Claims Validator

SUMMARY:
-

POSITION INFO:

Location: Hybrid – Bedfordview
Employment Type: Permanent
Industry: Insurance | Claims | Long-Term Insurance

WatersEdge Solutions is partnering with a client to recruit a compassionate and detail-oriented Claims Validator. This role is ideal for an experienced claims professional who understands the importance of accurate, timely claim settlements and delivering supportive service to members during sensitive moments.

About the Role

As Claims Validator, you will be responsible for preparing, validating, and finalising registered claims in line with policy wording, quality standards, and business rules. You’ll manage claims that need to be paid, repudiated, or moved to the awaiting information queue, while supporting efficient claim resolution and excellent client service.

Key Responsibilities

• Validate captured and registered claims accurately
• Handle claim queries from Claims Assessors, Supervisors, Managers, and clients
• Liaise with internal teams on claim issues and member queries
• Ensure claims are paid, repudiated, or moved to awaiting information correctly
• Prepare daily reconciliations for validated claims due for payment
• Manage and prepare daily claims metrics reports
• Meet required production and quality standards
• Follow QA processes, scripts, and standard operating procedures
• Validate claims on Dionysus
• Assist with training and upskilling across assessments, declined claims, fraud identification, and investigation
• Deliver strong customer service throughout the claims process

What You’ll Bring

• Matric
• 3–5 years of claims assessment or claims validation experience
• Experience in long-term insurance, ideally funeral or life insurance
• Computer literacy and Microsoft Office proficiency
• Strong attention to detail and accuracy
• Good communication and listening skills
• Ability to provide empathetic, client-focused service
• Ability to communicate in English and at least one of Afrikaans, Zulu, or Setswana
• Punctual, dedicated, hardworking, honest, and quick to learn
• Team-player mindset and willingness to work overtime when required

Nice to Have

• Experience using Dionysus
• Ability to speak Xhosa, Tsonga, or Venda
• Exposure to fraud identification or declined claims processes

What’s On Offer

• Permanent hybrid opportunity based in Bedfordview
• Opportunity to work in a purpose-driven insurance environment
• Role focused on meaningful client support and timely claims resolution
• Supportive team environment with scope to contribute to process quality and team upskilling

Company Culture

This is a client-focused and service-led environment where empathy, accountability, and accuracy matter. The team values people who are hardworking, compassionate, and committed to helping members through the claims process with professionalism and care.

If you do not receive a response within 10 working days, please consider your application unsuccessful.