Claims Investigator - Fraud Detection

Placements24; Noord-Kaap; On-site; ZAR 360,000 - 600,000; Full time

Benefits offered by this job

Competitive salary

Medical aid

Retirement fund contributions

Training in advanced investigativeTech

Job summary

Placements24 is seeking a diligent Claims Investigator to join a dedicated fraud detection unit in Kimberley, Northern Cape. You will scrutinize insurance claims for fraud indicators, conduct thorough investigations, gather evidence, and prepare comprehensive reports to support findings.

The role requires strong analytical and interviewing skills, detail-oriented work, and collaboration with claims and legal teams to safeguard assets and reduce losses.

Qualifications

• Solid analytical skills and attention to detail.
• Experience in insurance claims handling or fraud investigation.
• Ability to conduct interviews and gather evidence.

Responsibilities

• Review claims for fraud indicators and conduct investigations.
• Gather evidence, interview claimants and witnesses, and document findings.
• Analyse claim data, policy information and supporting docs.
• Prepare investigation reports with clear conclusions and recommendations.
• Coordinate with claims and legal departments; liaise with external agencies as needed.

Skills

Analytical thinking

Interviewing

Attention to detail

Report writing

Education

Matriculation or equivalent

Tertiary qualification a plus

Tools

Investigation software

Job description

About the Role

Our client, a leading insurance provider, is seeking a diligent and observant Claims Investigator to join their dedicated fraud detection unit in Kimberley . This vital role involves scrutinizing insurance claims to identify potential fraudulent activities, conducting thorough investigations, and gathering evidence to support findings. You will work closely with the claims and legal departments to prevent financial losses and maintain the integrity of the insurance process. The ideal candidate will possess strong analytical skills, a keen eye for detail, excellent interviewing techniques, and a solid understanding of insurance claims procedures. If you are a proactive individual with a passion for uncovering the truth and safeguarding our client's assets, this opportunity in the Northern Cape is for you.

Key Responsibilities

• Review insurance claims for indicators of fraud.
• Conduct detailed investigations into suspected fraudulent claims.
• Gather evidence, interview claimants, witnesses, and relevant parties.
• Analyze claim data, policy information, and supporting documentation.
• Prepare comprehensive investigation reports with clear findings and recommendations.
• Liaise with internal departments (claims, legal) and external agencies as required.
• Maintain accurate and confidential investigation records.
• Assist in the development and implementation of fraud prevention strategies.
• Testify in legal proceedings when required.

Requirements

• Matriculation certificate or equivalent; relevant tertiary qualification is a plus.
• Minimum of 3 years of experience in insurance claims handling or fraud investigation.
• Strong understanding of various insurance products and claims processes.
• Excellent analytical, observational, and critical thinking skills.
• Proficiency in conducting interviews and gathering evidence.
• Strong report writing and documentation skills.
• Ability to maintain confidentiality and exercise discretion.
• Good interpersonal skills and the ability to work effectively with diverse individuals.
• Familiarity with investigative techniques and relevant software is advantageous.

Benefits

• Competitive salary and potential performance-based incentives.
• Medical aid and retirement fund contributions.
• Opportunity to specialize in fraud detection within the insurance sector.
• Training in advanced investigative techniques.
• A stable and supportive work environment in Kimberley .
• Contribute to protecting the company from fraudulent activities in the Northern Cape .