Petvisor

Claims Operations Analyst

Petvisor

contract

Posted on:

Location Type: Hybrid

Location: Colombo • Sri Lanka

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Tech Stack

ServiceNow

About the role

  • Review, validate, and process discount claims daily, including triaging the Manual Review Queue for flagged claims and making approval or denial decisions based on program eligibility rules.
  • Investigate denial patterns and claim exceptions by performing root cause analysis and recommending process or rule adjustments to reduce resubmission rates.
  • Support reconciliation activities by verifying claim data accuracy across clinic, program, and reimbursement reports.
  • Collaborate with the Claims Operations Manager and engineering teams to document workflow gaps, suggest automation opportunities, and contribute to SOP and QA framework development.

Requirements

  • Bachelor's degree in Business Administration, Information Technology, Computer Science, or a related field.
  • 2–4 years of experience in claims processing, payment reconciliation, or operations (healthcare, insurance, fintech, SaaS).
  • Solid understanding of claims adjudication workflows, including approval, denial, exception handling, and remediation processes.
  • Experience with queue-based service management platforms (e.g., Jira Service Management, Zendesk, ServiceNow) for queue management, claim workflows, and SLA tracking.
  • Strong analytical and problem-solving abilities with a detail-oriented and process-driven mindset.
  • Excellent written and verbal communication skills with the ability to clearly document decisions, escalate issues, and coordinate across technical and non-technical stakeholders.
  • Serve as a professional point of contact for veterinary clinics and pharmaceutical partners, clearly communicating claim decisions, resolving inquiries, and ensuring a positive and trusted customer experience.
Applicant Tracking System Keywords

Tip: use these terms in your resume and cover letter to boost ATS matches.

Hard Skills & Tools
claims processingpayment reconciliationclaims adjudication workflowsroot cause analysisprocess adjustmentsSOP developmentQA framework development
Soft Skills
analytical skillsproblem-solvingdetail-orientedprocess-driven mindsetwritten communicationverbal communicationstakeholder coordinationcustomer experience
Certifications
Bachelor's degree