Nationwide · 19 hours ago
Analyst, Claims-Pet
Columbus, OH
Full-time
Remote
Mid Level
$43K/yr - $64K/yr
3+ years exp
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Responsibilities
Processes all new and pending medical claims according to the appropriate workflow. Reviews veterinary diagnosis and codes claims according to policy provisions. Ensures completion of claims by coding and processing or sending claims to appropriate workflow.
Determines coverage (i.e., pre-existing conditions, breed-specific and/or hereditary conditions) and approves benefits and eligibility of each claim based on the terms and conditions of the policy.
Accurately processes claims based on established criteria, provider contract plan and employer group provisions.
Requests, reviews and evaluates requested medical records or treatment notes for determination of resolving claims.
Ensures proper documentation in compliance with company policies and practices. Records the final disposition of claims, including denial and/or issuing payment.
Identifies and advises management of questionable claims and questionable risks.
Qualification
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Required
High school, vocational or technical school studies.
State licensing and/or other certification as required.
Associates must acquire the required Federal and/or state licenses/registrations within the time period designated by the business unit.
Three to five years of veterinary claims experience or equivalent training in a veterinary clinic / hospital position under the direct supervision of a veterinarian/veterinary technician.
Proven understanding of veterinary medical practices and treatment.
Ability to understand and use Nationwide Insurance policies, riders and endorsements and be able to recognize and resolve questionable coverage situations.
Ability to read, analyze, and interpret documents.
Ability to solve practical problems.
Ability to meet internal customer needs and provide service by informing customers of the claims process and ensuring a positive customer experience.
Written and verbal communication skills for contact with policyholders, claimants, physicians, medical staff, etc.
Requires use of basic math (addition, subtraction, multiplication and division).
Ability to operate personal computer and software for claims-related and other business applications.
Preferred
Undergraduate degree in biology, zoology or related animal science field.
Three to five years of veterinary claims experience or equivalent training in a veterinary clinic / hospital position under the direct supervision of a veterinarian/veterinary technician.
Benefits
Medical/dental/vision
Life insurance
Short and long term disability coverage
Paid time off with newly hired associates receiving a minimum of 18 days paid time off each full calendar year pro-rated quarterly based on hire date
Nine paid holidays
8 hours of Lifetime paid time off
8 hours of Unity Day paid time off
401(k) with company match
Company-paid pension plan
Business casual attire
Company
Nationwide
Nationwide, a Fortune 100 company based in Columbus, Ohio, is one of the largest and strongest diversified insurance and financial services organizations in the United States.
10001+ employees
Funding
Current Stage
Late StageLeadership Team
Jim Fowler
Chief Technology Officer
Ramon Jones
Executive Vice President and Chief Marketing Officer
Recent News
2024-11-08
Google Patent
2024-11-08
Company data provided by crunchbase
