Claims Processor

Fetch

6h•Remote

About The Position

The Claims Processor is a vital administrative role within the Specialty Claims team, focused on the essential "behind-the-scenes" operations that keep our claims moving efficiently. This role is primarily responsible for the procurement and organization of medical records, the adjudication of wellness claims, and providing administrative support to both Adjusters and the Service Department. The Processor acts as a problem-solver and investigator, navigating account discrepancies and ensuring all documentation is accurately captured to facilitate timely claim determinations. This position requires a high degree of organization, the ability to pivot quickly during clinic outreach, and a commitment to maintaining the integrity of our VIP accounts.

Requirements

Strong Communication Skills: Exceptional verbal communication for frequent clinic outreach and professional written skills for internal and external correspondence.
Technical Proficiency: Comfortable working within Google Suite; foundational skills in Google Sheets or Excel (sorting, filtering, and basic formula writing) are highly preferred.
Problem-Solving & Investigation: Ability to "think on your feet" to resolve account issues, find missing files, and investigate request discrepancies.
Organization & Multi-tasking: Proven ability to manage multiple administrative tasks simultaneously while maintaining high attention to detail.
Adaptability: Capable of pivoting quickly between different tasks, from phone outreach to data entry and special project support.
Remote Environment: Ability to work independently in a distraction-free remote environment, as a significant portion of the day is spent on the telephone.
High School Diploma or equivalent; Bachelor's degree or veterinary clinic experience is a plus.
Prior experience in an administrative, customer service, or data entry role, preferably within the insurance or veterinary industry.
Demonstrated ability to handle high-volume tasks in a fast-paced environment.
Active and valid Property & Casualty (P&C) Adjuster License in good standing is preferred; however, a willingness and ability to obtain licensure within a specified timeframe post-hire is required.

Nice To Haves

Bachelor's degree or veterinary clinic experience
Active and valid Property & Casualty (P&C) Adjuster License in good standing

Responsibilities

Conduct high-volume outbound calls to veterinary clinics to request missing medical records and documentation essential for claim adjudication.
Review incoming emails and accurately upload documents to the associated policyholder accounts, ensuring all files are correctly categorized.
Navigate difficult conversations with clinic staff, pivoting quickly to provide alternative identifiers when a patient is not easily found in their system.
Review and assess wellness-specific claims, ensuring they meet policy guidelines for routine care and preventative services.
Monitor administrative email queues to address requests from Adjusters and the Service Department regarding file status or account updates.
Provide specialized administrative support for VIP accounts, ensuring high-priority requests are handled with precision and care.
Monitor aging claim reports to identify files that require follow-up, ensuring claims remain within established processing timelines.
Assist with side administrative projects, including moving files between accounts, managing tracking sheets, and supporting automation initiatives.
Maintain and update Google Sheets or Excel trackers, utilizing sorting, filtering, and basic formulas to organize claims data.

Benefits

Comprehensive Medical, dental, and vision plan for you and your family
Health Savings Accounts (HSAs) and Flexible Spending Accounts (FSAs) are available
Highly competitive 401(k) matching
Generous 20-day PTO Policy, with rollover options. Earn an additional day of PTO each year on your anniversary with Fetch, for a maximum of 30 days
Paid company (9) holidays, including (1) floating holiday
Fetch Pet Insurance discount - up to 50% off, up to $1,000 savings/year
Educational Assistance Program
Fetch Discount Perks Program
Volunteering - earn up to 8 hours per calendar year at nonprofit organizations
NYC Office Amenities: Pet-friendly environment, free lunch, snacks, and additional amenities; transit accessible
Employee Referral Incentive
Tuition Assistance
Commuter Benefits
Employee Assistance Program (EAP)