Claims Adjudication Specialist
New
J
JobgetherProduct protection
Based in the United StatesFull-TimeSenior
Salary$45,000–$55,000, depending on experience, job-related skills, and work location.
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Job Details
- Experience
- 3–5 years of experience in technical customer service, claims management, claims adjudication, insurance adjusting, or contact center operations
- Required Skills
- Google WorkspaceAnalytical thinking
Requirements
- Have 3–5 years of experience in technical customer service, claims management, claims adjudication, insurance adjusting, or contact center operations.
- Bring experience in product protection or extended warranty environments, preferably.
- An active adjuster license is preferred but not required.
- Use strong analytical and critical-thinking skills to interpret policies, assess evidence, and investigate complex situations.
- Communicate complex claim decisions clearly to customers, service partners, and internal stakeholders, in writing and verbally.
- Manage escalations and resolve customer concerns while working within established policies and contractual requirements.
- Have experience using claims management systems, contact center platforms, and Google Workspace or similar productivity tools.
- Navigate multiple software applications while maintaining accurate documentation and attention to detail.
- Prioritize competing demands and meet response deadlines in a high-volume environment.
Responsibilities
- Review, investigate, and resolve complex product and shipping protection claims in accordance with contractual terms, coverage policies, and internal guidelines.
- Act as an escalation point for outsourced service providers, customer support teams, and service technician partners.
- Investigate claim processing delays, identify root causes, and coordinate solutions.
- Coordinate service technician dispatches and parts ordering when necessary.
- Handle escalated customer concerns and communicate claim decisions through phone calls and written correspondence.
- Investigate potentially fraudulent claims, document findings, and escalate suspicious activity when appropriate.
- Maintain accurate records of claim decisions, customer interactions, technical issues, and partner communications.
- Collaborate with Product and Engineering teams to troubleshoot unresolved claim issues and communicate recurring technical problems.
- Identify opportunities to streamline workflows, automate repetitive tasks, and improve operational efficiency.
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