Job
2d left · 28 Aug 2026
Fidelity Life Medical Aid Society (FLIMAS)
Forensic Officer
Posted 2 hours ago
About the Role
FLIMAS is hiring a Forensic Officer to help prevent and investigate fraud in the medical-aid business.
Responsibilities
- Participate in developing policies and procedures to prevent fraud and recover losses; plan and undertake statistical exercises to highlight over-servicing and tariff manipulation by providers and members.
- Prepare monthly statistical returns on cases under investigation; alert management to system weaknesses that facilitate irregular practices and suggest fixes.
- Investigate and report on information security; carry out compliance reviews; maintain the Vulnerability Management Programme.
- Research emerging medical-aid fraud trends; maintain the drug-file system and verify scheme rules; develop analytics models to identify anomalous claims and business trends.
Responsibilities
- Participate in developing policies and procedures to prevent fraud and recover losses; plan and undertake statistical exercises to highlight over-servicing and tariff manipulation by providers and members.
- Prepare monthly statistical returns on cases under investigation; alert management to system weaknesses that facilitate irregular practices and suggest fixes.
- Investigate and report on information security; carry out compliance reviews; maintain the Vulnerability Management Programme.
- Research emerging medical-aid fraud trends; maintain the drug-file system and verify scheme rules; develop analytics models to identify anomalous claims and business trends.
Requirements
- A degree in Forensic Audit or Insurance and Risk Management.
- Relevant knowledge of the medical-aid industry is a must.
- At least 3 years' experience in a similar role.
How to apply: submit your application with a detailed CV and certified copies of educational certificates to the Human Resources Department at [email protected], clearly stating the post in the subject line, no later than 28 August 2026. Only shortlisted candidates will be contacted.
- Relevant knowledge of the medical-aid industry is a must.
- At least 3 years' experience in a similar role.
How to apply: submit your application with a detailed CV and certified copies of educational certificates to the Human Resources Department at [email protected], clearly stating the post in the subject line, no later than 28 August 2026. Only shortlisted candidates will be contacted.