The Claim Adjuster is an individual contributor role responsible for successfully and compliantly adjudicating claims, meeting claim execution targets, and delivering a WoW! experience to our Pet Parents every day.
RESPONSIBILITIES
Adjudicating claims.
Meeting or exceeding daily claim targets.
Providing guidance, oversight, and final approval authority to non-licensed claims processors from Genpact, AdStrat, or Healthy Paws.
Obtaining and maintains advanced adjuster licenses according to state and municipality requirements
Ensuring claims are compliantly processed and adjudicated following standard operating procedures and processes.
Identifying process improvement opportunities and implementing solutions
SKILLS
Be a licensed Claim Adjuster or have the experience to become a licensed Claim Adjuster within six months
Property and Casualty License
Ability to effectively communicate with pet parents
Problem solving and decision-making skills
Organizational and time management skills
Basic IT skills - To be successful in this fully remote role, it's important that they feel confident managing basic functions independently—such as attaching files to emails, editing shared documents, troubleshooting simple issues like screensharing, and knowing when to escalate tech concerns to the right person—since all job duties are conducted online.
Outlook
Word
Access
Power Point
Experience with ERP or CRM systems a plus
EDUCATION AND EXPERIENCE
Veterinary knowledge or experience evaluating medical records a plus
2+ years of customer service or call center experience
High school diploma or equivalent work experience
They will be managing one calendar with minimal invites (team meetings, 1:1s, etc.). They will send both free form and templated emails in Salesforce, but the mechanism is similar between Outlook and Salesforce.
The ability to do Pivot Tables, VLOOKUP's, or formulas is not necessary but would be an asset if they became FTEs. They will have minimal, if there is any, work in Excel.
They will have minimal use of Power point but would use existing slides.
