Claims Adjudication Specialist (Tier I)
New
E
ExtendInsurance Technology
Remote, USFull-TimeMiddle
Salary45,000 - 55,000 USD per year
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Job Details
- Experience
- 3-5 years
- Required Skills
- Analytical SkillsGoogle Workspace
Requirements
- 3-5 years of technical customer service, claims management/adjudication, insurance adjusting, or contact center experience.
- Claims adjudication experience in a protection plan environment preferred.
- Active adjuster licenses preferred.
- Excellent verbal and written communication skills for explaining complex claim rationale.
- Ability to thrive in a fast-paced environment with high claim volumes.
- Experience with claims management systems and contact center platforms.
- Proficiency with Google Workspace products.
- Proven ability to navigate multiple software systems simultaneously.
- Strong analytical skills and critical thinking capabilities.
Responsibilities
- Serve as the escalation point of contact from outsourced partners, customer support teams and service technician partners.
- Investigate and resolve complex claim situations, ensuring decisions align with contract terms and internal policies.
- Troubleshoot delays in claims processing, ensuring timely resolutions and enhanced customer satisfaction.
- Coordinate service technician dispatching and parts ordering when necessary to support claim resolution.
- Resolve escalated customer issues by proposing fair resolutions within policy guidelines.
- Maintain detailed and organized documentation of all customer and partner interactions.
- Investigate suspected fraudulent claims and report findings as needed.
- Recommend process improvements and opportunities to automate routine tasks.
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