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Pet Insurance Claims Specialist
2 months ago
We are in search of a licensed Property & Casualty (P&C) Pet Claims Specialist with a background in veterinary technology.
Previous experience in pet insurance claims adjustment is essential.
A background as a veterinary technician is required.
An active P&C license is mandatory (or currently in process).
KEY RESPONSIBILITIES:
- Evaluate assigned claims in accordance with the specific Terms & Conditions of each pet's insurance policy.
- Examine medical documentation, laboratory results, invoices, and claims submissions for comprehensive assessment.
- Process claims decisions, including evaluation and payment for the claims submitted.
- Confirm claims coverage through a thorough understanding of policy Terms & Conditions.
- Engage with veterinary practices regarding the evaluation of medical records and required documentation.
- Maintain a quality assurance score that exceeds departmental standards.
- Complete assigned tasks within required compliance timelines.
- Achieve a productivity rate that surpasses departmental benchmarks.
- Provide insights on process improvements to enhance Standard Operating Procedures (SOPs).
ESSENTIAL SKILLS:
- In-depth knowledge of disease processes and veterinary medical terminology.
- Ability to interpret veterinary medical records and invoices accurately.
- Capability to identify both chronic and acute medical conditions.
- Adaptability in a dynamic, fast-paced environment while managing multiple computer systems.
- Ability to work independently in a remote setting while promoting teamwork and collaboration.
- Excellent communication skills for effective collaboration with team members and managerial support.
- Proven problem-solving abilities to navigate complex medical or veterinary scenarios affecting a pet's diagnosis or treatment plan.
QUALIFICATIONS:
- A minimum of five years of experience as a veterinary technician.
- A Bachelor's degree in veterinary science or equivalent certification is preferred.
- A Property and Casualty Adjuster license in good standing is preferred.
- Completion and passing of state adjuster licensing requirements.
- Reliability and good attendance are essential.
- Availability to work a minimum of 42 hours per week, including occasional weekends and additional hours as necessary.
WORK-FROM-HOME REQUIREMENTS:
- Access to a reliable high-speed internet connection (minimum of 100 Mbps download and 30 Mbps upload speed).
- A quiet, dedicated workspace at home that minimizes background noise and distractions.
- Workspace must accommodate dual 19" monitors, a laptop, mouse, keyboard, and headset.
- Ability to set up and connect equipment delivered to your home with guidance from a remote IT team.
Questpro is a comprehensive recruiting firm dedicated exclusively to the Insurance and Risk Management sector. We cater to a wide range of professionals, from recent graduates to seasoned executives, by identifying top talent across all levels. Our areas of expertise encompass Retainer, Direct-Hire, Contract/Contract to Hire, and Consulting Practices.
