Remote Claims Investigator

Placements24; Mtubatuba Local Municipality; Híbrido; ZAR 360.000 - 600.000; Jornada completa

Ventajas ofrecidas por este puesto de trabajo

Fully remote work arrangement

Competitive salary commensurate with经验

Company-provided equipment

Professional development and training

Medical aid contribution

Retirement fund

Paid annual leave

Online community of colleagues

Impactful work in insurance fraud

Descripción de la vacante

Placements24 is seeking a proactive Remote Claims Investigator to conduct thorough investigations of insurance claims from anywhere in South Africa. You will interview claimants and witnesses, review documents, and analyze data to determine validity and support settlements.

This remote role requires autonomous work, strong ethics, and the ability to manage a caseload with deadlines. The ideal candidate has proven experience in claims or fraud investigations, excellent interviewing and analytical

Formación

• Proven experience in claims investigation, fraud investigation, or related field.
• Strong understanding of insurance policies and claims processes.
• Excellent interviewing, observation, and analytical skills.

Responsabilidades

• Conduct comprehensive investigations into assigned insurance claims, including property, casualty, and other lines of business.
• Gather and analyze evidence, including reviewing policy documents, incident reports, and witness statements.
• Conduct interviews with claimants, witnesses, and other parties involved in a claim.
• Identify and assess potential fraud indicators, escalating suspicious cases for further review.
• Prepare detailed investigation reports, outlining findings, conclusions, and recommendations.
• Maintain accurate and organized case files, ensuring all documentation is complete and up-to-date.
• Collaborate with claims adjusters, legal counsel, and other internal stakeholders.
• Adhere to all company policies, procedures, and ethical guidelines throughout the investigation process.
• Manage a caseload effectively, prioritizing tasks and meeting investigation deadlines.
• Stay informed about investigative techniques, fraud detection methods, and relevant legal requirements.

Conocimientos

Investigations

Interviewing

Analytical thinking

Attention to detail

Independent work

Educación

Tertiary qualification in investigations

Herramientas

Investigation databases

Descripción del empleo

About the Role

Our client, a distinguished leader in the insurance sector , is looking for a proactive and diligent Remote Claims Investigator to join their expanding operations. This is a fully remote position, allowing you to work from anywhere within South Africa . The core function of this role involves conducting thorough investigations into insurance claims to verify facts, identify potential fraud, and gather evidence to support claim resolutions. You will play a critical part in protecting the company's assets by ensuring claims are legitimate and appropriately settled. This position demands excellent investigative skills, keen attention to detail, and the ability to work autonomously. You will be responsible for interviewing claimants and witnesses, reviewing documentation, and analyzing data to form objective conclusions. This is a fantastic opportunity for an experienced investigator to leverage their skills in a flexible, remote-first environment, contributing significantly to the integrity and efficiency of the claims process for our client. The role is central to maintaining trust and fairness within the insurance landscape.

Key Responsibilities

• Conduct comprehensive investigations into assigned insurance claims, including property, casualty, and other lines of business.
• Gather and analyze evidence, including reviewing policy documents, incident reports, and witness statements.
• Conduct interviews with claimants, witnesses, and other parties involved in a claim.
• Identify and assess potential fraud indicators, escalating suspicious cases for further review.
• Prepare detailed investigation reports, outlining findings, conclusions, and recommendations.
• Maintain accurate and organized case files, ensuring all documentation is complete and up-to-date.
• Collaborate with claims adjusters, legal counsel, and other internal stakeholders.
• Adhere to all company policies, procedures, and ethical guidelines throughout the investigation process.
• Manage a caseload effectively, prioritizing tasks and meeting investigation deadlines.
• Stay informed about investigative techniques, fraud detection methods, and relevant legal requirements.

Requirements

• Proven experience in claims investigation, fraud investigation, or a related investigative field, preferably within the insurance industry .
• Strong understanding of insurance policies and claims processes.
• Excellent interviewing, observation, and analytical skills.
• Ability to gather, interpret, and present complex information clearly and concisely.
• Proficiency in using investigative tools and databases.
• Strong written and verbal communication skills.
• Self-motivated and able to work independently with minimal supervision.
• Excellent organizational and time management skills, essential for a remote role.
• A relevant tertiary qualification or professional certification in investigations is advantageous.
• A commitment to maintaining confidentiality and ethical standards.

Benefits

• Fully remote work arrangement, providing flexibility and work-life balance.
• Competitive salary commensurate with experience.
• Company-provided equipment and software necessary for the role.
• Opportunities for professional development and advanced investigative training.
• Contribution to medical aid and retirement fund.
• Paid annual leave and statutory benefits.
• Access to a supportive online community of colleagues.
• A chance to make a significant impact on fraud prevention within the insurance sector.