Job Description
Job Description
Job Posting: Claims Adjuster – Remote
Join our team to support a leading pet insurance organization as a Claims Adjuster. This is a fully remote role offering the opportunity to help pet parents by efficiently managing, adjudicating, and finalizing insurance claims. We are looking for detail-oriented individuals who value accuracy, organization, and clear communication.
Key Responsibilities:
- Adjudicate insurance claims in a timely and compliant manner, adhering to standard operating procedures.
- Consistently meet or exceed daily claims targets.
- Provide guidance, oversight, and final approval authority to non-licensed claims processors (GenPact, AdStrat, or Healthy Paws).
- Maintain active adjuster licenses as required by state and municipal regulations.
- Identify and recommend process improvements to enhance the claims workflow.
- Ensure all claims are processed according to compliance and quality standards.
Required Skills:
- Active Property & Casualty Adjuster License, or the experience and aspiration to obtain licensing within six months.
- Experience in claims review and adjudication.
- Ability to clearly communicate with pet owners in writing and over the phone.
- Strong decision-making and problem-solving abilities.
- Excellent organizational and time management skills.
- Confidence with basic IT tasks in a remote environment: attaching files to emails, editing documents, screensharing, and escalating technical issues as needed.
- Experience with Microsoft Outlook, Word, Access, PowerPoint (primarily using existing slides).
- Familiarity with ERP or CRM systems is a plus.
Preferred Education & Experience:
- High school diploma or equivalent work background.
- Two years of experience in customer service or a call center environment.
- Veterinary knowledge or experience evaluating medical records is a plus.