Remote Licensed Claims Adjuster - Regulated Claims Expert

Cover Genius; United States; Remote; USD 60,000 - 90,000; Full time

Job summary

Cover Genius seeks a Licensed Claims Adjuster to adjudicate regulated insurance claims within the Digital Commerce vertical. The role combines regulatory compliance with technical accuracy to strengthen financial risk controls across the claims function.

Responsibilities include end-to-end claims handling, policy interpretation, and handling high-exposure cases with licensed authority, while maintaining licensure and ensuring regulatory compliance.

Qualifications

• Active state adjuster license in good standing.
• 2+ years handling regulated insurance claims, preferably electronics, appliances, or furniture.
• Strong knowledge of digital commerce and retail supply chain operations.
• Familiarity with repair networks and repair assessments.

Responsibilities

• Manage end-to-end handling of regulated claims including investigation, coverage analysis, and formal determinations.
• Interpret policy language and underwriting guidelines to issue compliant coverage decisions.
• Handle high-exposure or escalated claims requiring licensed authority and independent judgment.
• Maintain active state licensure and ensure compliance with laws and internal standards.
• Identify fraud indicators and escalate per protocols.

Skills

Active Adjuster License

Regulated claims handling

Digital commerce knowledge

Investigative skills

Written communication

KPI-driven

Education

Bachelor's degree in a relevant field

Job description

Cover Genius seeks a Licensed Claims Adjuster to adjudicate regulated insurance claims within the Digital Commerce vertical. The role combines regulatory compliance with technical accuracy to strengthen financial risk controls across the claims function.

Responsibilities include end-to-end claims handling, policy interpretation, and handling high-exposure cases with licensed authority, while maintaining licensure and ensuring regulatory compliance.