Claims Adjudication Specialist

Job Summary

A company is looking for a Claims Adjudication Specialist (Tier I).

Key Responsibilities:

• Serve as the escalation point of contact for outsourced partners and customer support teams
• Investigate and resolve complex claim situations in alignment with contract terms and internal policies
• Coordinate service technician dispatching and parts ordering to support claim resolution

Required Qualifications:

• Active adjuster licenses preferred
• 3-5 years of experience in technical customer service, claims management/adjudication, or insurance adjusting
• Experience with claims management systems and contact center platforms
• Ability to analyze complex issues and make efficient decisions
• Proven adaptability to frequent changes in processes and technology