Claims Assessor, Veterinary Experience

This is a fully remote position, open to applicants in Philippines.

📋 Description

• Evaluate and process new post-treatment pet insurance claims via the internal claims portal.

• Conduct final verifications prior to claim authorization.

• Examine claim details, medical documentation, medical history, treatment notes, treatment plans, invoices, and supplemental materials.

• Utilize veterinary expertise and clinical judgment to determine the appropriateness of treatments.

• Gather precise information and documentation necessary for pet claims.

• Detect inaccuracies, incompleteness, missing elements, or inconsistencies and follow up as necessary.

• Recognize policy exclusions and the reasons claims may be denied.

• Evaluate partial payment decisions with fairness and accuracy.

• Recommend claims for payment in accordance with policies, procedures, regulations, delegated authority, and company standards.

• Offer veterinary and technical guidance to the claims team.

• Assist with ongoing manual claims during the system implementation phase.

• Maintain precise claim records, assessment documentation, and internal communications.

• Ensure claims processing is prompt, accurate, and professional.

• Participate in remote meetings, training sessions, and team discussions.

• Undertake other position-related responsibilities as needed.

⛳️ Requirements

• A Bachelor’s degree in Veterinary Medicine is mandatory.

• 3 to 5 years of experience in veterinary medicine, small animal veterinary practice, pet claims assessment, insurance claims, veterinary administration, animal health, or a comparable role.

• Comprehensive veterinary knowledge and experience in animal treatment.

• Strong understanding of animal conditions and the ability to evaluate if treatment is appropriate for the diagnosis.

• Experience in reading and interpreting medical notes, medical histories, treatment notes, treatment plans, invoices, and veterinary documentation.

• Robust analytical skills to identify inaccuracies, incompleteness, inconsistencies, or missing information.

• Capability to assess policy issues, exclusions, or reasons for potential non-payment.

• Strong judgment and attention to detail.

• Exceptional written and verbal communication abilities.

• Skill in providing clear veterinary and technical advice.

• Experience with CRM or claims systems, or the ability to quickly learn new technologies.

• Proficient in Microsoft Office.

• Strong time management capabilities.

• Ability to engage with multiple stakeholders and collaborate effectively.

• A strong work ethic, reliability, and a commitment to thorough, fair, and efficient claim assessments.

• Capacity to work remotely and participate in weekly meetings as necessary.

🏝️ Benefits

• Permanent work-from-home arrangement.

• Monday–Friday: 7:00 AM – 4:00 PM PHT (adjustments will be made for daylight saving time).

• Health maintenance organization (HMO) coverage with 2 free dependents and medical reimbursements.

• Government-mandated benefits included.

• Opportunities to collaborate with leading companies in Australia and beyond.

• Training programs aimed at career development.

• Engaging company outings, team-building activities, and wellness sessions.

• Supportive and inclusive company culture.

• Dedicated managers focused on your growth and success.

• Competitive compensation and benefits package.

• Additional entitlements provided.

• Structured career development programs available.

• Commitment to equal opportunity and an inclusive work environment.

• Stability, growth, and a people-first culture.