Insurance Fraud Investigator

Job Description

As an Insurance Fraud Investigator, you will play a key role in identifying and investigating potential fraudulent claims. You will work closely with various teams to ensure compliance with legal and industry standards, conducting thorough investigations and audits to safeguard the company’s integrity.

Responsibilities

• Perform comprehensive analysis of fraudulent claims and supporting documents.
• Collaborate with underwriting teams to assess risk factors associated with fraud.
• Engage with external stakeholders, including investigators and auditors.
• Document all investigation procedures and maintain accurate records.
• Participate in community outreach programs to educate on fraud prevention.
• Review and revise internal policies to improve fraud detection effectiveness.

Requirements

Education

• Bachelor's degree in a relevant field such as Criminal Justice or Risk Management
• Certification in Insurance Fraud Prevention or related field is preferred

Experience

• 5+ years of experience in fraud detection or insurance investigation

Technical Skills

• Risk Assessment
• Forensic Analysis

Soft Skills

• Problem-Solving
• Negotiation Skills

Certifications

• CFE Certification
• Insurance Fraud Prevention Certification

Languages

• English: Fluent
• Afrikaans: Conversational

Advantageous

• Knowledge of South African Insurance Regulations: Understanding of local laws and regulations governing the insurance industry.
• Exposure to cross-border investigations: Experience in fraud cases involving international elements.

Benefits

• Medical aid and retirement savings plans
• Annual performance bonuses
• Work-from-home flexibility
• Access to professional development and training programs

Company Culture

• Diversity and Inclusion: We value diversity and create an inclusive atmosphere where everyone’s contributions are acknowledged.
• Employee Wellbeing: We prioritize the health and wellbeing of our employees, providing resources and support.
• Community Engagement: We believe in giving back to the community, supporting initiatives that make a positive impact.