Claims Adherence Analyst

Summary

Join Trupanion as a Claims Adherence Analyst and conduct accurate, timely reviews of high-risk claims, providing recommendations for consistent adjudication and fraud prevention. This remote, Canada-based position requires strong analytical and communication skills, experience in P&C or pet insurance, and the ability to interpret insurance policies and data. You will make eligibility decisions, authorize payments, and assist with audits. Trupanion offers a flexible schedule, competitive compensation including uncapped monthly bonuses and Restricted Stock Units, and comprehensive benefits.

Requirements

• 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
• 3+ years of experience related to P&C (Property and Casualty) or pet insurance
• 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
• Proficiency with Microsoft Office applications and Trupanion applications
• 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

Responsibilities

• Understand and translate complex data into meaningful actions and clear communications
• Assist in risk mitigation reviews, including fraud investigations, and make informed recommendations to prevent, intercept, and mitigate fraud
• Interpret and apply insurance policies to claims
• Extract, interpret, and convert raw data into plain language and formal written report recommendations
• Provide exceptional customer service to members, hospitals, and internal teams at Trupanion
• Assist with internal and external audits of all Trupanion-administered products
• 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

Preferred Qualifications

• 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

Benefits

• 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
• Uncapped monthly bonuses based on individual performance
• Restricted Stock Units to all new team members