Senior Claims Investigator

Placements24; Gqeberha; Hybrid; ZAR 600,000 - 900,000; Full time

Benefits offered by this job

Hybrid work model

Medical aid

Retirement fund

Professional development

Job summary

Placements24 is seeking a Senior Claims Investigator to join their Port Elizabeth team. You will lead complex investigations, gather evidence, interview claimants and witnesses, and collaborate with fraud units to uncover potential fraud.

The role requires 6+ years in insurance claims investigation or related law enforcement, strong knowledge of insurance policies, and ability to produce clear, detailed reports.

Qualifications

• Minimum of 6 years of experience in insurance claims investigation, fraud detection, or a related law enforcement field.
• Proven ability to conduct thorough investigations, gather evidence, and identify fraudulent activities.
• Strong knowledge of insurance policies, legal principles, and investigation techniques.
• Excellent interviewing, interpersonal, and communication skills.
• Ability to work independently, manage multiple cases, and produce high-quality reports.
• Experience working with databases and investigation software.

Responsibilities

• Conduct in-depth investigations into complex and suspicious insurance claims across various lines of business.
• Gather and analyze evidence, including documents, statements, and forensic reports.
• Conduct interviews with claimants, witnesses, and other relevant parties.
• Identify and pursue potential insurance fraud schemes, liaising with internal and external fraud units.
• Prepare detailed investigation reports, outlining findings, conclusions, and recommendations.
• Testify in legal proceedings when required, presenting investigative findings clearly and effectively.

Skills

Investigations

Fraud detection

Interviewing

Report writing

Stakeholder management

Tools

Investigation software

Job description

About the Role

Our client is seeking a highly experienced and resourceful Senior Claims Investigator to join their dedicated team in Port Elizabeth . This role is essential for thoroughly investigating complex insurance claims, identifying potential fraud, and ensuring accurate claim resolution. You will work closely with adjusters, legal counsel, and fraud units to gather evidence, conduct interviews, and build comprehensive case files. Your sharp investigative skills and deep understanding of insurance processes will be critical in protecting the company's assets and upholding its commitment to fairness in Gqeberha . This is an excellent opportunity to apply your expertise in a challenging and rewarding environment within the Eastern Cape .

Key Responsibilities

• Conduct in-depth investigations into complex and suspicious insurance claims across various lines of business.
• Gather and analyze evidence, including documents, statements, and forensic reports.
• Conduct interviews with claimants, witnesses, and other relevant parties.
• Identify and pursue potential insurance fraud schemes, liaising with internal and external fraud units.
• Prepare detailed investigation reports, outlining findings, conclusions, and recommendations.
• Testify in legal proceedings when required, presenting investigative findings clearly and effectively.

Requirements

• Minimum of 6 years of experience in insurance claims investigation , fraud detection, or a related law enforcement field.
• Proven ability to conduct thorough investigations, gather evidence, and identify fraudulent activities.
• Strong knowledge of insurance policies, legal principles, and investigation techniques.
• Excellent interviewing, interpersonal, and communication skills.
• Ability to work independently, manage multiple cases, and produce high-quality reports.
• Experience working with databases and investigation software.

Benefits

• Competitive annual salary and performance-based bonuses.
• Hybrid work model offering a blend of office-based and remote work flexibility.
• Comprehensive medical aid and retirement fund benefits.
• Support for professional development and continuing education in investigations.
• A stimulating work environment where your investigative expertise is highly valued in Port Elizabeth .