Remote Claims Fraud Detective

Placements24; Vereeniging; Hybrid; ZAR 360,000 - 600,000; Full time

Benefits offered by this job

Remote-work flexibility

Medical aid

Retirement fund

Performance-based bonuses

Job summary

Placements24 is seeking a diligent Remote Claims Investigator specializing in Fraud Detection for a leading South African insurer. This fully remote role lets you apply sharp investigative skills from anywhere in South Africa while safeguarding policyholders and company assets.

You will analyze claims data, interview claimants and witnesses, gather evidence, and prepare objective reports for risk assessment.

Qualifications

• Bachelor’s degree in Criminology, Law, or Forensic Science preferred.
• Minimum 3 years in claims investigation or fraud detection in insurance.
• Proven ability to conduct thorough investigations and gather evidence.
• Strong analytical and critical thinking with meticulous attention to detail.
• Excellent interviewing and interpersonal communication skills.
• Proficiency with investigative tools and databases.
• Ability to work remotely and meet deadlines.
• High integrity and ethics.
• Understanding of insurance policies and claims procedures.
• Familiarity with legal frameworks related to insurance fraud.

Responsibilities

• Conduct thorough investigations into suspected fraudulent insurance claims across lines of business.
• Analyze claim data, policy information, and other documentation to identify red flags and anomalies.
• Interview claimants, witnesses, and other parties involved in suspicious claims.
• Gather and preserve evidence, ensuring its admissibility in legal proceedings if necessary.
• Collaborate with internal stakeholders to assess fraud risk.
• Prepare detailed and objective investigation reports outlining findings and recommendations.
• Liaise with external law enforcement agencies and regulatory bodies when required.
• Stay updated on current fraud trends, methodologies, and detection techniques.
• Maintain accurate and confidential case files and records.
• Contribute to the development and improvement of fraud detection strategies and processes.

Skills

Analytical thinking

Investigative skills

Interviewing

Interpersonal communication

Remote work discipline

Data analysis tools

Education

Bachelors degree in Criminology, Law, Forensic Science or related

Tools

Investigation tools

Data analysis software

Job description

Placements24 is seeking a diligent Remote Claims Investigator specializing in Fraud Detection for a leading South African insurer. This fully remote role lets you apply sharp investigative skills from anywhere in South Africa while safeguarding policyholders and company assets.

You will analyze claims data, interview claimants and witnesses, gather evidence, and prepare objective reports for risk assessment.