Claims Specialist

This is a fully remote position, open to applicants in Switzerland, +1 more country.

📋 Description

• Evaluate claim eligibility and determine outcomes by reviewing veterinary medical records, clinical notes, invoices, and policy details.

• Consistently and accurately apply policy language, claims guidelines, and established procedures.

• Perform secondary claim assessments during the appeals process and articulate claim reasoning in a clear and professional manner.

• Investigate complex claim situations by collecting, validating, and interpreting relevant medical and policy data.

• Identify and obtain necessary documentation from veterinary clinics, specialists, or pet owners when information is missing or incomplete.

• Communicate with veterinary professionals, pet owners, and internal teams via phone and email regarding claim determinations, status updates, and policy inquiries.

• Provide an efficient, empathetic, and positive experience for both pet owners and veterinary partners.

• Maintain accurate records and documentation across multiple internal systems.

• Collaborate with cross-functional teams to promote operational excellence and continuous improvement efforts.

• Offer ideas and feedback that enhance claims processes, workflows, and the customer experience.

• Act as a reliable resource for pet owners, veterinary teams, and internal stakeholders.

⛳️ Requirements

• Professional working proficiency in English is essential.

• 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 the veterinary, animal health, pet insurance, or a related sector.

• Strong knowledge of veterinary medical terminology, common conditions, treatments, and diagnostic procedures.

• Direct experience working 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 advantageous.

• Proven ability to learn and navigate various systems, processes, and technologies.

• Proficient in Microsoft Office applications and other business software.

• Strong analytical skills and problem-solving capabilities.

• Excellent attention to detail, ensuring a high degree 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 even in challenging situations.

• Capability to manage multiple priorities and work efficiently across different systems.

• Adaptable and resilient in a dynamic and evolving environment.

• Self-motivated, able to work independently while contributing to a collaborative team culture.

• Proactive attitude with a commitment to continuous learning and improvement.

• Reliable, stable internet connection through hard-wire Ethernet is necessary.

• Flexibility to begin work as early as 07:00, work until 19:00, and availability to work on Saturdays.

🏝️ Benefits

• 25 days of holiday leave.

• Five-week sabbatical after five years of employment.

• Medical Insurance coverage for a cat or dog.

• Access to Medical Concierge (Summus).

• Lifestyle Spending Account (LSA).

• Family Planning support (Carrot).

• Employee Assistance Program.

• Open, casual, pet-friendly, and enjoyable office environment.

• Monthly bonuses based on individual and company performance.

• Restricted Stock Units that vest over four years.