Lead Claims Investigator

Placements24; Stellenbosch; Híbrido; ZAR 700.000 - 1.000.000; Jornada completa

Ventajas ofrecidas por este puesto de trabajo

Fully remote work environment

Health, dental, and vision insurance

Retirement savings plan

Generous paid time off

Career development opportunities

Performance bonuses

Descripción de la vacante

Placements24 is seeking a Lead Claims Investigator to oversee a remote investigations team. You will guide investigators, ensure thorough claim assessments, and uphold investigation protocols across lines of business.

The role requires a track record in complex investigations, fraud detection, and strong leadership in a distributed environment. Join a fully remote role offering flexible work, opportunities for professional development, and performance-based bonuses as you protect settlements and

Formación

• Bachelor's degree in Criminal Justice, Criminology, Law, or related field.
• 8+ years in insurance claims investigation with at least 3 years in a supervisory or leadership role.
• Extensive knowledge of investigation techniques, evidence handling, and legal procedures.
• Proven leadership of remote investigations teams.

Responsabilidades

• Lead, mentor, and manage a team of remote claims investigators.
• Oversee the investigation of complex and potentially fraudulent insurance claims.
• Develop and refine investigation strategies, methodologies, and best practices.
• Ensure investigations are thorough, ethical, and compliant with policies.
• Analyze findings to determine claim validity and fraud indicators.
• Collaborate with internal departments, legal, and law enforcement when needed.
• Prepare comprehensive investigation reports with findings and recommendations.
• Maintain organized case files and databases.
• Train new investigators and support ongoing development.
• Monitor team performance metrics and drive efficiency.

Conocimientos

Leadership

Remote team management

Investigation techniques

Fraud detection

Analytical thinking

Communication

Evidence handling

Legal procedures knowledge

Educación

Bachelor's degree in Criminal Justice/Criminology/Law

Herramientas

Investigation software

Office applications

Descripción del empleo

About the Role

Our client is seeking a highly experienced and skilled Lead Claims Investigator to manage their remote investigation team. This is a fully remote position, offering the flexibility to work from anywhere while overseeing critical claims investigation operations. You will be responsible for guiding a team of investigators, ensuring thorough and accurate claim assessments, and maintaining the highest standards of investigation protocols. This role requires exceptional leadership abilities, a profound understanding of insurance fraud detection, and a meticulous approach to evidence gathering and analysis. You will play a crucial role in protecting the company from fraudulent activities and ensuring fair settlements for legitimate claims. The ideal candidate is a seasoned professional with a proven track record in complex investigations and team leadership, adept at working remotely and driving results through a distributed workforce. This position is vital for upholding our client's integrity and financial security.

Key Responsibilities

• Lead, mentor, and manage a team of remote claims investigators, providing guidance and support.
• Oversee the investigation of complex and potentially fraudulent insurance claims across various lines of business.
• Develop and refine investigation strategies, methodologies, and best practices.
• Ensure all investigations are conducted thoroughly, ethically, and in compliance with legal and company policies.
• Analyze investigative findings, evidence, and documentation to determine claim validity and identify potential fraud indicators.
• Collaborate with internal departments, legal counsel, and law enforcement agencies when necessary.
• Prepare comprehensive investigation reports, including findings, conclusions, and recommendations.
• Maintain accurate and organized case files and databases.
• Train new investigators and conduct ongoing professional development for the team.
• Monitor team performance metrics and implement improvements to enhance efficiency and effectiveness.

Requirements

• Bachelor's degree in Criminal Justice, Criminology, Law, or a related field.
• Minimum of 8 years of experience in insurance claims investigation, with at least 3 years in a supervisory or leadership role.
• Extensive knowledge of investigation techniques, evidence handling, and legal procedures.
• Proven expertise in identifying and investigating insurance fraud schemes.
• Strong analytical, critical thinking, and problem-solving skills.
• Excellent leadership, communication, and interpersonal skills, particularly for remote team management.
• Proficiency in investigation management software and standard office applications.
• Ability to work independently and manage a remote team effectively.
• High level of integrity, discretion, and ethical conduct.
• Willingness to travel occasionally for critical investigations if required.

Benefits

• A competitive annual salary of ZAR.
• Fully remote work environment offering significant flexibility.
• Comprehensive health, dental, and vision insurance.
• Retirement savings plan.
• Generous paid time off and holidays.
• Opportunities for career advancement and professional development.
• Performance bonuses based on team and individual achievements.
• The chance to lead a critical function for our client from anywhere.