Senior Claims Assessor (Veterinary Experience Required) - Work from Home

• Review and assess complex pet insurance claims using veterinary knowledge and in accordance with policy terms and conditions.
• Evaluate medical records, invoices, diagnostic results, and treatment plans to determine claim eligibility.
• Provide advice and technical guidance to claims consultants on the clinical aspects of claims and payment decisions.
• Analyse pet claims to ensure treatment aligns with the pets diagnosis/condition.
• Identify reasons for declined or partial claim payments, ensuring fair and justified outcomes.
• Communicate with veterinary clinics to clarify treatment histories or obtain missing clinical information.
• Escalate and investigate unusual, high-value, or disputed claims with appropriate documentation.
• Ensure the customer is treated fairly, and claims are assessed and processed promptly and accurately.
• Support continuous improvement efforts, including claims processing enhancements, quality assurance activities, and internal training.
• Mentor and support junior claims assessors and contribute to professional development initiatives.
• Contribute to the review and updating of internal claims guidelines, assessment tools, and best practices.
• Work collaboratively with internal stakeholders including Claims, Customer Service, and Compliance.
• Ensure adherence to regulatory requirements, industry regulations, and company standards in claims handling.

Requirements

• Mandatory: Bachelors degree in Veterinary Medicine (DVM, BVSc, or equivalent qualification).
• Minimum 35 years of clinical experience in small animal veterinary practice.
• Strong understanding of veterinary diagnostics, treatments, and medications.
• Prior experience in insurance, claims assessment, or related fields preferred.
• Excellent written and verbal communication skills.
• High level of accuracy, critical thinking, and analytical skills.
• Strong work ethic and excellent time management skills.
• Ability to work independently in a fast-paced, remote environment while managing competing priorities.
• Proficiency in CRM systems, Microsoft Office, and ability to adapt to new technologies quickly.
• Ability to collaborate with multiple stakeholders and work cross-functionally.

Benefits

As a Twoconnect employee, you get to enjoy the following:

• Work From Home
• Shift: Monday to Friday, 7:00 AM to 4:00 PM or 6:00 AM to 3:00 PM PHT
• HMO benefits
• Government-mandated benefits
• Training and Development programmes
• Employee Engagement Events (company outings, fun activities, quarterly wellness and self-care sessions)
• Experience working with leading organisations
• Fun, supportive, and inclusive culture
• Dedicated Team Managers that look after your development