Remote Claims Investigator - Specialized Risks

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

Benefits offered by this job

Remote work

Medical aid

Retirement fund

Professional development

Job summary

Placements24 is seeking a dedicated Claims Investigator to join our expanding remote team. This role focuses on investigating a diverse range of specialized insurance claims, requiring meticulous analysis and thorough documentation from anywhere, with independent work and strict deadlines.

You will gather evidence, interview witnesses, prepare reports, collaborate with claims adjusters and legal counsel, and look for subrogation opportunities while maintaining compliance and high integrity.

Qualifications

• Minimum 3 years in insurance claims investigation or related field.
• Experience handling specialized or complex claims.
• Strong investigative, interviewing, and analytical skills.
• Clear and concise report writing abilities.

Responsibilities

• Conduct thorough investigations into specialized insurance claims, including liability, property damage, and potential fraud indicators.
• Gather and analyze evidence, interview witnesses and claimants, and collect relevant documentation.
• Prepare comprehensive investigation reports detailing findings, analysis, and recommendations.
• Maintain accurate and up-to-date case files using company-provided systems.
• Collaborate with claims adjusters, underwriters, and legal counsel to ensure claims are handled appropriately.
• Identify potential subrogation opportunities.
• Ensure compliance with company policies, procedures, and regulatory requirements throughout the investigation process.
• Manage a caseload effectively, prioritizing tasks and meeting deadlines.
• Communicate investigation progress and findings clearly to relevant stakeholders.
• Continuously develop knowledge of insurance products, claims handling best practices, and investigative techniques.

Skills

Investigative skills

Analytical thinking

Report writing

Remote work

Time management

Tools

Claims management software

MS Office

Job description

About the Role

Our client is seeking a dedicated and detail-oriented Claims Investigator to join their expanding remote team. This position focuses on investigating a diverse range of specialized insurance claims, requiring meticulous analysis and thorough documentation. As a fully remote role, you will have the flexibility to work from anywhere, contributing essential investigative skills to our client's operations. The ideal candidate possesses a keen eye for detail, strong analytical abilities, and a commitment to uncovering facts and resolving claims efficiently and accurately.

Key Responsibilities

• Conduct thorough investigations into specialized insurance claims, including liability, property damage, and potential fraud indicators.
• Gather and analyze evidence, interview witnesses and claimants, and collect relevant documentation.
• Prepare comprehensive investigation reports detailing findings, analysis, and recommendations.
• Maintain accurate and up-to-date case files using company-provided systems.
• Collaborate with claims adjusters, underwriters, and legal counsel to ensure claims are handled appropriately.
• Identify potential subrogation opportunities.
• Ensure compliance with company policies, procedures, and regulatory requirements throughout the investigation process.
• Manage a caseload effectively, prioritizing tasks and meeting deadlines.
• Communicate investigation progress and findings clearly to relevant stakeholders.
• Continuously develop knowledge of insurance products, claims handling best practices, and investigative techniques.

Requirements

• A minimum of 3 years of experience in insurance claims investigation, or a closely related field such as law enforcement or investigative journalism.
• Demonstrated experience in handling various types of insurance claims, with a focus on specialized or complex cases.
• Excellent investigative, interviewing, and analytical skills.
• Strong report writing abilities, with a clear and concise communication style.
• Proficiency in using claims management software and standard office applications.
• Ability to work independently, manage time effectively, and maintain a high level of productivity in a remote environment.
• High level of integrity, discretion, and ethical conduct.
• A proactive approach to problem-solving and a keen attention to detail.
• Must have a reliable internet connection and a suitable home office setup.
• Willingness to travel occasionally for specific investigative needs, if required.

Benefits

This remote position offers a competitive salary and a comprehensive benefits package, including medical aid and retirement fund contributions. Our client prioritizes work-life balance and provides employees with the tools and support needed to succeed in a remote setting. Opportunities for professional development and advancement within the claims department are available. You will join a collaborative and supportive virtual team environment, working on challenging and diverse cases.