Fraud Investigator - Special Investigations Unit

Placements24; Rustenburg; Hybrid; ZAR 550,000 - 900,000; Full time

Benefits offered by this job

Medical aid

Retirement annuity

Generous leave

Remote-first environment

Job summary

Placements24 seeks an experienced Fraud Investigator for its remote-first SIU team in South Africa. You will investigate suspected insurance fraud across lines, gather evidence, interview stakeholders, and prepare objective reports to support enforcement actions.

This role emphasizes independent work from a home office, strict confidentiality, and collaboration with legal and law enforcement partners to protect the insurer and clients.

Qualifications

• 4+ years in insurance fraud investigation, law enforcement, or related field.
• Experience in complex investigations, evidence gathering, interviewing and reporting.
• Strong understanding of insurance products, claims processes and fraud schemes.
• Excellent analytical, communication and interpersonal skills.
• Relevant certifications (e.g., CFE) are a strong advantage.

Responsibilities

• Conduct proactive and reactive investigations into suspected insurance fraud.
• Gather and analyze data, documents, and evidence from diverse sources.
• Interview claimants, witnesses and relevant parties to elicit information.
• Prepare comprehensive investigation reports with findings and recommendations.
• Collaborate with claims handlers, legal counsel and law enforcement to build cases.
• Testify in court proceedings when required and support internal controls.

Skills

Insurance fraud investigations

Interviewing & reporting

Analytical thinking

Legal awareness

Remote work discipline

Education

CFE certification

Tools

Investigation software

Data analysis tools

Claims system/CRM

Job description

About the Role

Our client, a leading insurance group, is seeking a highly experienced and analytical Fraud Investigator to join their elite Special Investigations Unit (SIU) in **Rustenburg**. This critical role involves meticulously investigating suspicious insurance claims across various lines of business to detect and prevent fraudulent activities. The successful candidate will possess exceptional investigative skills, a keen eye for detail, and a deep understanding of insurance fraud schemes. You will be responsible for gathering evidence, conducting interviews, preparing detailed reports, and collaborating with legal and law enforcement agencies. This is a remote-first position, allowing you to leverage your expertise from the comfort of your home office, while still being an integral part of our **Rustenburg**-based operations. We are looking for a proactive and ethical professional committed to upholding the integrity of the insurance industry.

Key Responsibilities

• Conduct proactive and reactive investigations into suspected insurance fraud, including policy application fraud, claims fraud, and internal fraud.
• Gather and analyze data, documents, and other evidence from various sources to identify fraudulent patterns and indicators.
• Conduct interviews with claimants, witnesses, and other relevant parties to elicit information and assess credibility.
• Prepare comprehensive and objective investigation reports, documenting findings, evidence, and recommendations for action.
• Collaborate closely with claims handlers, legal counsel, and law enforcement agencies to build strong cases against perpetrators of fraud.
• Testify in court proceedings as required, presenting evidence and findings clearly and effectively.
• Identify emerging fraud trends and recommend preventive measures and internal control enhancements.
• Maintain strict confidentiality and adhere to all legal and ethical standards throughout investigations.
• Utilize various investigative tools and databases to support fraud detection and analysis.
• Contribute to the training of other staff members on fraud awareness and detection techniques.

Requirements

• Minimum of 4 years of experience in insurance fraud investigation, law enforcement, or a related investigative field.
• Demonstrated experience in conducting complex investigations, including evidence gathering, interviewing, and report writing.
• Strong understanding of insurance products, claims processes, and common fraud schemes.
• Excellent analytical, critical thinking, and problem-solving skills.
• Exceptional interpersonal and communication skills, with the ability to build rapport and conduct interviews effectively.
• Proficiency in using investigation software, databases, and analytical tools.
• Ability to work independently, manage time efficiently, and maintain focus in a remote setting.
• Relevant certifications in fraud examination (e.g., CFE) are a strong advantage.
• A clean criminal record and the ability to pass background checks.
• Based within a reasonable commuting distance to **Rustenburg** if occasional office visits are required, though the role is primarily remote.

Benefits

Our client offers a competitive salary and benefits package, recognizing the critical nature of this role. This includes a comprehensive medical aid plan, a retirement annuity, and a generous leave allowance. As a remote-first position, you benefit from the flexibility and autonomy of working from home, reducing commute times and improving work-life integration. Our client invests in continuous professional development, offering opportunities for advanced training and certifications in fraud investigation. You will be part of a dedicated and specialized unit, contributing significantly to the company's loss prevention efforts and the overall integrity of the insurance market. Join a team that values expertise, diligence, and a commitment to justice.