Company Background Petsure Services Incorporated (PSI) is a support service provider exclusively focused on the pet industry globally tailoring solutions that enhance customer experiences and streamline operations. With over 14 years of expert pet care outsourcing solutions. Job Summary A Veterinary Claims Assessor (VCA) is primarily responsible for lodging, assessing, and finalizing claims from policy holders of pet insurance from different Australian and New Zealand brand partners submitted via different channels within the delegated authority limit, with excellent accuracy, efficiency, and professionalism. When trained, the role will also be rostered to: - Reviewing and processing pre-approval requests from policyholders against their policy coverage terms and exclusions and communicate the outcome with a high degree of accuracy, efficiency, and professionalism. Key Accountabilities 1. Deliver the best claims experience to Petsure Australia customers as a greater part of the Petsure Claims Team. - Handle claims in an efficient, honest, and fair manner. - Assess and finalize claims based on policy provisions and Fetch guidelines, within the agreed Turn Around Time. - Review and summarize veterinary history, symptoms, and diagnosis and determine if the procedures or treatment are applicable to the condition. - Attach claim documents to the correct policy and lodge claims accurately. - Ensure proper and accurate notes are inputted, depending on the claim status. - Exercise due diligence and best judgment when requesting additional documents to assess the claim. - Review and process preapproval requests in a timely manner. - Liaise with veterinary clinics to obtain the necessary information about the request or seek clarification and confirmation about the case. 2. Contribute to Petsure and PSI’s growth - Meet or exceed the KPI targets consistently. - Managing day-to-day workload efficiently by taking ownership of the claim and avoiding hand-offs. - Use one’s technical knowledge and apply it in a financial services setting. - Contribute to trainees and newbies’ success by supporting during hands-on assessing (Fishbowl) and nesting (Boot Camp) through claims checking, analysis, and feedback. - Contribute to regular team meetings by providing guidance and insights on claims processes and procedures related to cases at hand and sharing of best practices to improve or maintain quality outcome. - Contribute to process improvements by providing analysis of the current procedures and suggesting continuous improvements. - Manage the report and process the daily ageing claims and provide feedback to the TLs as applicable. - Contribute to a team’s performance improvement by using technical expertise on claims with disputes. - Take ownership of ageing claims. - Assume the OIC role where needed and attend TL meetings, as necessary. 3. Managing risks through awareness and confidence in reporting it - Taking ownership of own performance and being proactive in reporting potential failures before outcomes fall below expectations. - Initiate mitigation plans w/in one’s control, adjusting as necessary, and openly discussing this with the immediate supervisor. - Recognize, analyze and report suspiciously fraudulent claims and handle them according to Fetch guidelines. Required Knowledge, Skills, and Experience 1. Knowledge and Technical Experience - Licensed Doctor of Veterinary Medicine - 2 years of experience in small animal medicine (dogs and cats) - Nice to Have: Experience in claims processing, assessment, or adjudication within a BPO or shared services environment - Proficient in basic computer applications and documentation tools - Comfortable navigating multiple systems and digital documents efficiently - Must be willing to work onsite (Giga Tower) for the first 3 months upon hiring - Must be willing to work on rotating workdays (Monday–Friday, Tuesday–Saturday, or Wednesday Sunday. With prior approval from immediate supervisor) Shifts may start as early as 5:00 AM (Manila time) or be assigned to evening/night shifts, based on operational needs - Possible Hybrid Work set-up depending on the work performance - Can start on September 14, 2026 2. Skills and Behaviour a. Customer-orientation - Demonstrates a strong understanding of the customer impact of claim decisions and assessments - Applies a customer-oriented approach by considering the customer experience when assessing claims, while remaining compliant with policy terms and assessment guidelines b. Analytical and Decision-Making skills - Strong ability to assess veterinary claims using defined assessment guidelines, policy terms, and coverage rules - Able to determine claim outcomes (pay, decline, or request further information) within authorized limits - Applies consistent judgment and escalates complex or unclear cases appropriately c. Accuracy and Attention to Detail - High level of accuracy when reviewing invoices, clinical notes, itemized charges, and supporting documents - Able to identify discrepancies, non-covered items, or missing information - Understands the financial and customer impact of assessment errors d. Compliance - Strong understanding of documentation standards, data privacy, and audit requirements - Ensures assessments are well-documented, accurate, and defensible - Consistently meets quality benchmarks and turnaround time targets. e. Behavioural expectations - Detail-oriented and quality-focused - Objective, fair, and consistent in decision-making - Accountable and able to work independently - Coachable and receptive to feedback - Amenable to shifting schedules and holidays Benefits: - With opportunity to work from home / Hybrid work arrangement - HMO coverage on Day 1 - Statutory Benefits- SSS, Pag-ibig & Philhealth - Meal Allowance - Transportation Allowance - Medicine and Optical Reimbursement Allowances - 13th Month Bonus and 14th Month Bonus - Performance-based incentive (Monthly, Quarterly and Annually)\* - Early Retirement Plan Package - Group Life Insurance - 30 days annual leave credits - Annual Leave Conversion - Free HMO Dependent - 5-day work week - and More APPLY NOW