Claims Validator – Injury on Duty

Location: Groenkloof, Pretoria

Remuneration: Market-Related (Based on Experience)

About the Opportunity

Medical Resources Group is recruiting on behalf of our client, a well-established organisation specialising in Injury on Duty (IOD) claims administration and medical accounts management, for an experienced Senior Validator to join their production team.

This role is ideally suited to a candidate with strong experience in IOD claims, medical claims validation, or a related healthcare funding environment. The successful candidate will play a key role in assessing claims, validating billing, supporting clients, and ensuring accurate processing within strict deadlines.

This is an excellent opportunity for a detail-driven professional who enjoys problem-solving, working with complex claims, and contributing to operational excellence.

Key Responsibilities

Claims Validation & Processing

• Assess and validate Injury on Duty claim information
• Review medical billing per line item in accordance with applicable tariffs and regulations
• Assess accounts against payment histories and supporting information
• Ensure accurate claim processing and adherence to deadlines
• Update internal systems with relevant claim information

Client & Operational Support

• Manage allocated client accounts / practices professionally
• Communicate effectively with clients regarding claims, accounts, and outstanding information
• Provide guidance on claims processes and account-related queries
• Follow up on required documentation from clients, employers, and third parties
• Resolve queries relating to legislation, claims, and treatment submissions

Quality & Team Contribution

• Ensure procedures and production standards are followed
• Contribute to achieving production and revenue targets
• Assist with onboarding and training of new team members
• Support other departments when required
• Perform ad hoc duties aligned to business objectives

Minimum Requirements

• Matric / Grade 12 (Essential)
• Previous experience in Injury on Duty (IOD) claims or similar claims environment (Essential)
• Medical claims experience (Essential)
• Experience in client and funder communication (Essential)
• Tertiary qualification (Advantageous)

Key Skills & Competencies

• Strong analytical and validation skills
• Excellent attention to detail and accuracy
• Computer literate (MS Word, Excel, Outlook)
• Experience with medical claims / online funder systems (Advantageous)
• Strong communication skills (written and verbal)
• Problem-solving mindset and proactive approach
• Ability to multitask and meet deadlines
• Able to work effectively under pressure

Candidate Profile

The ideal candidate will be:

• Experienced in claims validation and healthcare administration
• Detail-oriented and process-driven
• Professional and client-focused
• Reliable and accountable
• A strong team player willing to support others

How to Apply

Please email your CV and supporting documents to recruitment@medicalresources.co.za with Subject line: Validator

If you do not receive feedback within 2 weeks, please consider your application unsuccessful.