Remote Claims Investigator

Placements24; Rustenburg; Hybrid; ZAR 420,000 - 650,000; Full time

Benefits offered by this job

Fully remote work arrangement

Company-provided equipment

Medical and retirement benefits

Job summary

Placements24 is seeking a proactive Remote Claims Investigator to support operations across South Africa. This fully remote role involves thorough investigations into insurance claims to assess validity and liability, with a focus on preventing fraud and ensuring fair settlements.

You will work independently, manage your own workload, and collaborate with policyholders, witnesses, and internal teams while complying with legal and regulatory requirements.

Qualifications

• Proven experience in claims investigation, fraud detection, or related field within insurance.
• Strong understanding of insurance principles, claims processes and investigation techniques.
• Excellent interviewing, communication, and report-writing skills.
• Ability to work independently, manage time effectively, and meet deadlines remotely.

Responsibilities

• Conduct comprehensive investigations into assigned insurance claims, gathering evidence and interviewing relevant parties.
• Identify fraud indicators and escalate suspicious claims for specialized review.
• Prepare detailed investigation reports with findings and recommendations.
• Liaise with policyholders, witnesses, legal counsel, and internal departments for information.
• Ensure compliance with legal/regulatory requirements and company policies.
• Maintain accurate case files in the claims system.

Skills

Claims investigation

Fraud detection

Interviewing

Report writing

Remote work

Digital investigation tools

Tools

Digital investigation tools

Job description

About the Role

Our client is looking for a proactive and detail-oriented Remote Claims Investigator to join their growing team, supporting operations across South Africa . This role is fully remote, allowing you to work from the comfort of your home office. You will be responsible for conducting thorough investigations into insurance claims to determine the validity, circumstances, and extent of liability. Your investigative skills and keen eye for detail will be crucial in preventing fraudulent claims and ensuring fair settlements. This is an ideal position for an independent worker who excels at managing their own workload and thrives in a virtual team setting, contributing to the company's commitment to integrity and customer service from anywhere in the country.

Key Responsibilities

• Conduct comprehensive investigations into assigned insurance claims, gathering evidence, interviewing relevant parties, and analysing documentation.
• Identify potential fraud indicators and escalate suspicious claims for further specialised review.
• Prepare detailed investigation reports, outlining findings, conclusions, and recommendations for claim resolution.
• Liaise with policyholders, witnesses, legal counsel, and internal departments to obtain necessary information.
• Ensure all investigative activities comply with relevant legal and regulatory requirements and company policies.
• Maintain accurate and organised case files within the electronic claims system.

Requirements

• Proven experience in claims investigation, fraud detection, or a related field within the insurance sector.
• Strong understanding of insurance principles, claims processes, and investigation techniques.
• Excellent interviewing, communication, and report-writing skills.
• Ability to work independently, manage time effectively, and meet deadlines in a remote environment.
• Proficiency with digital investigation tools and standard office software.
• A background in law enforcement or a related investigative discipline is advantageous.

Benefits

• Competitive annual salary and performance-based bonuses.
• Fully remote work arrangement, offering flexibility and work-life balance.
• Company-provided equipment and support for home office setup.
• Comprehensive medical and retirement benefits.
• Opportunities for continuous learning and professional development in Rustenburg and other regions via online platforms.