Analyst, Claims Adherence

3 days ago

Vancouver, Canada Trupanion Full time

**Company Description**
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.

**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.
- 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.

**Qualifications** 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.
- 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 $33.88 to $41.69 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.

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

**Benefits and Perks**:

- Employer-paid extended health coverage for you and your family
- Trupanion will partner with Wealthsimple to register your RRSP, pension, etc.
- Four weeks of paid time off and 11 paid float holidays (you can decide which days are most important to you)
- Five weeks, paid, sabbatical after five years of employment
- Employer-paid medical insurance for one pet (cat or dog)
- Paid time off to volunteer at nonprofit organizations
- Open, casual, pet-friendly, and fun work environment

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.

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