Claims Investigator

Placements24; Soweto; Hybrid; ZAR 300,000 - 520,000; Full time

Benefits offered by this job

Hybrid work arrangement

Comprehensive health insurance

Retirement plan

Training in fraud detection

Job summary

Placements24 is seeking a thorough and analytical Claims Investigator for the Soweto area and beyond in Gauteng. You will verify the legitimacy of insurance claims, conduct detailed investigations, and gather evidence to support claim decisions.

Collaborating with adjusters and legal teams, you will help prevent fraud and ensure fair settlements. This hybrid role emphasizes integrity, investigative skill, and precise reporting to protect the claims process.

Qualifications

• Experience in claims investigation, law enforcement, or related investigative field.
• Strong understanding of insurance claims processes and common fraud schemes.
• Excellent interviewing, observation, and evidence-gathering skills.
• Proficiency in report writing and documentation.

Responsibilities

• Conduct thorough investigations into suspicious or complex insurance claims to determine validity.
• Gather evidence, including interviewing claimants, witnesses, and reviewing relevant documents.
• Analyze claim information and investigative findings to prepare comprehensive reports.
• Identify potential instances of fraud and provide recommendations for further action.
• Liaise with legal counsel, law enforcement, and other external parties as needed during investigations.

Skills

Interviewing

Investigation

Report writing

Analytical ability

Job description

About the Role

Our client is seeking a thorough and analytical Claims Investigator to join their claims department serving the Soweto area and beyond. This role is essential for verifying the legitimacy of insurance claims, conducting detailed investigations, and gathering evidence to support claim decisions. You will work closely with adjusters and legal teams to prevent fraud and ensure fair claim settlements. Your diligence and investigative skills will be key to maintaining the integrity of the claims process for our client in Gauteng .

Key Responsibilities

• Conduct thorough investigations into suspicious or complex insurance claims to determine validity.
• Gather evidence, including interviewing claimants, witnesses, and reviewing relevant documents.
• Analyze claim information and investigative findings to prepare comprehensive reports.
• Identify potential instances of fraud and provide recommendations for further action.
• Liaise with legal counsel, law enforcement, and other external parties as needed during investigations.

Requirements

• Previous experience in claims investigation, law enforcement, or a related investigative field.
• Strong understanding of insurance claims processes and common fraud schemes.
• Excellent interviewing, observation, and evidence-gathering skills.
• Proficiency in report writing and documentation.
• High level of integrity, discretion, and analytical ability.

Benefits

• Competitive salary and performance-based incentives.
• Hybrid work arrangement offering flexibility.
• Comprehensive health insurance and retirement plan.
• Training and development opportunities in fraud detection and investigation techniques.
• A challenging and rewarding role contributing to the prevention of insurance fraud.