Resolution & Escalations Specialist — Claims Expert

Choice Home Warranty; Town of Florida (NY); On-site; USD 48,000 - 64,000; Full time

Benefits offered by this job

Health benefits

Vision benefits

Dental benefits

Paid time off

401k

Job summary

Choice Home Warranty is seeking a Resolution/Escalations Specialist (on site) in Sunrise, FL. The role focuses on appeals for warranty claims, determining coverage, and maintaining communication with customers and team members.

Ideal candidates will be organized, customer-focused, and able to work independently or in a team environment. Education and insurance claims experience are preferred.

Qualifications

• College degree or the recognized equivalent in education and experience preferred.
• 2 years of claims related experience in insurance industry preferred.

Responsibilities

• Develop, investigate, analyze and execute plan of action for pending appeals on claims to determine coverage and eligibility.
• Prioritize and review new appeals on claims; identify missing information to expedite outcomes.
• Provide excellent customer service while maintaining regulatory standards; communicate claim status and decisions.
• Act as primary contact for all claim case processing.
• Maintain ownership of cases during the appeal process and review regularly.
• Communicate with team regarding case processing issues and resolutions.

Skills

Relationship management

Customer service

Organizational skills

Communication skills

Teamwork

Time management

Problem solving

Education

College degree or equivalent

2 years claims experience

Tools

Microsoft Office

Job description

Choice Home Warranty is seeking a Resolution/Escalations Specialist (on site) in Sunrise, FL. The role focuses on appeals for warranty claims, determining coverage, and maintaining communication with customers and team members.

Ideal candidates will be organized, customer-focused, and able to work independently or in a team environment. Education and insurance claims experience are preferred.