Claims Adjudication Specialist

OpenKrill; EE. UU.; A distancia; USD 45.000 - 55.000; Jornada completa

Ventajas ofrecidas por este puesto de trabajo

Medical, dental, and vision benefits

Stock options

Generous PTO

401(k) with financial guidance

Descripción de la vacante

Extend in the United States is seeking a Claims Adjudication Specialist to evaluate and service claims tied to Product and Shipping Protection plans for a broad merchant network. You will review submissions, handle escalations, and collaborate with Customer Support and Service Technicians to ensure accurate, timely decisions.

This role requires strong analytical skills, attention to detail, and the ability to interpret diverse policies across product categories.

Formación

• 3–5 years of technical customer service, claims management/adjudication, or insurance/adjusting experience.
• Experience with claims adjudication in a protection plan environment is preferred.
• Able to communicate complex claim details clearly to customers and internal teams.
• Comfortable navigating multiple software systems simultaneously.

Responsabilidades

• Serve as escalation point from outsourced partners and internal teams.
• Investigate and resolve complex claim situations per contract terms and policies.
• Troubleshoot delays and coordinate technician dispatching for claim resolution.
• Maintain detailed documentation of all interactions and outcomes.
• Provide timely responses to claim inquiries via phone and email per SLAs.

Conocimientos

Technical customer service

Claims adjudication

Insurance knowledge

Analytical thinking

Communication skills

Herramientas

Claims management systems

Google Workspace

CRM software

Data analysis tools

Descripción del empleo

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 escalse 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