Claims Specialist

## Company Description Trupanion is a leading provider of medical insurance for cats and dogs in North America, and a new provider in Europe. Our mission is to help loving, responsible pet owners budget and care for their pets. We create solutions to ensure our members, their pets, and their vets experience unparalleled customer service. At Trupanion, we offer a collaborative, informal, and pet-friendly environment where everyone is encouraged to authentically be the best version of themselves. ## Job Description 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 techn…