Analyst, Claims Adherence

Trupanion is a leading provider of medical insurance for cats and dogs in North America. Our mission is to help the pets we all love receive the veterinary care they need. At Trupanion, we offer a collaborative, casual, and pet-friendly environment where everyone is encouraged to be themselves.

As a Analyst, Claims Adherence, you will conduct accurate and timely reviews of high-risk situations requiring impartial and unbiased investigations. You will also provide recommendations to support consistent claims adjudication and ensure fair, equitable outcomes, with a focus on claims-related insurance fraud.

At Trupanion, we believe a flexible workplace! We know that talented pet-loving professionals are everywhere. This is a remote position open to candidates anywhere in the US. You must be able to have a reliable/stable connection to the internet through hard-wire Ethernet. If you enjoy a mix of on-site and remote work, you may choose to have a hybrid schedule in our Seattle office.

Schedule

• Monday to Friday from 7:00 a.m. PDT to 3:00 p.m. PDT.

Key Responsibilities Include:

• Understanding and translating complex data into meaningful actions and clear communications.
• Assisting in risk mitigation reviews, including fraud investigations, and making informed recommendations to prevent, intercept, and mitigate fraud.
• Interpreting and applying insurance policies to claims.
• Extracting, interpreting, and converting raw data into plain language and formal written report recommendations.
• Providing exceptional customer service to members, hospitals, and internal teams at Trupanion.
• Assisting with internal and external audits of all Trupanion-administered products.

Decision Making Authority:

As a Analyst, Claims Adherence, you will have the authority to:

• Make eligibility decisions on claims and appeals.
• Authorize payments on claims with subtotals under $40K.
• Reopen or interrupt payments on claims processed by others for assessment and payout validation.
• Request or conduct additional information gathering or validation tasks related to those claims.

Education, Registration & Certification:

• Licensed Veterinary Technician credentials preferred, or equivalent experience in a veterinarian clinic
• Currently licensed or ability to obtain property and casualty adjuster license in Canada and/or the United States

Experience:

• 3+ years of experience related to P&C (Property and Casualty) or pet insurance.
• Veterinary technician or assisting experience in a clinic/hospital environment is a plus.
• Education or certification in insurance operations, insurance fraud detection and investigation, or risk management is a plus.

Skills, Knowledge & Abilities:

• Knowledge of veterinary practice operations and medicine, including medical terminology and conditions.
• Strong desire to contribute to an evolving team with shared goals around group performance.
• Ability to work creatively and adapt to shifting processes and goals.
• Desire to collaborate and help develop a wide variety of processes over time.
• Knowledge of Trupanion policies.
• Proficiency with Microsoft Office applications and Trupanion applications.
• Effective communicator (written and spoken).
• Problem-solving skills in high-pressure situations.
• Strong attention to detail.
• Ability to work both independently and as part of a team.

Compensation:

• The hourly pay range for this position is $25.00 to $30.76 per hour on a full-time schedule.
• Along with the hourly pay, Trupanion employees may be eligible for uncapped monthly bonuses based on individual performance.
• We want all employees to be invested in Trupanion’s success, so we grant Restricted Stock Units to all new team members. Our new hire grants vest over 4 years.

All your information will be kept confidential according to EEO guidelines.

Benefits and Perks:

• Full medical, dental, and vision benefits at no cost to the employee
• Four weeks of paid time off and 9 paid float holidays (you can decide which days are most important to you!)
• Five-week sabbatical after five years of employment
• Open, casual, pet-friendly, and fun office environment
• Free medical health insurance for your pet (1 dog or cat)
• Paid time off to volunteer at nonprofit organizations
• Seattle Office Amenities: Free on-site gym, free dog walking services for office pets during business hours, free parking, and paid ORCA cards.

For more information about Trupanion, visit https://trupanion.com/about

Learn more about how Trupanion has revolutionized our industry and the reimbursement model: https://www.youtube.com/watch?v=vdWZ4KHiPTQ

Trupanion is an equal-opportunity employer and embraces diversity. We are committed to building a team that represents a variety of backgrounds, abilities, perspectives, and skills.

We will ensure that individuals are provided reasonable accommodation to participate in the job application or interview process, perform essential job functions, and receive other benefits and privileges of employment. Please contact us to request accommodations.