Claims Investigator

Placements24; Vereeniging; Hybrid; ZAR 300,000 - 420,000; Full time

Benefits offered by this job

Hybrid work

Medical insurance

Retirement savings plan

Professional development

Performance bonus

Job summary

Placements24 is seeking a proactive Claims Investigator to join our client’s team in Vereeniging. You will verify claims, gather evidence, interview relevant parties, and prepare reports to support fair decisions. This hybrid role blends remote work with in-office collaboration to maintain teamwork.

You will review complex claims, apply insurance principles, and identify red flags while upholding legal and company standards. A dynamic environment offers growth and impact in the insurance field.

Qualifications

• Previous experience as a Claims Investigator or in a related field such as law enforcement or fraud detection.
• Strong understanding of insurance principles and claims handling processes.
• Excellent interviewing, surveillance, and evidence-gathering techniques.
• Proficiency in report writing and maintaining detailed investigation records.
• Strong analytical and critical thinking skills to assess complex situations.
• Ability to work independently and manage multiple cases simultaneously.

Responsibilities

• Conduct thorough investigations into suspicious or complex insurance claims across various policy types.
• Gather evidence, including documents, statements, and physical inspection where necessary.
• Interview claimants, witnesses, and other relevant parties to obtain accurate information.
• Analyze investigation findings and prepare detailed, objective reports for claims adjusters and management.
• Identify potential fraud indicators and recommend appropriate actions.
• Ensure investigations are conducted efficiently, ethically, and in compliance with legal and company standards.

Skills

Investigation

Insurance knowledge

Interviewing

Report writing

Analytical thinking

Independent work

Case management

Job description

About the Role

Our client is seeking a proactive and thorough Claims Investigator to join their dedicated team in Vereeniging . This role is essential for verifying the circumstances and validity of insurance claims, ensuring that payouts are made accurately and appropriately. You will conduct detailed investigations, gather evidence, interview relevant parties, and prepare comprehensive reports to support claims decisions. This position offers a challenging yet rewarding career path within the insurance industry, providing the opportunity to contribute to fairness and integrity, with a hybrid work model that offers flexibility while maintaining essential team collaboration.

Key Responsibilities

• Conduct thorough investigations into suspicious or complex insurance claims across various policy types.
• Gather evidence, including documents, statements, and physical inspection where necessary.
• Interview claimants, witnesses, and other relevant parties to obtain accurate information.
• Analyze investigation findings and prepare detailed, objective reports for claims adjusters and management.
• Identify potential fraud indicators and recommend appropriate actions.
• Ensure investigations are conducted efficiently, ethically, and in compliance with legal and company standards.

Requirements

• Previous experience as a Claims Investigator or in a related field such as law enforcement or fraud detection.
• Strong understanding of insurance principles and claims handling processes.
• Excellent interviewing, surveillance, and evidence-gathering techniques.
• Proficiency in report writing and maintaining detailed investigation records.
• Strong analytical and critical thinking skills to assess complex situations.
• Ability to work independently and manage multiple cases simultaneously.

Benefits

• Competitive salary and potential performance bonuses.
• Hybrid work arrangement combining remote work with in-office collaboration.
• Comprehensive medical insurance and retirement savings plan.
• Support for professional development and relevant certifications.
• A challenging and dynamic work environment.