Fraud Investigator - Claims Department

Placements24; Soweto; Hybrid; ZAR 480,000 - 720,000; Full time

Benefits offered by this job

Salary bonus

Medical aid

Provident fund

Life insurance

Training opportunities

Team environment

Exposure to complex cases

Job summary

Placements24 is seeking a Fraud Investigator to join the Soweto claims team. You will meticulously examine insurance claims, gather evidence, interview relevant parties, and prepare reports to support decision-making and potential legal action.

The role requires strong analytical skills, attention to detail, and experience in fraud investigations within insurance or related fields. A hybrid work arrangement in Soweto is offered.

Qualifications

• Minimum of 4 years in fraud investigation or related field.
• Strong understanding of insurance claims processes and legal considerations.
• Ability to manage a caseload in a hybrid work environment.
• Discretion and high integrity are essential.

Responsibilities

• Investigate suspicious insurance claims across lines of business.
• Analyze documents, financial records, and data to identify red flags.
• Interview claimants, witnesses and other parties as needed.
• Gather and preserve evidence in a legally compliant manner.
• Prepare investigation reports with findings and recommendations.
• Collaborate with law enforcement, counsel, and external parties as required.
• Support claims adjusters and management in evaluating claim validity.
• Stay updated on fraud trends and investigation techniques.

Skills

Fraud investigation

Analytical thinking

Interpersonal skills

Data analysis

Education

Tertiary qualification in criminal justice

Tools

MS Excel

Evidence handling

Job description

About the Role

Our client, a well-established insurance provider, is seeking a proactive and discerning Fraud Investigator to join their dedicated claims team in Soweto . This essential role involves meticulously examining insurance claims to detect and prevent fraudulent activities, thereby protecting the company's assets and maintaining policy integrity. You will conduct thorough investigations, gather evidence, interview relevant parties, and prepare detailed reports to support decision-making and legal action where necessary. The ideal candidate will possess strong analytical skills, a keen eye for detail, excellent investigative techniques, and a solid understanding of insurance claims processes. This position offers a rewarding opportunity to contribute to upholding justice within the insurance sector in Gauteng .

Key Responsibilities

• Investigate suspicious insurance claims across various lines of business.
• Analyze claim documentation, financial records, and other data to identify red flags.
• Conduct interviews with claimants, witnesses, and other relevant parties.
• Gather and preserve evidence in accordance with legal and company standards.
• Prepare comprehensive investigation reports outlining findings and recommendations.
• Liaise with law enforcement agencies, legal counsel, and other external parties as required.
• Collaborate with claims adjusters and management to assess the validity of suspicious claims.
• Develop and implement strategies to prevent insurance fraud.
• Maintain confidentiality and discretion throughout all investigations.
• Stay updated on emerging fraud trends and investigation techniques.

This role is based in Soweto , with a hybrid work arrangement.

Requirements

• A relevant tertiary qualification or a strong background in criminal justice, law enforcement, or a related field.
• Minimum of 4 years of experience in fraud investigation, preferably within the insurance industry or a related field (e.g., law enforcement, audit).
• Proven ability to conduct complex investigations and gather evidence effectively.
• Excellent analytical, critical thinking, and problem-solving skills.
• Strong interviewing and interpersonal skills.
• Proficiency in data analysis and report writing.
• Familiarity with insurance claims processes and relevant legislation.
• Ability to work independently and manage a caseload effectively in a hybrid work environment.
• Discretion and a high level of integrity are paramount.

Benefits

• Our client offers a competitive salary commensurate with experience and a performance-based bonus.
• Comprehensive benefits include medical aid, a provident fund, and life insurance.
• Opportunities for specialized training in fraud investigation techniques are provided.
• A supportive team environment that values integrity and diligence.
• Exposure to complex cases provides valuable professional experience.
• This hybrid role offers flexibility, balancing office-based investigative work in Soweto with remote capabilities.
• Join a team dedicated to combating insurance fraud in Gauteng .