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Forensics Investigator Benoni

Employer
National Risk Managers
Location
Benoni Benoni, Gauteng Ekurhuleni, South Africa
Salary
Competitive
Closing date
Jun 12, 2022

View more

Job Role
Other
Sector
Finance
Contract Type
Permanent
Hours
Full Time
We are looking for a Forensics Investigator who can detect, prevent, analyse, investigate and resolve suspected fraud cases, unlawful conduct, financial crime and other breaches of the Code of Ethical Conduct in accordance with professional standards in respect of all the businesses serviced by National Risk Managers.

Key Performance Areas:

  • Analysing data and processes to identify risks and possible fraudulent trends by comprehensive investigations and audits
  • Instituting measures to prevent fraud, waste and abuse of benefits
  • Investigate alleged fraud or suspicious cases received via Whistle-blowers and internal or external parties
  • Report findings and recommend the actions required
  • Assist with recovery of funds were possible


Key Tasks:
  • Perform investigations through proper planning, fact-finding by the gathering of information and evidence, as well as the analysis and the identification/linking thereof to transgressions.
  • Conduct in-person or telephonic interviews of members, providers, and/or additional contacts to gather information to support investigation and record findings
  • Conduct onsite investigations and relevant providers and/or clients to gather and analyze all necessary information and documents related to the investigation.
  • Conduct internal and external audits to identify trends and investigate trends and risks identified.
  • Compile reports and affidavits concerning irregularities, regulatory transgressions, including criminal conduct and make recommendations for further actions, including reports to members.
  • Identification of patterns or tendencies and then make recommendations with reference to implementation of preventative measures and areas of risk.
  • Review and research evidence/documents to analyse the overall fact pattern of claim and synthesize data into a professional report with recommendations
  • Report any illegal activities in accordance with all laws and regulations
  • Provide input and assistance to the Compliance Department for reporting to the Regulatory authorities
  • Testify at internal, regulatory and criminal proceedings.

General Responsibilities:

  • Daily submission of updates regarding work performed, findings and progress on investigations and audits
  • Special Investigations to, dedicated to identifying, investigating and eradicated fraud
  • Putting findings into a report with a suggested action plan and escalate to relevant internal departments
  • Maintain due dates for completion of investigations
  • Maintain confidentiality and do security checks before information is disclosed to clients
  • Keep abreast of amendments to policy rules, benefit options, legislation, protocols, processes, and systems
  • Adhere and comply to Company policies, Payor Guidelines and Regulator requirements
  • Compliance awareness and identification of training needs
  • As a team member add value and contribute to the company.
  • Show willingness to adapt to industry and company changes.
  • Show positive attitude towards your job, colleagues, and clients.
  • Adhere to all verbal or written instructions and comply with Company policies and Regulator requirements


Required Qualifications/Experience:
  • Matric
  • Claims/Legal/Compliance/Audit/Clinical Diploma or Degree
  • FP(SA) from Institute of Commercial Forensic Practitioners (ICFP) and/or CFE from the Association of Certified Fraud Examiners (ACFE
  • 3-5 years fraud investigation experience in the financial services industry
  • Sound knowledge of legislation, regulations and legal principles applicable to the financial industry (FAIS, LTIA, FICA, PRECCA, POPIA, Criminal and Civil Procedure Act etc.).

Skills:
  • Excellent interviewing and interrogation skills
  • Excellent reporting skills

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