
Claims Specialist
Posted Sep 2

Posted Sep 2
This is a fully remote position, open to applicants in Germany, +1 more country.
• Assess veterinary medical records, clinical notes, invoices, and policy details to determine claim eligibility and outcomes.
• Consistently and accurately apply policy language, claims guidelines, and established procedures.
• Perform secondary claim reviews during the appeals process and clearly communicate the rationale behind claims decisions in a professional manner.
• Investigate intricate claim scenarios by collecting, validating, and interpreting pertinent medical and policy information.
• Identify any missing or incomplete information and proactively request necessary documentation from veterinary clinics, specialists, or pet owners.
• Engage with veterinary professionals, pet owners, and internal teams via phone and email regarding claim decisions, status updates, and policy inquiries.
• Provide an efficient, empathetic, and positive experience for pet owners and veterinary partners in sensitive situations.
• Keep accurate records and documentation across various internal systems.
• Collaborate with cross-functional teams to promote operational excellence and continuous improvement initiatives.
• Offer insights and feedback to improve claims processes, workflows, and overall customer experience.
• Professional working proficiency in English is required.
• Professional fluency in German is required.
• Professional fluency in French is required.
• A minimum of 2 years of experience in a customer-facing role within veterinary, animal health, pet insurance, or a related field.
• Strong knowledge of veterinary medical terminology, common conditions, treatment options, and diagnostic procedures.
• Prior experience working directly with clients or pet owners in a veterinary clinic, hospital, or animal health environment is highly preferred.
• Experience in reviewing medical records, supporting patient care, claims adjudication, or insurance operations is considered an asset.
• Proven ability to learn and navigate multiple systems, processes, and technologies.
• Proficiency in Microsoft Office applications and other business software.
• Strong analytical and problem-solving skills.
• Excellent attention to detail with a high level of accuracy and consistency.
• Ability to evaluate complex information, identify key details, and make informed decisions.
• Exceptional written and verbal communication skills.
• Strong customer focus with empathy and professionalism in challenging situations.
• Ability to manage multiple priorities and work efficiently across various systems.
• Adaptability and resilience in a dynamic and evolving environment.
• Self-motivated with the capacity to work independently while fostering a collaborative team culture.
• Proactive mindset with a commitment to ongoing learning and improvement.
• Reliable and stable internet connection via hard-wire Ethernet.
• Flexibility to start as early as 07:00, work until 19:00, and work on Saturdays.
• Monthly bonuses based on individual and company performance.
• Restricted Stock Units that vest over 4 years (may be provided).
• 25 days of holiday leave.
• Five-week sabbatical after five years of employment.
• Medical Insurance for a cat or dog.
• Medical Concierge (Summus).
• Lifestyle Spending Account (LSA).
• Family Planning (Carrot).
• Employee Assistance Program.
• Open, casual, pet-friendly, and enjoyable office atmosphere.
• Reasonable accommodations for the application/interview process, essential job functions, and employee benefits and privileges.
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