Claims Adjudication Specialist

Summary

Join Extend as a Claims Adjudication Specialist and become a critical part of our Operations Department, focusing on evaluating and servicing claims for Product and Shipping Protection plans. You will serve as a subject matter expert, supporting our Customer Support and Service Technician partners to ensure accurate and timely service of complex claims. This role demands strong analytical skills, critical thinking, and the ability to interpret multiple policies across various product categories. You will review complex claim submissions, manage escalations, and investigate unusual claim patterns. Collaboration with customers, service partners, and internal teams is essential to deliver accurate claim decisions and exceptional customer experiences. The position involves inbound and outbound calls and written communications.

Responsibilities

• Serves 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 and clearly communicating outcomes to the customer
• 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
• Provide timely responses to claim inquiries via phone and email, in line with established SLAs
• Collaborate with Product and Engineering teams to troubleshoot and escalate unresolved claim issues
• Stay up to date on product offerings, service workflows, and policy updates to better support customers
• Identify and communicate training needs for front-line support teams to improve service quality
• Keep internal systems current with relevant technical issues, customer feedback, and insights

Preferred Qualifications

• Active adjuster licenses (preferred)
• 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
• 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
• Generous, flexible paid time off policy
• 401(k) with Financial Guidance from Morgan Stanley