Remote Senior Claims Investigator

Placements24; Mossel Bay; Hybrid; ZAR 650,000 - 900,000; Full time

Benefits offered by this job

Remote work benefits

Home office stipend

Medical, dental, vision insurance

Job summary

Placements24 is seeking a Senior Claims Investigator for a fully remote role operating nationwide from South Africa. The candidate will conduct independent investigations into complex insurance claims, assessing fraud indicators and ensuring comprehensive reporting.

The role requires strong analytical abilities, excellent communication, and experience with digital investigation tools. A remote-friendly environment supports flexible scheduling and professional growth.

Qualifications

• Bachelor's degree in Criminal Justice, Criminology, Law, or related field.
• Minimum 5 years in insurance claims investigation, fraud detection, or related field.
• Proven ability to conduct thorough investigations, gather evidence, and write comprehensive reports.

Responsibilities

• Conduct investigations into potentially fraudulent or complex insurance claims.
• Gather and analyze evidence including documentation and witness statements.
• Interview claimants, witnesses, and others via video/phone.
• Prepare detailed investigation reports with findings and recommendations.
• Collaborate with internal/external teams and law enforcement when needed.
• Identify patterns of suspicious activity and contribute to fraud prevention.

Skills

Analytical skills

Investigative skills

Remote communication

Education

Bachelor's degree in Criminal Justice/Criminology/Law

Tools

Digital investigation tools

Databases

Video conferencing platforms

Job description

About the Role

Our client is actively seeking a highly experienced Senior Claims Investigator to join their fully remote team. This critical role will involve conducting thorough and impartial investigations into complex insurance claims across various lines of business, from the comfort of your own home office. The ideal candidate will possess exceptional analytical, communication, and investigative skills, coupled with a deep understanding of insurance fraud detection and prevention. This is a remote-first position, offering unparalleled flexibility and the opportunity to contribute to a leading insurance provider without geographical constraints. You will play a vital role in ensuring the integrity of the claims process and maintaining our client's reputation for fairness and efficiency across **South Africa**.

Key Responsibilities

• Conduct comprehensive investigations into potentially fraudulent or complex insurance claims.
• Gather and analyze evidence, including documentation, witness statements, and digital records.
• Interview claimants, witnesses, and other relevant parties via video conferencing and phone.
• Prepare detailed and accurate investigation reports, documenting findings and recommendations.
• Collaborate with internal claims adjusters, legal teams, and external law enforcement agencies when necessary.
• Identify patterns of suspicious activity and contribute to fraud prevention strategies.
• Maintain meticulous records of all investigative activities within a secure digital environment.
• Ensure compliance with all relevant laws, regulations, and company policies throughout the investigation process.
• Stay abreast of emerging fraud schemes and investigation techniques relevant to the insurance industry.
• Effectively manage a caseload of complex investigations from initiation to closure, ensuring timely resolution.

Requirements

• A Bachelor's degree in Criminal Justice, Criminology, Law, Business Administration, or a related field.
• A minimum of 5 years of experience in insurance claims investigation, fraud detection, or a closely related field.
• Proven ability to conduct thorough investigations, gather evidence, and write comprehensive reports.
• Strong understanding of insurance principles, policy interpretation, and common fraud indicators.
• Excellent interviewing, negotiation, and communication skills, particularly in a remote setting.
• Proficiency in using digital investigation tools, databases, and virtual communication platforms.
• Demonstrated ability to work independently, manage time effectively, and meet deadlines in a remote work environment.
• High level of integrity, ethical conduct, and discretion.
• Experience with various insurance lines (e.g., property, casualty, life) is a significant advantage.
• Access to a reliable internet connection and a dedicated, quiet workspace.

Benefits

• An excellent annual salary of ZAR .
• Comprehensive remote work benefits package, including potential home office stipends.
• Full medical, dental, and vision insurance coverage.
• Generous paid time off and holiday schedule.
• Opportunities for professional development, certifications, and continuous learning.
• The ultimate flexibility of a fully remote work arrangement.
• Be part of a globally recognized insurance company, contributing from **Mossel Bay** or anywhere in **South Africa**.
• Join a dedicated team focused on upholding the integrity of insurance claims nationwide.