Remote Claims Investigator

Placements24; Mbombela (Nelspruit); Hybrid; ZAR 420,000 - 640,000; Full time

Benefits offered by this job

Competitive salary with bonuses

Health, dental, and vision insurance

Retirement savings plan with company 


Flexible working hours

Professional development opportunities

Job summary

Placements24 seeks a meticulous Remote Claims Investigator to bolster their claims department nationwide from a remote setting, supporting the Nelspruit region's claims oversight.

You will gather evidence, interview claimants and witnesses, analyze records, and prepare detailed, objective reports to aid fraud prevention and claims resolution. This role offers flexible hours and a strong remote work culture.

Qualifications

• Minimum of 3 years in claims investigation, fraud detection, or related insurance role.
• Strong investigative techniques, evidence collection, and legal knowledge.
• Excellent analytical, problem-solving, and written/verbal communication.
• Proficient with investigation tools and databases.
• Ability to work independently with remote caseload.

Responsibilities

• Conduct comprehensive investigations to determine validity and identify fraud.
• Gather and analyze evidence, including documents, statements, and financial records.
• Interview claimants, witnesses, and other parties.
• Prepare detailed reports with findings and recommendations.
• Collaborate with adjusters, legal teams, and law enforcement as required.

Job description

About the Role

Our client is seeking a meticulous and investigative Remote Claims Investigator to bolster their claims department, supporting operations nationwide from a remote setting. This role is essential for ensuring the integrity and accuracy of insurance claims by conducting thorough investigations into potentially fraudulent or complex claims. You will gather evidence, interview relevant parties, and analyze information to provide detailed reports that support claims resolution. This is an excellent opportunity for a self-driven professional with a keen eye for detail and a strong ethical compass, to contribute significantly to fraud prevention and claims management within a fully remote work structure, supporting the Nelspruit region's claims oversight.

Key Responsibilities

• Conduct comprehensive investigations into suspicious or complex insurance claims to determine validity and identify potential fraud.
• Gather and analyze evidence, including documentation, witness statements, and financial records.
• Conduct interviews with claimants, witnesses, and other relevant parties.
• Prepare detailed and objective investigation reports with findings and recommendations.
• Collaborate with claims adjusters, legal teams, and law enforcement agencies as required.
• Maintain strict confidentiality and adhere to all company policies and legal guidelines.

Requirements

• Minimum of 3 years of experience in claims investigation, fraud detection, or a related field within the insurance industry .
• Strong understanding of investigative techniques, evidence collection, and legal procedures.
• Excellent analytical, critical thinking, and problem-solving skills.
• Exceptional written and verbal communication skills, with the ability to document findings clearly and concisely.
• Proficiency in using investigation tools and databases.
• Ability to work independently and manage a caseload effectively in a remote work environment .

Benefits

• Competitive annual salary and performance-based bonuses.
• Comprehensive health, dental, and vision insurance.
• Retirement savings plan with company matching.
• Flexible working hours and a supportive remote work culture.
• Opportunities for professional development in fraud investigation and claims management.