Junior Desktop Investigator

1 week ago

Bellville, South Africa Momentum Full time

Role Purpose The role incumbent will perform desktop investigations into allegations of fraud, waste, and abuse within the medical aid industry. Must be willing to travel on behalf of the office when required. Requirements Formal Qualifications Matric certificate. Degree in Forensics, Compliance, Accounting, Investigations and Forensic Accounting, Commerce, Auditing or Forensic Auditing. Specific licensing or registration ACFE certification is advantageous. Knowledge Forensic Investigations. MS Excel. Report writing. Medical Industry knowledge (Advantageous). Skills An ability to analyse and interpret large amounts of complex data in Excel. Strong time management skills. Proven and exceptional organising and coordinating skills. Experience At least 0 - 3 years forensic or investigative experience (commercial and/or desktop). Duties and Responsibilities Process Performing (desktop) investigations into allegations of fraud, waste, and abuse using outputs of large data sets from MS Excel and other applications. Conducting investigative interviews with scheme members, healthcare service providers, members and other third parties to validate findings. Interpreting collected data and compiling comprehensive case reports using Ms Word. Reporting cases to the relevant Regulatory Bodies or to SAPS. Preparing; indexing and paginating investigation packs to be assigned to legal; the Filed Investigators or Regulatory bodies. Client Build and maintain relationships with clients and internal and external stakeholders. Perform duties within defined turnaround times. Deliver on service level agreements applicable to clients and internal and external stakeholders in order to ensure that client expectations are managed. Participate and contribute to a culture which builds rewarding relationships, facilitates feedback and provides exceptional client service. Continuously monitor case investigation turnaround times and the quality of written reporting. Drive client service delivery goal achievement in line with predefined standards in order to ensure that clients receive expected service levels at the expected standard. Provide management with relevant information to assist with managing client query processes. People Continuously develop own expertise in terms of industry and forensic investigations. Participate and contribute to a culture of work centric thinking, productivity, service delivery and quality management. Take ownership for driving career development. Finance Escalate unresolved policy and governance compliance issues via appropriate channels for investigation and resolution purposes. #J-18808-Ljbffr

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