Senior Claims Assessor (Veterinary Experience Required) - Work from Home - Muntinlupa
Twoconnect Muntinlupa Full-time
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).
- Minimum 3–5 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
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