Senior Remote Claims Investigator - Fraud

About the Role

Our client is seeking a highly experienced and astute Senior Remote Claims Investigator specializing in fraud detection and prevention to join their dedicated investigations unit, operating fully remotely from the Queenstown area. This critical role involves conducting thorough investigations into potentially fraudulent insurance claims, gathering evidence, and providing detailed reports to support decision-making. You will play a key role in protecting the company's financial assets and maintaining the integrity of its claims processes. The ideal candidate possesses a keen eye for detail, strong analytical skills, and a deep understanding of fraud schemes prevalent in the insurance industry, all within a remote work setting.

Key Responsibilities

• Conduct comprehensive investigations into suspected insurance fraud across various policy types.
• Gather and analyze evidence, including documentation, interviews, and database checks, to substantiate or refute fraud allegations.
• Prepare detailed, objective investigation reports for internal stakeholders and, when necessary, for legal proceedings.
• Collaborate with claims handlers, legal counsel, and law enforcement agencies as required.
• Identify emerging fraud trends and recommend proactive measures for prevention and detection.
• Maintain strict confidentiality and adhere to all legal and ethical guidelines throughout investigations.

Requirements

• Proven experience as a Claims Investigator , with a specialization in insurance fraud.
• In-depth knowledge of common insurance fraud schemes and investigative techniques.
• Strong analytical, critical thinking, and deductive reasoning skills.
• Excellent interviewing and report-writing abilities.
• Proficiency in using investigative databases and relevant software tools.
• Ability to work independently and manage a caseload effectively in a fully remote environment.

Benefits

• Competitive annual salary with a bonus structure based on investigation outcomes and efficiency.
• Fully remote work arrangement offering flexibility and independence.
• Comprehensive health, dental, and vision insurance plans.
• Support for professional development and relevant certifications in fraud investigation.
• A vital role contributing to the financial security and integrity of the organization.