Remote Insurance Claims Investigator - Fraud

Placements24; Mtubatuba Local Municipality; Hybrid; ZAR 360,000 - 600,000; Full time

Benefits offered by this job

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

Job summary

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

Qualifications

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

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.

Skills

Investigations

Interviewing

Analytical thinking

Attention to detail

Independent work

Education

Tertiary qualification in investigations

Tools

Investigation databases

Job description

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