Claims Adjudication Specialist

Extend

2h•$45,000 - $55,000

About The Position

As a Claims Adjudication Specialist in Extend’s Operations Department, you will evaluate and service claims related to Product and Shipping Protection plans offered by more than 1,000 merchant partners. You will act as a subject matter expert, supporting Customer Support and Service Technician partners with accurate and timely handling of complex claims that require deeper investigation. The role involves reviewing complex claim submissions, managing escalations, and investigating unusual claim patterns. It calls for analytical and critical-thinking skills, careful interpretation of policies across multiple product categories, attention to detail, evidence-based decision-making, and adaptability in a fast-changing environment. You will work with customers, service partners, and internal teams to make accurate claim decisions and deliver a positive customer experience. The position includes inbound and outbound calls and written communications with customers, service providers, and internal stakeholders.

Requirements

3–5 years of experience in technical customer service, claims management or adjudication, insurance adjusting, or contact center work; claims adjudication in a protection plan environment is preferred.
Excellent verbal and written communication skills, including the ability to explain complex claim details and decision rationales clearly to customers and in internal system notes.
Flexibility and resilience in adapting to frequent changes in processes and technology.
Experience with claims management systems, contact center platforms, and Google products.
Ability to work effectively across multiple software systems simultaneously.
Ability to analyze complex issues, identify solutions, and make decisions efficiently.
Ability to perform accurately in high-volume claims environments during rapid company growth.

Nice To Haves

Active adjuster licenses.
Claims adjudication experience in a protection plan environment.

Responsibilities

Serve as the escalation point of contact for 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 claims-processing delays and work toward timely resolutions and improved customer satisfaction.
Coordinate service technician dispatching and parts ordering when needed to resolve claims.
Resolve escalated customer issues by proposing fair resolutions within policy guidelines and clearly communicating outcomes.
Maintain detailed, organized documentation of customer and partner interactions.
Investigate suspected fraudulent claims and report findings as needed.
Recommend process improvements and opportunities to automate routine tasks.
Respond to claim inquiries by phone and email within established service-level agreements.
Collaborate with Product and Engineering teams to troubleshoot and escalate 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 relevant technical issues, customer feedback, and insights.