Advocate, Claims & Underwriting

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.

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