Claims Specialist

WatersEdge Solutions; Johannesburg; On-site; ZAR 300,000 - 400,000; Full time

Benefits offered by this job

Market-related salary

Performance-based annual bonus

Subsidised Life and Disability Cover

Funeral Cover

Job summary

A leading financial services company in Johannesburg is looking for a dedicated Claims Specialist to enhance their claims process within the funeral and insurance sector. The ideal candidate will validate registered claims, ensuring accuracy and customer satisfaction. Applicants should have 3-5 years of experience in claims assessment and strong communication skills in English and Afrikaans. This full-time role offers a market-related salary and performance-based bonuses, with the opportunity to make a positive impact on clients' lives.

Qualifications

• Matric / NQF 4 minimum required.
• 3-5 years of experience in Claims Assessment or Claims Validation.
• Strong working knowledge of Microsoft Office and Outlook.

Responsibilities

• Validate registered claims for accuracy and completeness.
• Prepare and reconcile claims for payment.
• Offer support and guidance to clients on claim queries.
• Meet production and quality benchmarks.

Skills

Claims Assessment

Attention to detail

Communication Skills (English and Afrikaans)

Team Player

Problem-solving skills

Education

Matric / NQF 4 minimum

Tools

Microsoft Office

Dionysus claims processing platform

Job description

Direct message the job poster from WatersEdge Solutions

Claims Specialist

We are seeking a dedicated and detail‑oriented Claims Specialist to join our growing team. This role is essential in delivering a seamless, client‑centric claims experience within the funeral and insurance space. The successful candidate will be responsible for the end‑to‑end validation and finalisation of registered claims, ensuring that members receive the support they need during emotionally sensitive times.

Role Overview

• Validate all registered claims, ensuring accuracy, completeness, and compliance with policy terms.
• Prepare and reconcile validated claims for payment.
• Ensure high levels of customer service, offering support and guidance to clients on claim queries.
• Liaise with Claims Assessors, Supervisors, and Managers to resolve any discrepancies.
• Meet required production and quality benchmarks as set by management.
• Prepare and maintain daily claims metrics and reports.
• Assist in fraud detection and investigations where required.
• Conduct validations on Dionysus and follow standard operating procedures.
• Contribute to ongoing training and upskilling within the team.
• Ensure cross‑functional collaboration with other departments on client claims.
• Take ownership of the validation process and escal

Qualifications & Experience

• Matric / NQF 4 minimum.
• 3–5 years of experience in Claims Assessment or Claims Validation is essential.
• Computer literate with strong working knowledge of Microsoft Office and Outlook.
• Experience working on Dionysus or similar claims processing platforms is an advantage.
• Strong communication skills; able to communicate effectively in English, Afrikaans, Zulu or Setswana (additional languages such as Xhosa, Tsonga, and Venda are a bonus).
• Client‑service driven with high attention to detail.
• Strong interpersonal and problem‑solving skills.
• Team player who is punctual, honest, compassionate, and committed.
• Willingness to work extra hours/overtime when required.
• Ability to thrive in a fast‑paced, process‑driven environment.

What We Offer

• Market‑related salary based on experience.
• Performance‑based annual bonus.
• Subsidised Life and Disability Cover.
• Funeral Cover.
• Opportunity to be part of a mission‑driven team that delivers real impact to South Africans.

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

Seniority Level

Associate

Employment Type

Full‑time

Job Function

Administrative

Industry

Financial Services and Insurance