Claims Manager - Pet Insurance

at  Oneplan Underwriting Managers Pty Ltd

JOB SUMMARY:

The Role as Claims Manager will be responsible for overseeing the administration and authorisations of claims of daily administrative operations and managing the insurance processes for client transactions for approvals of procedures through veterinary clinics. This role involves liaising with veterinary clinics addressing clients’ queries and concerns, ensuring compliance with health regulations, streamlining administrative processes, and working closely with clinical teams to support client / patient care. The manager also plays a critical role managing the administration team, enhancing operational efficiency and ensuring timely client / patient access to necessary services.

Education:

• Bachelor’s degree in business financial administration (BCom), Business Management Degree / Qualification (NQF5) and or Bachelor of science (BSc) or a related field, would be preferable and advantageous.
• Medical workplace experience working within a veterinary clinic / hospital or medical centre for 2-3 years.
• Qualified Veterinary Nurse would be advantageous and should be very familiar with the veterinary clinic services and practices.
• Additional certifications in pet healthcare management or insurance billing are a plus

Experience:

• 5+ years of experience in pet healthcare administration, including at least 2 years in an insurance authorisation or billing role.
• Proven experience managing a team within a pet healthcare setting.
• In-depth knowledge of pet health insurance policies, reimbursement processes, and authorization procedures.
• Familiarity with veterinary service, pet hospital administrative processes and insurance claim systems.
• Proficient in office management software and Microsoft Office Suite.
• Strong organizational and leadership skills.
• Excellent communication and interpersonal abilities.
• Ability to multitask and prioritize effectively in a fast-paced environment.
• Problem-solving skills and attention to detail.
• Highly administrative and accurate in execution of tasks.
• Proven experience as an Admin Manager or in a similar role, including motivating of staff and ensuring the team is highly productive

Skills & Competencies:

• Strong understanding of pet healthcare regulations and standards.
• Excellent communication and interpersonal skills for pet patients and interactions with the veterinary clinic interaction, pet owner interactions and insurance negotiations.
• Leadership and team management capabilities, with fast understanding of the pet / veterinary sector.
• Proficiency with pet healthcare management software (e.g., EHR systems, billing software).
• Strong organizational and problem-solving skills.
• Ability to work under pressure and meet deadlines, within a high-performance driven environment

KEY REQUIREMENTS OF THE ROLE:

Education:

• Bachelor’s degree in business financial administration (BCom), Business Management Degree / Qualification (NQF5) and or Bachelor of science (BSc) or a related field, would be preferable and advantageous.
• Medical workplace experience working within a veterinary clinic / hospital or medical centre for 2-3 years.
• Qualified Veterinary Nurse would be advantageous and should be very familiar with the veterinary clinic services and practices.
• Additional certifications in pet healthcare management or insurance billing are a plus.

Experience:

• 5+ years of experience in pet healthcare administration, including at least 2 years in an insurance authorisation or billing role.
• Proven experience managing a team within a pet healthcare setting.
• In-depth knowledge of pet health insurance policies, reimbursement processes, and authorization procedures.
• Familiarity with veterinary service, pet hospital administrative processes and insurance claim systems.
• Proficient in office management software and Microsoft Office Suite.
• Strong organizational and leadership skills.
• Excellent communication and interpersonal abilities.
• Ability to multitask and prioritize effectively in a fast-paced environment.
• Problem-solving skills and attention to detail.
• Highly administrative and accurate in execution of tasks.
• Proven experience as an Admin Manager or in a similar role, including motivating of staff and ensuring the team is highly productive.

Skills & Competencies:

• Strong understanding of pet healthcare regulations and standards.
• Excellent communication and interpersonal skills for pet patients and interactions with the veterinary clinic interaction, pet owner interactions and insurance negotiations.
• Leadership and team management capabilities, with fast understanding of the pet / veterinary sector.
• Proficiency with pet healthcare management software (e.g., EHR systems, billing software).
• Strong organizational and problem-solving skills.
• Ability to work under pressure and meet deadlines, within a high-performance driven environment.

Personal Attributes:

• Must have an in depth understanding of pet / veterinary environment.
• Have a vast understanding and willingness to animal wellbeing, care for pet health and the love for animals.
• Attention to detail and accuracy in managing paperwork.
• Empathy and patience when dealing with clients claims and their concerns.
• Adaptability in a fast-paced and evolving healthcare environment.
• Ethical and compliant approach to administrative duties.