Investigator Internal Control

1 week ago

Johannesburg, South Africa PPS Group Full time

**Main duties and responsibilities**:
Forensics Investigations:

- Aiding with 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
- Performing specialised investigations
- Assessing and interpreting evidence; maintaining the integrity of the investigation; evaluating the results and determining cause; analysing the circumstances and make valid recommendations
- Performing investigations in such a way that the image of PPS is not detrimentally affected
- Executing and actively participating in complex investigations
- Compiling case dockets for criminal prosecution
- Producing an investigative report

Stakeholder Management:

- Responsible for claims investigations within the agreed time frame / service level agreement (SLA)
- Providing the Claims department with properly investigated cases that will enable the assessors or requester to assess and pay valid claims

Data and reporting:

- Formulating data extracts and analysis to detect invalid claims and creating data intelligence to ensure preventative management of claims investigations
- Doing research on best practices and new trends in the industry
- Conducting audits and fraud risk assessments and, where necessary, reporting findings or deviations and assisting with the implementation of recommended controls
- Preparing comprehensive audit and forensic reports regarding action to be taken regarding the investigation may be required
- Preparing reports for different departments or upper management

**Education**:

- Matric (Grade 12)
- Bachelor’s Degree in Forensic or equivalent qualification
- Certified Fraud Examiner (CFE)
- Relevant post graduate degree will be advantageous

**Experience**:

- 5 years’ relevant experience in a similar role
- Experience in working in the Insurance or Banking environment

**Knowledge and Skills**:

- Data analysis (conversant with pivot tables and other analysis tools)
- Able to present case(s) using the relevant presentation tools
- Able to evaluate, identify and assess trends and patterns requiring further investigation
- Advanced forensic investigation capability and strategy implementation
- Identification of fraudulent activity/behaviour
- Formulation of investigations with other stakeholders (Audit/HR/Insurance)
- Able persuade and ensure compliance with established methods, models and concepts of investigation and facilitate discussion among authorities involved in an investigation, reconciling differing interpretations of evidence

**Competencies**:

- Strong written and verbal communication skills
- Strong networking and relationship building skills with internal and external stakeholders
- Strong analytic and problem-solving skills
- Adaptability to different stakeholders, audiences, and environments
- Ready to work in a challenging environment.
- Commercial acumen
- Persuading and influencing
- Deciding and initiating action
- Collaboration

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