Representative, Petline Claims

Economical; Winnipeg; Hybrid; CAD 55,000 - 75,000; Full time

Benefits offered by this job

Company share ownership

Incentive plans

RRSP matching

Volunteer days

Job summary

Definity’s Petline division is seeking a Pet Health Claims Adjudicator in Winnipeg. In this hybrid role, you will adjudicate pet health claims in line with policy terms and guide cross-functional teams to help achieve profitability targets.

You will assess claim eligibility, request records, manage Pre-Authorizations, and support veterinarians through Vetline while collaborating with partners to collect information for submissions and post-claim surveys.

Qualifications

• Animal Health Technologist designation or equivalent combination of education and experience.
• AMF Quebec License is an asset.
• Previous veterinary clinic experience.

Responsibilities

• Assess eligibility of claim conditions based on policy wordings
• Assess claims and request medical records for review in association with claims
• Assess requests for Pre-Authorizations and Pay Practice Direct claim forms and determining outcome of disallowance or approval
• Provide support of decisions and guidance on product and claims adjudication for Insurance Advisors and Territory Managers
• Provide support and guidance to veterinary practices through the Vetline
• Collaborate with channel partners and customer policy holders to obtain information for claims submissions and adjudication
• Provide support to customer and channel partner enquiries regarding claims submissions and conducting post-claims customer surveys to strive toward improving Net Promoter Score
• Draft customer correspondence and documents of insurance

Skills

Veterinary clinic experience

Bilingual English/French

Education

Animal Health Technologist (AHT) designation

Job description

Petline is part of Definity, which includes some of Canada’s most long-standing and innovative insurance brands, including Economical Insurance, Sonnet Insurance, Family Insurance Solutions, and Petline Insurance. Our ambition is to be one of Canada’s leading and most innovative property and casualty insurers. We can’t do that without our people, so we embrace and encourage a culture that’s collaborative, ambitious, rewarding, and empowering.

We offer a flexible, hybrid work experience where employees work from the office and virtually depending on the type of work they are doing and who they are working with. Bring your true self and be a part of our journey. It’s better here.

The Opportunity

In this role, you will adjudicate pet health claims in compliance with the policy terms and conditions. You will also provide expert guidance to cross‑functional teams to facilitate attainment of profitability targets.

What to Expect

• Assess eligibility of claim conditions based on policy wordings
• Assess claims and request medical records for review in association with claims
• Assess requests for Pre‑Authorizations and Pay Practice Direct claim forms and determining outcome of disallowance or approval
• Provide support of decisions and guidance on product and claims adjudication for Insurance Advisors and Territory Managers
• Provide support and guidance to veterinary practices through the Vetline
• Collaborate with channel partners and customer policy holders to obtain information for claims submissions and adjudication
• Provide support to customer and channel partner enquiries regarding claims submissions and conducting post‑claims customer surveys to strive toward improving Net Promoter Score
• Draft customer correspondence and documents of insurance

What You Bring

• Animal Health Technologist (AHT) designation or equivalent combination of education and experience.
• Holder of an AMF Quebec License is an asset.
• Previous veterinary clinic experience.

Bilingual (English/French) is an asset for opportunities based in Montreal, while English proficiency is required for positions based in Winnipeg.

Actual salary for the role may vary depending on work location of the successful candidate and other factors including but not limited to, skills, education, experience, working conditions and the local labour market.

This position is being posted to fill an existing vacancy.

We’re actively seeking diverse backgrounds and perspectives to help us make insurance better.

At Definity, inclusion, diversity, and equity aren’t just "nice to have" — they’re essential to our success.

What’s in it for you?

• Company share ownership program
• Incentive Program - Eligible employees may participate in various incentive plans which are paid out at the discretion of the company and subject to individual and company performance.
• Pension and savings programs, with company‑matched RRSP contributions
• Paid volunteer days and company matching on charitable donations
• Educational resources, tuition assistance, and paid time off to study for exams
• Focus on inclusion with employee groups, support for gender affirmation surgery, access to BIPOC counsellors, access to programs for working parents
• Wellness and recognition programs
• Discounts on products and services

Go ahead and expect a lot — you deserve it.

It’s better here — but don’t take our word for it. Definity was named by Great Place to Work as one of the Best Workplaces in Canada for women, for youth, and for inclusion.

Our inclusive work environment welcomes diversity and supports accessibility. If you require accommodation at any time during the recruitment process, please let us know by contacting [e-mail].

As part of Definity’s commitment to reconciliation, we acknowledge that our work, meetings, and travel take place on the lands now known as Canada, and recognize the enduring presence, wisdom, and stewardship of the First Nations, Métis, and Inuit peoples who have long cared for these lands.

Background checks

This role requires successful clearance of background checks (including criminal checks and leadership references).