Claims Adjudication Specialist

Extend

. Serve as the escalation point of contact for outsourced partners, customer support teams, and service technician partners .

Posted 11/11/2026full-timeRemote • United StatesMid-LevelSenior💰 $45,000 - $55,000 per yearWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in claims management and customer service, with a strong ability to analyze complex issues and communicate effectively. Proficient in utilizing claims management systems and maintaining documentation while ensuring timely resolutions.

Highest-signal resume keywords

Claims ManagementTechnical Customer ServiceClaims AdjudicationCommunication SkillsClaims Management Systems

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Claims AdjudicationClaims ProcessingIssue ResolutionDocumentation MaintenanceProcess ImprovementFraud InvestigationDecision MakingPerformance AnalysisTechnical Issue NavigationCustomer Feedback Analysis

Soft Skills

Verbal CommunicationWritten CommunicationFlexibilityResilienceCollaboration

Tools & Technologies

Claims Management SystemsContact Center PlatformsGoogle Suites

Certifications & Qualifications

Active Adjuster License

Industry Keywords

Insurance AdjustingProtection Plan EnvironmentCustomer SupportService WorkflowsEscalation Management

About the role

Key responsibilities & impact

Serve as the escalation point of contact for outsourced partners, customer support teams, and service technician partners
Investigate and resolve complex claims in accordance with contract terms and internal policies
Troubleshoot claims-processing delays and ensure timely resolutions
Coordinate service technician dispatching and parts ordering when necessary
Resolve escalated customer issues and communicate outcomes clearly
Maintain detailed documentation of customer and partner interactions
Investigate suspected fraudulent claims and report findings
Recommend process improvements and automation opportunities
Respond to claim inquiries by phone and email within established SLAs
Collaborate with Product and Engineering teams on unresolved claim issues
Stay current on product offerings, service workflows, and policy updates
Identify and communicate training needs for frontline support teams
Keep internal systems updated with technical issues, customer feedback, and insights

Requirements

What you’ll need

3-5 years of technical customer service, claims management/adjudication, insurance adjusting, or contact center experience
Claims adjudication experience in a protection plan environment preferred
Excellent verbal and written communication skills
Ability to convey complex claim details and supporting rationale clearly and concisely
Flexibility and resilience in a fast-paced, frequently changing environment
Experience with claims management systems, contact center platforms, and Google Suites products
Ability to navigate and work effectively across multiple software systems simultaneously
Ability to analyze complex issues, identify solutions, and make efficient decisions
Ability to maintain performance and accuracy in high-volume claims environments
Active adjuster licenses preferred
No immigration-related sponsorship provided

Benefits

Comp & perks

Competitive salary based on experience
Full medical benefits
Dental and vision benefits
Stock in an early-stage startup growing quickly
Generous, flexible paid time off policy
401(k) with Financial Guidance from Morgan Stanley
Collaborative and supportive environment
Diverse team environment