Claims Adjudication Specialist (Tier I)
Extend · United States
- Hybrid
- Full-time
- $55,000 / year
- United States
Job highlights
- Evaluate and service product/shipping protection claims.
- Investigate complex claims requiring deeper investigation.
- Collaborate with customers, partners, and internal teams.
- Utilize strong analytical and critical thinking skills.
- Maintain detailed documentation and recommend improvements.
About the role
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. 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 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.
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.
Key skills/competency
- Claims Adjudication Specialist
- Customer Service
- Problem Solving
- Communication Skills
- Policy Interpretation
- Analytical Skills
- Decision Making
- Attention to Detail
- Documentation
- Fraud Investigation
Skills & topics
- Claims Adjudication
- Specialist
- Customer Service
- Claims Management
- Insurance Adjusting
- Contact Center
- Policy Interpretation
- Fraud Investigation
- Analytical Skills
- Problem Solving
- Extend
- San Francisco
- Operations
- Product Protection
- Shipping Protection
How to get hired
- Tailor your resume: Highlight claims adjudication, customer service, and analytical skills. Quantify achievements with numbers.
- Craft a compelling cover letter: Emphasize your understanding of Extend's mission and how your experience aligns with the Claims Adjudication Specialist role.
- Prepare for behavioral questions: Be ready to discuss your problem-solving approach, how you handle complex claims, and your experience with frequent change.
- Showcase technical proficiency: Detail your experience with claims management systems, contact center platforms, and Google Suite.
- Research Extend's values: Understand their focus on customer satisfaction and revenue growth to align your answers with their company culture.
Technical preparation
Master claims management system features.,Practice using Google Suite tools efficiently.,Familiarize yourself with contact center platforms.,Review common protection plan policies.
Behavioral questions
Describe a complex claim you resolved.,How do you handle frequent process changes?,Share an example of evidence-based decision-making.,How do you ensure customer satisfaction in claims?
Frequently asked questions
- What are the primary responsibilities of a Claims Adjudication Specialist at Extend?
- As a Claims Adjudication Specialist at Extend, you will evaluate and service claims for Product and Shipping Protection plans. This involves investigating complex claims, acting as an escalation point, coordinating with service partners, and ensuring customer satisfaction through clear communication and fair resolutions.
- What kind of experience is preferred for the Claims Adjudication Specialist role at Extend?
- Extend prefers candidates with 3-5 years of experience in technical customer service, claims management/adjudication, insurance adjusting, or contact center environments. Experience with protection plans and active adjuster licenses are a plus. Strong analytical, communication, and problem-solving skills are essential.
- How does Extend handle claim escalations for the Claims Adjudication Specialist role?
- The Claims Adjudication Specialist serves as an escalation point of contact for outsourced partners, customer support teams, and service technician partners. They are responsible for investigating and resolving these complex claim situations, ensuring decisions align with contract terms and internal policies.
- What is the estimated salary range for a Claims Adjudication Specialist at Extend?
- The estimated pay range for a Claims Adjudication Specialist at Extend is $45,000 to $55,000 per year, salaried. The final salary offered will depend on factors such as work location, relevant knowledge, skills, and experience.
- What kind of benefits does Extend offer to its employees, including a Claims Adjudication Specialist?
- Extend offers a competitive salary, full medical, dental, and vision benefits, stock options in an early-stage startup, a generous paid time off policy, and a 401(k) with financial guidance from Morgan Stanley.
- How does Extend support its employees in adapting to changes in processes and technology for the Claims Adjudication Specialist role?
- Extend emphasizes flexibility and resilience in its fast-paced environment, acknowledging frequent changes in processes and technology. Employees are encouraged to embrace these changes, and collaboration with Product and Engineering teams helps troubleshoot and adapt to evolving systems.
- What soft skills are most important for a Claims Adjudication Specialist at Extend?
- Key soft skills for this role include strong analytical skills, critical thinking, meticulous attention to detail, evidence-based decision-making, and the ability to adapt to frequent change. Excellent verbal and written communication skills are also crucial for interacting with customers and internal stakeholders.