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 processes.

• Participate in secondary claim reviews during the appeals process, clearly and professionally communicating claim rationale.

• Investigate complex claim situations by collecting, validating, and interpreting pertinent medical and policy information.

• Proactively gather required documentation from veterinary clinics, specialists, or pet owners by identifying missing or incomplete information.

• Engage with veterinary professionals, pet owners, and internal teams through phone and email regarding claim decisions, status updates, and policy inquiries.

• Provide a compassionate, efficient, and positive experience for pet owners and veterinary partners in sensitive situations.

• Keep accurate records and documentation across multiple internal systems.

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

• Offer ideas and feedback to enhance claims processes, workflows, and customer experiences.

• Act as a trusted resource for pet owners, veterinary teams, and internal stakeholders in complex claim situations.

⛳️ Requirements

• Required professional working proficiency in English.

• Required professional fluency in German.

• Required professional fluency in French.

• 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, treatments, and diagnostic procedures.

• Preferably, experience working directly with clients or pet owners in a veterinary clinic, hospital, or animal health environment.

• Experience in reviewing medical records, supporting patient care, claims adjudication, or insurance operations is an asset.

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

• Proficiency in Microsoft Office applications and other business software.

• Strong analytical thinking and problem-solving skills.

• Excellent attention to detail with a high level of accuracy and consistency.

• Capable of assessing complex information, identifying key details, and making informed decisions.

• Exceptional written and verbal communication skills.

• Strong customer orientation with empathy and professionalism in challenging situations.

• Ability to manage multiple priorities and work effectively across various systems.

• Adaptable and resilient in a dynamic and evolving environment.

• Self-motivated with the ability to work independently while fostering a collaborative team culture.

• Proactive mindset with a dedication to continuous 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 on Saturdays.

🏝️ Benefits

• 25 days of holiday leave.

• Five-week sabbatical after five years of employment.

• Medical Insurance for a pet (cat or dog).

• Medical Concierge services (Summus).

• Lifestyle Spending Account (LSA).

• Family Planning support (Carrot).

• Employee Assistance Program.

• A casual, open, pet-friendly, and enjoyable office environment.

• Monthly bonuses tied to individual and company goals.

• Restricted Stock Units that vest over four years.

• Flexible remote work arrangement.