Veterinary Insurance Claims Specialist

Work Hours

Experience Required

Who We Are

Job Summary

Key Responsibilities

• Review and process veterinary insurance claims according to company policies and SLAs
• Evaluate clinical notes, treatment plans, invoices, and medical histories for claim validity
• Verify coverage eligibility, exclusions, and benefits before claim adjudication
• Communicate with veterinary clinics, pet owners, and internal teams for missing or unclear information
• Identify discrepancies, potential fraud indicators, and documentation gaps
• Accurately document claim decisions and maintain records in claim management systems
• Collaborate with QA, Operations, and Support teams for continuous process improvement
• Participate in daily standups, workflow reviews, and training sessions
• Ensure compliance with data protection and regulatory standards
  

Required Qualifications

• Experience with veterinary, medical, pet insurance, or healthcare claims processing
• Strong understanding of veterinary medical terminology, procedures, and diagnostics
• Ability to interpret invoices, SOAP notes, treatment records, and lab reports
• Proficiency with claims management systems and documentation tools
• Strong analytical ability with excellent attention to detail
• Good working knowledge of MS Office (Excel, Outlook, Word)
  

Preferred Qualifications

• Experience with US/UK/AUS insurance processes
• Familiarity with claim adjudication guidelines and regulatory compliance
• Exposure to workflow tools such as CRM platforms, ticketing systems, or BPM tools
• Knowledge of denial management, appeals, and resubmission processes
  

Soft Skills

• Excellent verbal and written communication skills
• Strong problem-solving and decision-making abilities
• Ability to work independently and in a fast-paced environment
• Team-oriented mindset with strong collaboration skills
• High level of accuracy, integrity, and professionalism