Consultant: Forensic Investigations - Centurion, South Africa - PPS Recruitment

PPS Recruitment

Verified Company

Centurion, South Africa

1 week ago

Posted by:

Thabo Mthembu

beBee Recruiter

Description

Job Advert Summary:

Applications are invited for the above-mentioned position, to be filled as soon as possible.

Minimum Requirements:

Qualifications & Experience

Grade 1
Bachelor's Degree in Forensic or equivalent (Desirable)
Certified Fraud Examiner (CFE) Desirable
5+ years experience in a similar role (Desirable)
2+ Experience in working in the healthcare/insurance or banking environment

Duties and Responsibilities:

Key Responsibilities:

Forensics Investigations

Must assist in detecting and investigating fraud and suspected fraud and abuse within PPS, from initiation to finalisation of court cases. This would include the interviewing of witnesses and suspects as well as the examination of supporting evidence and documentation
Assisting with the investigation of leads
Must be able to perform investigations
Ability to assess and interpret evidence, maintain the investigation's integrity, evaluate results and determine the cause, analyse the circumstance and make valid recommendations.
Must be able to perform investigations

so that the image of PPS is not detrimentally affected.

Execute and actively participate in investigations
Compiling case dockets for criminal prosecution ? Produce an investigative reporting

Stakeholder Management

Responsible for claims investigations within the agreed time frame / SLA
To provide the Claims department with properly investigated cases that will enable the assessors or requester to assess the claim and pay valid claims

Data & Reporting

Must be able to formulate data extracts and analysis to detect invalid claims and create data intelligence ability to ensure preventative management of claims investigations
Preparing comprehensive audit and forensic reports, as may be required regarding action to be taken regarding the investigation.