Description: Max Pay Rate: *** per hour
Training will be 6-8 weeks; no time off allowed during training.
Fully virtual role

Required Skills & Experience:
- 1 years of veterinary medical experience OR 6 months plus experience working in pet claims.

Role Value Proposition:

The Claims Coordinator accurately reviews medical records and invoices, utilizing their understanding of pet health diagnoses and procedures, to evaluate coverage and equitably settle pet health insurance claims with respect to policy limits & terms. Communicates with the Veterinarian to determine the details of the claim, requesting and verifying necessary documentation, and informs the Insured of claim status or claim outcome. Utilizes the workflow queues to perform job functions to include: claim entry/policy association, pre-adjudication, Insured/Veterinarian documentation requests, claim closeouts, claim appeals, and good to go claims processing.

Key Responsibilities:

Requests and communicates with Veterinarians for clarification of diagnosis/additional information necessary to accurately process claim
Adjudicates for allocation of deductibles, co-pays, co-insurance maximums and provider reimbursements. Follows adjudication policies and procedures to ensure proper payment of claims
Documents phone calls in system and follows up on issues if needed
Resolves problems resulting from claim adjudication and communicates claim status and claim outcome with Insureds
Prepares reports as required by management and enters/receives inbound documents as assigned

Essential Business Experience and Technical Skills:

Required:
High school diploma or equivalency
One year veterinary medical experience or equivalency preferred
Strong understanding of veterinary medical terminology
Proven history of adherence to corporate policies, procedures, and guidelines
Proven Attendance Reliability
Excellent tracking, follow-up, and relationship building skills

Preferred:
Vet Tech License
Ability to operate in a fast-pace, multi-tasking environment with deadlines
Strong written, verbal, interpersonal, and phone communication skills
Articulate, professional, and possesses a strong quality customer service mindset with attention to detail
Strong computer background using MS Word, Outlook, Excel, and Internet
Ability to learn quickly (to include our proprietary CRM system for managing customers)
Ability to identify problems and logically research with minimum assistance to locate answer through appropriate reference materials

Custom Fields:
Name: Operating Unit
Value: 09000000

Name: GL Account
Value: ***

Name: Building Access Dropdown
Value: No

Name: State
Value: None

Name: Project Name (If Applicable)
Value: None

Name: Onshore/Offshore
Value: Onshore

Name: Country
Value: UNITED STATES

Name: On Site/Off Site
Value: Virtual - Working full-time in non-*** location

Name: Business Unit
Value: 01300

Name: City
Value: None

Name: Product Number
Value: 001000

Name: *** Systems Etc Dropdown
Value: Yes

Name: ***LaptopDropdown
Value: Yes