Claims and Underwriting Advocate

PETHEALTH - Oakville, ON (30+ days ago)

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Tuesday, October 8, 2019

Our Mission at Pethealth Inc. is to bring vitality to lives… furry and otherwise. This includes pets, and the people who care for them; our employees, our partners, our customers, our business and our communities.

Position Summary:
Reporting to the Claims and Underwriting Supervisor the primary objective is to ensure high quality, expedient and profitable turnaround of member/client claims, appropriate risk analysis in underwriting files and ensuring a positive member experience through the claims and underwriting process.

Job Duties/Responsibilities:
Adjusting claims on a daily basis within claims turnaround timelines and daily goals
Reviewing reassessments and pre-approvals within set turnaround times daily
Ensuring owner and pet information on claim forms corresponds with information contained in medical history and policy administration systems
Reaching out to members/clinics to obtain any additional medical information required for claim completion
Underwriting new policies within underwriting turnaround times brand specific
Review of complete medical history relating to submitted claims to ensure not related to pre-existing conditions
Communicating details of processed claim to clients as required
Assisting the Customer Service Representatives with claims related calls
Other duties as assigned

Education/Experience:
Post-secondary education in animal care or related field; CVT, LVT, or RVT is preferred, or equivalent experience
2-3 years of experience working in a clinical/veterinary environment, preferably in primary care
Strong knowledge of veterinary medical terminology
Previous insurance experience is an asset

Required Qualifications (Certifications, Licenses, Software Programs, KSA’s):
Strong knowledge of veterinary medical terminology
Strong communication and service skills
Comfortable using a computer and proficiency with Microsoft office.
Ability to multi-task and meet tight deadlines.
Exceptional telephone and interpersonal communication skills
Strong problem solving and de-escalation skills
Positive attitude, highly self-motivated and goal-orientated
Ability to work both independently and as part of a team

Additional Qualifications:
Prior experience working in an administrative/office-based role is an asset, but not a requirement
Must be able to pass background checks (criminal and credit)

Work Requirements:
Frequent communications, verbal and written.
Must be able to remain in a stationary position 80% of the time.
Must be able to read, count and do simple mathematics.
Be able to lift up to 10lbs. occasionally.
The person in this position needs to occasionally move about inside the office to access file cabinets, office machinery, etc
Constantly operates a computer and other office productivity machinery, such as a phone with headset, calculator, copy machine, and computer printer.

We thank all candidates for their interest, . If selected for an interview, you will be contacted by email within 7 business days. Pethealth is an equal opportunity at will employer and does not discriminate against any employee or applicant for employment because of age, race, religion, race, disability, gender, sexual orientation or national origin.

Other details
Job Family
Claims & Underwriting
Pay Type
Salary