Senior Claims Assessor (Veterinary Medicine Background) - WFH / Dayshift at Twoconnect

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Senior Claims Assessor (Veterinary Medicine Background) - WFH / Dayshift at Twoconnect. . 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 pet’s 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.. . . . Mandatory:. Bachelor’s degree in Veterinary Medicine (DVM, BVSc, or equivalent qualification). . . 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.. . Company Location: Philippines.