Remote Insurance Fraud Investigator

Placements24; Polokwane; Hybrid; ZAR 540,000 - 900,000; Full time

Benefits offered by this job

Health insurance

Retirement plan

Remote work

Generous leave

Job summary

Placements24 is recruiting a dedicated Remote Insurance Fraud Investigator for a leading global insurer. The role is fully remote anywhere in South Africa, with a focus on detecting, investigating, and preventing fraudulent claims across lines of business.

You will interview claimants and witnesses, analyze data, prepare detailed reports, and collaborate with internal teams and external law enforcement. A minimum of five years’ experience in fraud or investigations is expected, with strong

Qualifications

• Bachelor's degree in a related field preferred.
• 5+ years in insurance fraud investigation or related field.
• Proven ability to conduct complex investigations and reports.
• Strong understanding of insurance policies and fraud schemes.
• Excellent interviewing, negotiation, and interpersonal skills.
• Ability to work independently in a remote environment.

Responsibilities

• Conduct comprehensive investigations into suspected fraudulent insurance claims.
• Analyze claim data, policy information, and sources to spot fraud.
• Interview claimants, witnesses, and others to gather evidence.
• Prepare detailed investigation reports with findings and recommendations.
• Collaborate with claims handlers, legal counsel, and internal departments.
• Liaise with external agencies, including law enforcement and regulators.
• Develop and deliver training on fraud awareness and detection techniques.
• Maintain confidentiality and adhere to legal/ethical guidelines.
• Contribute to fraud detection strategies and tools development.

Skills

Interviewing

Data analysis

Report writing

Analytical thinking

Investigations

Communication

Education

Bachelor's degree in Criminal Justice, Criminology, Law, Business or related field

Job description

About the Role

Our client, a leading global insurer, is actively recruiting for a dedicated **Remote** Insurance Fraud Investigator to join their specialized investigative unit. This is a fully remote position, allowing you to work from the comfort of your home office anywhere in South Africa. You will play a critical role in detecting, investigating, and preventing fraudulent insurance claims, thereby safeguarding the company's assets and maintaining its integrity. This role requires a sharp, analytical mind, excellent investigative skills, and a thorough understanding of insurance fraud schemes. You will collaborate with internal claims teams, legal departments, and external law enforcement agencies to build strong cases and recover losses. This is an exceptional opportunity for an experienced investigator to contribute to a proactive anti-fraud strategy in a flexible, remote work setting. We are looking for a meticulous and discreet professional with a strong ethical compass and a commitment to upholding justice. The ideal candidate will possess outstanding interviewing and reporting skills and thrive in an independent, remote work environment. Join us in making a difference in the fight against insurance fraud.

Key Responsibilities

• Conduct comprehensive investigations into suspected fraudulent insurance claims across various lines of business.
• Analyze claim data, policy information, and other relevant sources to identify red flags and patterns indicative of fraud.
• Interview claimants, witnesses, and other parties involved in claims to gather evidence.
• Prepare detailed and well-documented investigation reports, including findings, evidence, and recommendations.
• Collaborate effectively with claims handlers, legal counsel, and other internal departments to manage fraud cases.
• Liaise with external agencies, including law enforcement and regulatory bodies, as required.
• Develop and deliver training to internal teams on fraud awareness and detection techniques.
• Maintain strict confidentiality and adhere to all legal and ethical guidelines during investigations.
• Contribute to the development and enhancement of fraud detection strategies and tools.

Requirements

• A Bachelor's degree in Criminal Justice, Criminology, Law, Business, or a related field is preferred.
• A minimum of 5 years of experience in insurance fraud investigation, claims investigation, or law enforcement with a focus on financial crimes.
• Proven ability to conduct complex investigations, gather evidence, and prepare comprehensive reports.
• Strong understanding of insurance policies, claims processes, and common fraud schemes.
• Excellent interviewing, negotiation, and interpersonal skills.
• Proficiency in investigative techniques and data analysis tools.
• Strong analytical and critical thinking abilities.
• Excellent written and verbal communication skills.
• Ability to work independently, manage workload effectively, and maintain high levels of productivity in a remote environment.
• Must possess a reliable internet connection and a suitable home office setup.

Benefits

• Competitive salary and performance-based incentives.
• Comprehensive health, dental, and vision insurance.
• Retirement savings plan with company contributions.
• Fully remote work arrangement with flexible hours.
• Generous annual leave and paid public holidays.
• Opportunities for professional development and specialized training in fraud investigation.
• Home office allowance and necessary technological support.
• Collaborative online environment and access to a global network of investigators.
• Employee assistance program for well-being support.