Claims Adjudication Specialist

Summary

Join Extend, a modernizing force in the protection plan industry, as a Claims Adjudication Specialist. You will play a key role in our Operations Department, evaluating claims for product and shipping protection plans. This position demands a deep understanding of policies and terms, meticulous attention to detail, and strong analytical skills. You will handle complex claims, investigate fraud, and collaborate with internal and external stakeholders. Success requires evidence-based decision-making and excellent communication. This role offers a chance to contribute to a fast-growing startup and make a significant impact on our operations.

Requirements

• Possess a complex understanding and ability to interpret multiple policies across dozens of product categories each with their own set of terms and conditions
• Demonstrate meticulous attention to detail, critical thinking, robust analytical capabilities, and the ability to make evidence-based decisions
• Effectively communicate (inbound, outbound and email) with customers, service providers, and internal stakeholders

Responsibilities

• Utilize your comprehensive understanding of applicable terms and conditions and knowledge and technology tools to accurately adjudicate Product and Shipping Protection claims
• Ensure adherence to established policies and guidelines while delivering exceptional Customer Experience with timely resolutions
• Handle escalated claims requiring advanced analysis and resolution
• Engage with internal stakeholders and leadership to identify and provide insights to the root causes of escalations, process gaps, and technology opportunities
• Conduct thorough investigations into suspected fraudulent activities associated with claims
• Make recommendations for automating redundant tasks and creating efficiency and improvement opportunities

Preferred Qualifications

• 3-5 years of technical customer service, claims management/adjudication, insurance adjusting, or contact center experience. Claims adjudication preferably in a protection plan environment
• Excellent communication skills, both verbal and written with the ability to convey complex claim details and supporting rationale for decisioning in a clear and concise way both to customers and internal system notations
• Embraces frequent change in processes and technology within a fast-paced environment, demonstrating flexibility and resilience in managing evolving challenges
• Active adjuster licenses preferred
• Experienced with claims management systems, contact center platforms and Google suites of products
• Proven ability to to navigate and work effectively across various software systems simultaneously
• Ability to analyze complex issues, identify solutions and make decisions efficiently
• Thrive in environments of high claim volumes with exponential company growth while maintaining excellent performance and accuracy

Benefits

• Competitive salary based on experience, with full medical and dental & vision benefits
• Stock in an early-stage startup growing quickly
• Very generous, flexible paid time off policy
• 401(k) with Financial Guidance from Morgan Stanley