Investigations Agent

4 days ago

Nelspruit, South Africa Mediplus SA Full time

Mediplus SA is looking for a meticulous and analytical Investigations Agent to join the Membership Department. This role requires conducting thorough investigations into claims, fraud, and compliance issues while ensuring adherence to company protocols and policies. The Investigations Agent will collaborate with various teams to resolve cases and contribute to the integrity and efficiency of our operations.

**Key Responsibilities**:

- Conduct fraud investigations and claims analysis.
- Audit employer groups and monitor claims ratios.
- Ensure compliance with policies and the POPI Act.
- Collaborate with teams to resolve non-disclosure cases.
- Manage group reporting and maintain accurate records.

**Requirements**:

- Matric with mathematics
- Diploma in business management, risk management (advantageous)
- Computer literacy
- Strong analytical and risk assessment skills.
- Ability to handle sensitive information with discretion.
- Problem-solving mindset and solution-driven approach.
- Knowledge of organizational processes, scheme objectives, and applicable protocols.
- Ability to work both independently and as part of a team.
- Excellent verbal and written communication skills.
- Inquisitive personality with strong attention to detail.

**What We Offer**:

- A collaborative work environment.
- Opportunities for professional growth.
- Competitive compensation and benefits.

Take the next step in your career and become a vital part of Mediplus SA's mission to deliver exceptional service to our members

**Join Mediplus SA and make a meaningful difference in healthcare**

**Job Type**: Permanent

Pay: Up to R9 000,00 per month

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