Johannesburg: Claims Validator posted by WatersEdge Solutions

Location: On-site (South Africa)
Employment Type: Full-Time
Industry: Insurance | Claims | Customer Experience

About the Role

WatersEdge Solutions is partnering with a forward-thinking insurance provider to recruit a compassionate and detail-oriented Claims Validator. This role plays a vital part in ensuring timely and accurate processing of funeral insurance claims. You’ll manage end-to-end claims validation, provide client support, and assist with fraud prevention, all while delivering empathetic and efficient service during difficult times. This is an ideal position for someone with prior long-term insurance and claims experience looking to make a meaningful impact in peoples lives.

Key Responsibilities

• Validate captured and registered claims in line with policy and compliance standards
• Ensure appropriate claim outcomes: payment, repudiation, or awaiting information
• Reconcile daily validated claims due for payment
• Track and report daily claims metrics
• Liaise with clients and internal teams regarding claim statuses and queries
• Use internal claims systems (e.g., Dionysus) for validation and reporting
• Adhere to standard operating procedures, QA standards, and scripts
• Support in training and upskilling team members on claims assessments and fraud

What Youll Bring

• Matric / NQF Level 4
• 35 years of experience in Claims Validation or Assessment
• Experience in the long-term insurance sector (funeral or life insurance)

• Computer literacy and proficiency with Microsoft Office (Outlook, Word, Excel)
• Experience using claims management systems such as Dionysus
• Excellent attention to detail and time management
• Strong verbal and written communication skills
• Ability to communicate in English and at least one other South African language (Afrikaans, Zulu, Setswana preferred)
• Compassionate, team-oriented, and customer-centric
• Willingness to work overtime if required

Nice to Have

• Additional languages such as Xhosa, Tsonga, or Venda
• Experience assisting in team training or process improvement
• Exposure to fraud detection and quality assurance

Whats On Offer

• Market-related salary (based on experience)
• Performance-based annual bonus
• Subsidised Life and Disability Cover
• Funeral Cover
• An empathetic and purpose-driven work culture focused on support and accountability

Company Culture

Our client is a purpose-led insurance provider with a reputation for innovation and heart. With over 25 years in the industry, they focus on non-traditional insurance sectors and serve their clients with empathy and care. Their culture promotes teamwork, humility, and resilience, with a shared mission to make difficult times easier for South African families. Youll be part of a growing team that values hard work, compassion, and continuous learning.

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