Claims Investigator - Remote

Placements24; Gqeberha; Hybrid; ZAR 300,000 - 450,000; Full time

Benefits offered by this job

Competitive salary

Remote work

Health insurance

Job summary

Placements24 is seeking a dedicated Claims Investigator to join a fully remote team. You will verify claim legitimacy, prevent fraud, and prepare reports supporting claims decisions across insurance types.

The role requires strong analytical, interviewing, and documentation skills, with the ability to work independently and handle multiple investigations remotely.

Qualifications

• Experience as a Claims Investigator, fraud examiner, or law enforcement investigator.
• Solid understanding of insurance principles and claims processes.
• Excellent interviewing, observational, and analytical skills.
• Proficient in report writing and evidence documentation.
• Ability to work independently and manage multiple investigations.
• Familiarity with relevant legal frameworks and investigative techniques.

Responsibilities

• Conduct thorough investigations into suspicious or complex insurance claims.
• Gather and analyze evidence, including interviewing witnesses and reviewing documents.
• Prepare detailed, objective investigative reports outlining findings and recommendations.
• Collaborate with claims adjusters, legal counsel, and law enforcement when necessary.
• Identify potential indicators of fraud, waste, or abuse within the claims process.
• Maintain strict confidentiality and adhere to legal and ethical guidelines.

Skills

Interviewing

Analytical skills

Observational skills

Report writing

Independent work

Job description

About the Role

Our client is actively seeking a dedicated and thorough Claims Investigator to join their fully remote team. This role is integral to verifying the legitimacy of insurance claims and preventing fraudulent activities. You will conduct comprehensive investigations, gather evidence, and prepare detailed reports to support claims decisions. This position is ideal for individuals with a keen eye for detail, strong analytical abilities, and a commitment to upholding ethical standards in the insurance industry. Working remotely, you will collaborate with claims adjusters and legal teams to ensure fair and accurate claim resolutions across various insurance types.

Key Responsibilities

• Conduct thorough investigations into suspicious or complex insurance claims.
• Gather and analyze evidence, including interviewing witnesses, reviewing documents, and examining incident sites (virtually or through field agents).
• Prepare detailed, objective investigative reports outlining findings and recommendations.
• Collaborate with claims adjusters, legal counsel, and law enforcement when necessary.
• Identify potential indicators of fraud, waste, or abuse within the claims process.
• Maintain strict confidentiality and adhere to all legal and ethical guidelines.

Requirements

• Previous experience as a Claims Investigator, fraud examiner, or law enforcement investigator.
• Strong understanding of insurance principles and claims processes.
• Excellent interviewing, observational, and analytical skills.
• Proficiency in report writing and evidence documentation.
• Ability to work independently and manage multiple investigations simultaneously.
• Familiarity with relevant legal frameworks and investigative techniques.

Benefits

• Competitive annual salary.
• Remote work flexibility, allowing you to work from home.
• Comprehensive health, dental, and vision insurance.
• Retirement savings plan with company contributions.
• Opportunities for specialized training in fraud detection and investigation.