Pet Insurance Claims Consultant – Vet Nurse – South Africa

What we believe:

At PD Australia, we believe that every pet parent and fur baby deserve a soft landing.  We do this through our pet loving team, our friendly approach, easy to understand products, top dog service and our fast claims service.

Please consider the working hours:

Monday to Friday: 00h00 – 07h30 OR 04h00 – 11h00 (Rotational shifts)

These hours are in line with the operational hours in Australia – providing you with flexibility during the day.

What’s the overall purpose of this position?

You will leverage your veterinary nursing experience to assess claims accurately and efficiently, ensuring that our customers receive the support they need during challenging times. Ensuring that claims are processed in an accurate and timely manner, mitigating claims costs in accordance with policy guidelines, delegated authorities’ industry laws and regulations. A customer facing role, this position embraces our soft landings philosophy in ensuring a high level of customer service from lodgement to claim closure.

What are the duties and responsibilities?

• Receive inbound and outbound calls from existing customers and third parties.
• Provide, reliable and accurate information to customers and third parties in a timely manner.
• Utilise your veterinary nursing expertise to assess the medical necessity and validity of claims, ensuring accuracy and compliance with insurance policies.
• Apply the Policy Disclosure Statement (PDS)and underwriting guidelines to determine coverage for claims.
• Identify and report potentially fraudulent activity.
• Communicate with pet owners, veterinary clinics, and other relevant parties to gather necessary information and documentation for claims assessment.
• Provide empathetic and professional support to customers throughout the claims process, addressing any questions or concerns they may have.
• Collaborate with internal teams, including underwriters and claims specialists, to facilitate the timely resolution of claims and ensure customer satisfaction.
• Obtain documentation from customers to facilitate claims handling in line with organisational Policies and Procedures.
• Maintain detailed records of claim activities and correspondence for documentation and reporting purposes.
• Accept or decline claims in accordance with Underwriting guidelines, and as instructed by Manager.
• Maintain an appropriate level of compliance and adhere to regulatory requirements.
• Report incidents, breaches, or complaints in a timely manner and in accordance with relevant Policies and Procedures
• Negotiate claims costs and engage in negotiations regarding quantum.
• You will be required to carry out other duties that are within the limits of your skills, competence, training and/or experience as directed by your manager.

What we offer:

• Competitive monthly salary with benefits.
• Employee Wellness benefits – exciting offers from our Lifestyle department to keep you fit and healthy!
• On-site coffee shop and restaurant dedicated to our employees.
• Training and development: We don’t expect you to walk in and hit the ground running; all newbies attend the Badger Induction Training and on-the-job training programme to equip you with the knowledge and tools to be the best!
• Complementary staff transport to the office in the mornings is available.

The essentials you’ll need:

• Completed diploma or degree in veterinary nursing.
• Minimum of two years of experience working as a Veterinary Nurse in a clinical environment.
• Strong understanding of veterinary medical terminology, procedures, and diagnoses.
• Excellent communication and interpersonal skills, with the ability to empathise with pet owners and build rapport.
• Attention to detail and analytical skills to assess and evaluate insurance claims accurately.
• Ability to work independently and collaboratively in a fast-paced, customer-focused environment.
• Proficiency in computer applications and data entry software.

Other valuable skills you may have:

• Prior experience in insurance claims processing or customer service is preferred but not required.
• Skills in negotiation, persuasion and investigation with customers and service providers.
• Sound interpersonal skills, building rapport with customers and service providers.
• Skilled in asking probing questions and gaining detailed information to support claims handling.

Posted on 28 May 14:20, Closing date 26 Jun