Claims Adjudication Specialist

Extend
United States
Remote

Who this role is best for

Strong fit for candidates with claims management experience who thrive in fast-paced environments and can adapt to evolving processes.

Best fit for

  • Candidates with 3-5 years in claims adjudication or protection plan environments
    — “3-5 years of technical customer service, claims management/adjudication, insurance adjusting, or contact center experience.”
  • Professionals experienced in using claims management systems and Google products
    — “Experienced with claims management systems, contact center platforms, and Google suites of products.”

Things to consider

  • The role requires handling high claim volumes and adapting to rapid company growth
    — “high claim volumes with exponential company growth while maintaining excellent performance and accuracy.”
  • Candidates must be prepared to handle both inbound and outbound communication
    — “The role involves inbound and outbound calls, as well as written communications with customers, service providers, and internal stakeholders.”

How to stand out

  • Highlight experience with policy interpretation in diverse product categories
    — “the ability to interpret multiple policies across a wide range of product categories.”
  • Demonstrate a track record of resolving complex claim situations efficiently
    — “Investigate and resolve complex claim situations, ensuring decisions align with contract terms and internal policies.”
  • Showcase process improvement recommendations from prior roles
    — “Recommend process improvements and opportunities to automate routine tasks.”
Pace · Fast PacedCollaboration · HighAutonomy · MediumDecision Impact · Team

Derived from job-description analysis by Serendipath's career intelligence engine.

What success looks like

  • Serve as the escalation point of contact from outsourced partners, customer support teams and service technician partners
  • Investigate and resolve complex claim situations
  • Troubleshoot delays in claims processing
  • Coordinate service technician dispatching and parts ordering
  • Resolve escalated customer issues
Typical background
Strong analytical skills, critical thinking, and the ability to interpret multiple policies across a wide range of product categories

Skills & requirements

Required

Claims AdjudicationComplex Claim SituationsFraud DetectionCustomer SupportService Technician DispatchingProcess ImprovementsCustomer ExperienceInternal Communication

Stack & domain

Claims AdjudicationFraud DetectionCustomer ServiceReturns/exchange ManagementAnalyticalCritical ThinkingCollaborativeCommunicationRetail

About the role

Original posting from Extend via Greenhouse

About Extend:

Extend is revolutionizing the post-purchase experience for retailers and their customers by providing merchants with AI-driven solutions that enhance customer satisfaction and drive revenue growth. Our comprehensive platform offers automated customer service handling, seamless returns/exchange management, end-to-end automated fulfillment, and product protection and shipping protection alongside Extend's best-in-class fraud detection. By integrating leading-edge technology with exceptional customer service, Extend empowers businesses to build trust and loyalty among consumers while reducing costs and increasing profits.

Today, Extend works with more than 1,000 leading merchant partners across industries, including fashion/apparel, cosmetics, furniture, jewelry, consumer electronics, auto parts, sports and fitness, and much more. Extend is backed by some of the most prominent technology investors in the industry, and our headquarters is in downtown San Francisco.

About the Role: 

As a Claims Adjudication Specialist, you will play a critical role within our Operations Department, focused on evaluating and servicing claims related to our Product and Shipping Protection plans, which are offered by over 1,000+ Merchant Partners. You’ll serve as a subject matter expert, supporting our Customer Support and Service Technician partners to ensure accurate and timely service of complex claims that require deeper investigation.

This position requires strong analytical skills, critical thinking, and the ability to interpret multiple policies across a wide range of product categories. On a daily basis, you’ll review complex claim submissions, manage escalations, and investigate unusual claim patterns. Success in this role relies on meticulous attention to detail, evidence-based decision-making and ability to adapt to frequent change in processes and technology within a fast-paced environment.

You'll collaborate closely with customers, service partners, and internal teams to deliver accurate claim decisions while ensuring an exceptional customer experience. The role involves inbound and outbound calls, as well as written communications with customers, service providers, and internal stakeholders.

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 Experience, Skills, and Knowledge:

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.

Estimated Pay Range: $45,000 - $55,000 per year salaried*

*The target base salary range for this position is listed above. Individual salaries are determined based on a number of factors including, but not limited to, work location and job-related knowledge, skills and experience.

Extend does not provide immigration-related sponsorship for this role.

Life at Extend:

Working with a great team from diverse backgrounds in a collaborative and supportive environment.

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.

Extend CCPA HR Notice

Source: Extend careers (Greenhouse)

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