Remote Insurance Claims Investigator & Fraud Analyst

Placements24; Vereeniging; Hybrid; ZAR 240,000 - 360,000; Full time

Benefits offered by this job

Remote-first work model

Provident fund contributions

Paid time off

Job summary

Placements24 is seeking a meticulous Remote Claims Investigator to join our fully remote operations. You will conduct comprehensive investigations into insurance claims, gather evidence, interview parties, and assess validity while maintaining strict confidentiality.

Ideal candidates have experience in claims investigation, strong analytical skills, and the ability to work independently in a remote setting.

Qualifications

• Proven experience in claims investigation, fraud detection, or related investigative field.
• Strong analytical and critical thinking skills with the ability to interpret complex information.
• Excellent interviewing and communication skills, both written and verbal.

Responsibilities

• Conduct thorough investigations into assigned insurance claims, gathering all relevant facts and evidence.
• Interview claimants, witnesses, and other relevant parties to obtain statements and information.
• Review policy documents, claim forms, and supporting evidence to assess claim validity.
• Identify and pursue leads related to potential fraudulent activity, escalating as necessary.
• Collect and analyze documentation, including incident reports, medical records, and financial statements.
• Prepare detailed investigation reports summarizing findings, conclusions, and recommendations.
• Maintain accurate and organized case files, documenting all investigative activities and communications.
• Liaise with internal claims handlers, legal counsel, and other stakeholders to provide investigative updates.
• Ensure compliance with all relevant laws, regulations, and company policies.
• Utilize various investigative tools and techniques to gather information effectively.

Skills

Claims investigation

Fraud detection

Analytical thinking

Interviewing

Tools

Case management software

Job description

Placements24 is seeking a meticulous Remote Claims Investigator to join our fully remote operations. You will conduct comprehensive investigations into insurance claims, gather evidence, interview parties, and assess validity while maintaining strict confidentiality.

Ideal candidates have experience in claims investigation, strong analytical skills, and the ability to work independently in a remote setting.