ET INSURANCE CLAIMS EXAMINER/ADJUSTER 1099 INDEPENDENT
CONTRACTOR
Job Summary:
A Pet Insurance Claims Examiner/Adjuster investigates, verifies, and processes pet insurance claims to determine coverage and appropriate compensation. They evaluate claims, review documentation, and communicate with policyholders, veterinary hospitals, and other providers.
Responsibilities:
- Review individual policies to make an eligibility determination with a high degree of accuracy
- Contact veterinarians and clinic staff
- Ensure compliance guidelines are met and both internal policies, procedures and contractual commitments
- Work independently and with others in a virtual team setting
- Use PC-based programs to enter data into the claims system, communicate with leaders and teammates, and organize information.
- Create and issue claim decisions to policyholders using proper spelling, grammar, and punctuation in line with the policy terms
- Calculate invoice totals, discounts, and tax rates
- Be able to meet partners standards and metrics.
Qualifications:
- High School Diploma or equivalent
- 5+ years of recent clinical veterinary experience (dog and cat) as a veterinary assistant, veterinary technician or veterinarian
- Property & Casualty Adjuster License required
- Knowledge of medical conditions and associated symptoms, procedures, treatments, secondary conditions, and pharmaceuticals used in veterinary medicine
- Knowledge of canine and feline breeds, anatomy, and associated predispositions to illness
- Ability to read and interpret medical diagnoses via medical records review, both written and digital.
- Ability to navigate computer OS, Google Chrome and corresponding applications
- Ability to work independently and as part of a team in a virtual environment
- Demonstrable Microsoft Office proficiency: Work, PowerPoint, Excel, Outlook, Teams
- Excellent oral and written communication skills
- Strong mathematical and problem-solving skills
- Ability to pass background check
- Be able to work on weekends.
Qualifications a plus:
- Certified Veterinary Technician (CVT), Licensed Veterinary Technician (LVT) or Registered Veterinary Technician (RVT) (Min 5 years’ experience)
- Hands-on clinical experience within an emergency and/or specialty practice setting (examples include Oncology (medical +/-radiation), Ophthalmology, Internal Medicine, Neurology, and Cardiology)
- Previous processing of pet health insurance claims
- Bi-lingual (Spanish)
Special Requirements:
- Must possess a laptop computer and Microsoft Work and Exce