Fraud Investigator

Gotyme Za; Johannesburg; Hybrid; ZAR 350,000 - 520,000; Full time

Benefits offered by this job

Hybrid work model

Competitive salary

Medical aid

Retirement savings plan

Training opportunities

Job summary

Gotyme Za is seeking an Insurance Fraud Investigator in Soweto, a role combining fieldwork and remote analysis to protect policyholders from fraudulent claims.

The candidate should have proven investigative experience, strong analytical skills, and proficiency in evidence collection and reporting. The position offers a hybrid work model with opportunities for training and career development.

Qualifications

• Proven experience as an Insurance Fraud Investigator or in a similar investigative role.
• Strong knowledge of insurance claims processes and common fraud schemes.
• Excellent analytical, critical thinking, and problem-solving skills.
• Proficiency in investigative techniques, evidence collection, and report writing.
• Strong interviewing and interrogation skills.
• Ability to work independently and manage sensitive case information.

Responsibilities

• Receive and assess potential fraud referrals from internal departments and external sources.
• Conduct thorough investigations into suspected fraudulent insurance claims, gathering evidence and interviewing relevant parties.
• Analyze claim data, financial records, and other relevant information to identify patterns of suspicious activity.
• Prepare detailed investigation reports outlining findings, evidence, and recommendations for further action.
• Liaise with law enforcement agencies, legal counsel, and other stakeholders as required.
• Maintain strict confidentiality and adhere to all legal and ethical guidelines throughout investigations.

Skills

Insurance fraud investigation

Investigative interviewing

Data analysis

Report writing

Analytical thinking

Case management

Job description

Our client is looking for a vigilant and analytical Insurance Fraud Investigator to join their dedicated team in Soweto. This role is crucial in protecting the company and its honest policyholders from financial losses due to fraudulent claims. You will be responsible for detecting, investigating, and resolving suspected cases of insurance fraud across various lines of business. The ideal candidate possesses strong investigative skills, a keen eye for detail, and an understanding of forensic techniques and legal procedures. This hybrid role combines essential fieldwork and on-site investigation with remote analysis and reporting, ensuring comprehensive coverage and effective fraud prevention strategies within the organization.

Key Responsibilities

• Receive and assess potential fraud referrals from internal departments and external sources.
• Conduct thorough investigations into suspected fraudulent insurance claims, gathering evidence and interviewing relevant parties.
• Analyze claim data, financial records, and other relevant information to identify patterns of suspicious activity.
• Prepare detailed investigation reports outlining findings, evidence, and recommendations for further action.
• Liaise with law enforcement agencies, legal counsel, and other stakeholders as required.
• Maintain strict confidentiality and adhere to all legal and ethical guidelines throughout investigations.

Requirements

• Proven experience as an Insurance Fraud Investigator or in a similar investigative role.
• Strong knowledge of insurance claims processes and common fraud schemes.
• Excellent analytical, critical thinking, and problem-solving skills.
• Proficiency in investigative techniques, evidence collection, and report writing.
• Strong interviewing and interrogation skills.
• Ability to work independently and manage sensitive case information.

Benefits

• Competitive annual salary with performance-based bonuses.
• Hybrid work model offering flexibility for both field and remote work.
• Comprehensive medical aid and retirement savings plan.
• Training and development opportunities in fraud investigation techniques.
• A challenging and rewarding role contributing to the integrity of the insurance industry.