Job Summary:

A Pet Insurance Claims Examiner/Adjuster investigates, verifies, and processes pet insurance claims to determine coverage and appropriate compensation. They evaluate claims, review documentation, and communicate with policyholders, veterinary hospitals, and other providers.

Responsibilities:

• Review individual policies to make an eligibility determination with a high degree of accuracy

• Contact veterinarians and clinic staff

• Ensure compliance guidelines are met including internal policies, procedures, and contractual commitments

• Work independently and with others in a virtual team setting

• Use PC-based programs to enter data into the claims system, communicate with leaders and teammates, and organize information.

• Create and issue claim decisions to policyholders using proper spelling, grammar, and punctuation in line with the policy terms

• Calculate invoice totals, discounts, and tax rates

• Be able to meet partners' standards and metrics.

Qualifications:

• High School Diploma or equivalent

• 5+ years of recent clinical veterinary experience (dog and cat) as a veterinary assistant, veterinary technician or veterinarian

• Property & Casualty Adjuster License required

• Knowledge of medical conditions and associated symptoms, procedures, treatments, secondary conditions, and pharmaceuticals used in veterinary medicine

• Knowledge of canine and feline breeds, anatomy, and associated predispositions to illness

• Ability to read and interpret medical diagnoses via medical records review, both written and digital.

• Ability to navigate computer OS, Google Chrome, and corresponding applications

• Ability to work independently and as part of a team in a virtual environment

• Demonstrable Microsoft Office proficiency: Word, PowerPoint, Excel, Outlook, Teams

• Excellent oral and written communication skills

• Strong mathematical and problem-solving skills

• Ability to pass background check

• Be able to work on weekends.

Qualifications a plus:

• Certified Veterinary Technician (CVT), Licensed Veterinary Technician (LVT) or Registered Veterinary Technician (RVT) (Min 5 years’ experience)

• Hands-on clinical experience within an emergency and/or specialty practice setting (examples include Oncology (medical +/-radiation), Ophthalmology, Internal Medicine, Neurology, and Cardiology)

• Previous processing of pet health insurance claims

• Bilingual (Spanish)

Special Requirements:

• Must have a laptop computer and Microsoft Word and Excel. Cell phone with text messaging, internet, and email.