Claims Specialist

Claims Specialist

As a Claims Specialist, you will combine veterinary medical knowledge, critical thinking, and policy expertise to assess pet insurance claims and deliver accurate, fair, and timely claim decisions. You will review medical records, clinical notes, invoices, and policy information to determine claim eligibility while ensuring consistency with Trupanion and Smart Paws policy guidelines.

In this role, you will service as a trusted resource for pet owners, veterinary teams, and internal stakeholders, helping navigate complex claim scenarios with empathy, professionalism, and attention to detail. You will also support the appeals process by conducting secondary claim reviews and providing clear rationale for claim outcomes.

Success in this role requires strong analytical skills, sound judgement, curiosity, and the ability to balance policy interpretation with an exceptional customer experience. The ideal candidate brings a combination of veterinary knowledge, customer-facing experience, and problem-solving abilities, allowing them to confidently navigate complex claims while delivering a positive experience for pet owners and veterinary partners.

At Trupanion, we believe in a flexible workplace! This is a remote position for candidates in Germany or Switzerland. You must be able to have a reliable and stable connection to the internet through hard-wire Ethernet.

Expectation is to meet as a team once per quarter, for up to a week. The location is subject to change, based on needs.

Responsibilities:

• Review veterinary medical records, clinical notes, invoices, and policy information to evaluate claim eligibility and determine claim outcomes
• Apply policy language, claims guidelines, and established processes consistently and accurately
• Conduct secondary claim reviews as part of the appeals process and communicate claim rationale clearly and professionally
• Investigate complex claim scenarios by gathering, validating, and interpreting relevant medical and policy information
• Identify missing or incomplete information and proactively obtain required documentation from veterinary clinics, specialists, or pet owners
• Communicate with veterinary professionals, pet owners, and internal teams via phone and email regarding claim decisions, status updates, and policy questions
• Deliver an efficient, empathetic, and positive experience for pet owners and veterinary partners during potentially sensitive situations
• Maintain accurate records and documentation within multiple internal systems
• Collaborate with cross-functional teams to support operational excellence and continuous improvement initiatives
• Contribute ideas and feedback that enhance claims processes, workflows, and customer experience

Qualifications:

• Professional working proficiency in English required
• Professional fluency in German required
• Professional fluency in French required
• 2+ years of experience in a customer-facing veterinary, animal health, pet insurance, or related environment
• Strong understanding of veterinary medical terminology, common conditions, treatments, and diagnostic procedures
• Experience working directly with clients or pet owners in a veterinary clinic, hospital, or animal health setting is highly preferred
• Experience reviewing medical records, supporting patient care, claims adjudication, or insurance operations is considered an asset
• Demonstrated ability to learn and navigate multiple systems, processes, and technologies
• Proficiency with Microsoft Office applications and other business software

Skills:

• Strong analytical thinking and problem-solving abilities
• Excellent attention to detail with a high degree of accuracy and consistency
• Ability to assess complex information, identify key details, and make sound decisions
• Exceptional written and verbal communication skills
• Strong customer focus with empathy and professionalism in challenging situations
• Ability to manage multiple priorities and work efficiently across various systems
• Adaptability and resilience in a dynamic, evolving environment
• Self-motivated with the ability to work independently while contributing to a collaborative team culture
• Proactive mindset with a commitment to continuous learning and improvement

Schedule:

• This is a full-time position of 37.5 hours per week; schedule may vary based on business needs.
• Flexibility is required to start as early as 07:00, work until 19:00, and on Saturdays.
• After hire, any schedule changes will be communicated with at least 30 days' notice.

Compensation:

• The pay for this position is based on a full-time schedule. Along with salary, our employees will be eligible for monthly bonuses based on individual and company goals.
• Trupanion may also provide Restricted Stock Units, which vest over 4 years

Benefits and Perks:

• 25 holiday leave days.
• Five-week sabbatical after five years of employment
• Medical Insurance for a cat or dog
• Medical Concierge (Summus)
• Lifestyle Spending Account (LSA)
• Family Planning (Carrot)
• Employee Assistance Program
• Open, casual, pet-friendly, and fun office 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.