this job

Fully remote position

Health & wellness benefits

Ongoing training in fraud detection

Competitive salary and incentives

Job summary

Placements24 in South Africa is seeking a proactive Claims Investigator to join our remote team serving clients in the Eastern Cape and beyond. You will verify claims, gather evidence, interview parties, and produce comprehensive reports to support settlement decisions.

The role offers a fully remote arrangement, competitive salary with incentives, health benefits, and ongoing training in fraud detection. You will work independently to manage cases and liaise with claims handlers and law

Qualifications

• Proven experience as a Claims Investigator in the insurance industry.
• Strong investigation, evidence collection, and report-writing skills.
• Excellent interviewing abilities and the ability to work remotely.
• Ability to manage case files independently in a remote environment.

Responsibilities

• Conduct thorough investigations into insurance claims to assess validity.
• Gather documents, statements, and physical evidence to build a case.
• Interview claimants, witnesses, and involved parties.
• Prepare objective investigation reports with findings and recommendations.
• Liaise with claims handlers, legal counsel, and law enforcement as needed.
• Identify patterns to aid fraud prevention strategies.

Skills

Investigation techniques

Evidence collection

Interviewing

Report writing

Remote work

Tools

Case management system

Job description

About the Role

Our client is seeking a proactive and thorough Claims Investigator to join their remote team, serving clients across the Eastern Cape and beyond. This role is essential for verifying the circumstances and validity of insurance claims, preventing fraudulent payouts, and ensuring that legitimate claims are processed efficiently. You will be responsible for conducting detailed investigations, gathering evidence, interviewing relevant parties, and providing comprehensive reports to support claims settlement decisions. This is an excellent opportunity for an experienced investigator to work remotely and contribute significantly to the integrity of the insurance process.

Key Responsibilities

• Conduct thorough investigations into suspicious or complex insurance claims across various lines of business.
• Gather and analyze evidence, including documents, statements, and physical evidence, to determine the validity of claims.
• Interview claimants, witnesses, and other involved parties to obtain accurate information.
• Prepare detailed, objective investigation reports with clear findings and recommendations.
• Liaise with claims handlers, legal counsel, and law enforcement agencies as necessary.
• Identify patterns and trends in fraudulent activities to aid in prevention strategies.

Requirements

• Proven experience as a Claims Investigator or in a similar investigative role, preferably within the insurance industry.
• Strong understanding of investigation techniques, evidence collection, and report writing.
• Excellent interviewing and interpersonal skills, with the ability to remain objective and professional.
• Proficiency in researching and analyzing information from various sources.Ability to work independently and manage case files effectively in a remote environment.

Benefits

• Competitive annual salary and potential performance incentives.
• Fully remote position offering significant flexibility.
• Comprehensive health and wellness benefits.
• Opportunities for ongoing training in investigative techniques and fraud detection.
• A crucial role in upholding the company's commitment to fairness and fraud prevention.