Extend · 15 hours ago

Claims Adjudication Specialist

United States

Full-time

Remote

Mid Level

3+ years exp

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E-CommerceInsurTech

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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.

Qualification

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Claims AdjudicationTechnical Customer ServiceInsurance AdjustingClaims Management SystemsGoogle SuiteFraud InvestigationAdjuster License

Required

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

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 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.