Job Functions1. Investigate, evaluate, and adjudicate vehicle service contract (VSC) claims in accordance with contract terms and coverage guidelines.2. Determine coverage based on shop diagnostics, repair estimates, and inspection findings.3. Authorize or deny repairs within settlement authority; escalate claims that exceed authority limits to a supervisor with recommendations.4. Communicate professionally with repair facilities, dealership personnel, and agreement holders throughout the claims process.5. Review labor times and parts pricing to ensure estimate accuracy and cost control.6. Negotiate scope of work and pricing with shops when necessary.7. Escalate any grayarea coverage issues or concerns to management that may impact the customer or dealer experience.
Job Requirements1. Bachelor's degree or equivalent work experience2. 2–4 years of experience in automotive claims adjudication, preferably related to VSC or extended warranty claims3. Prior experience in a dealership service department (e.g., service advisor, technician, warranty administrator) is highly valuable.4. Handson experience as an automotive technician or mechanic is a strong plus.5. Experience as a warranty administrator, insurance adjuster, or within a thirdparty administrator (TPA) is beneficial.6. Background in parts management, fleet maintenance coordination, or service writing is also relevant.7. Familiarity with automotive diagnostics, repair procedures, and labor/parts pricing.8. ASE certifications, factory training, or other industry certifications are a plus.
Skills1. Strong analytical and communication skills2. Prior experience in automotive claims adjudication, preferably related to VSC or extended warranty claims3. Handson experience as an automotive technician or mechanic is a strong plus4. Experience as a warranty administrator, insurance adjuster, or within a thirdparty administrator (TPA) is beneficial5. Background in parts management, fleet maintenance coordination, or service writing is also relevant6. Familiarity with automotive diagnostics, repair procedures, and labor/parts pricing7. ASE certifications, factory training, or other industry certifications are a plus1. Prior experience in a dealership service department (e.g., service advisor, technician, warranty administrator) is highly valuable.2. Comfortable working across multiple claims management and estimating systems.3. Previous experience in a claim’s assistance center or highvolume claims environment is preferred.4. Industry certifications, factory training, and ASE certifications are a plus.
The VSC Mechanical Claims Adjuster is responsible for handling incoming claims calls, evaluating mechanical failures, and determining coverage under Vehicle Service Contracts (VSC). This role is part of our Claims Assistance Center and requires strong analytical and communication skills to interpret contract terms, assess shop diagnostics and repair estimates, and negotiate with repair facilities. The adjuster will play a key role in delivering a positive customer experience while supporting service level goals.
Minimum Qualifications:
- Bachelor's degree or equivalent work experience.
- 2–4 years of experience in automotive claims adjudication, preferably related to VSC or extended warranty claims.
- Prior experience in a dealership service department (e.g., service advisor, technician, warranty administrator) is highly valuable.
- Hands-on experience as an automotive technician or mechanic is a strong plus.
- Experience as a warranty administrator, insurance adjuster, or within a third-party administrator (TPA) is beneficial.
- Background in parts management, fleet maintenance coordination, or service writing is also relevant.
- Familiarity with automotive diagnostics, repair procedures, and labor/parts pricing.
- Comfortable working across multiple claims management and estimating systems.
- ASE certifications, factory training, or other industry certifications are a plus.
- Previous experience in a claim’s assistance center or high-volume claims environment is preferred.
- Industry certifications, factory training, and ASE certifications are a plus.
Primary Job Functions:
- Investigate, evaluate, and adjudicate vehicle service contract (VSC) claims in accordance with contract terms and coverage guidelines.
- Determine coverage based on shop diagnostics, repair estimates, and inspection findings.
- Authorize or deny repairs within settlement authority; escalate claims that exceed authority limits to a supervisor with recommendations.
- Communicate professionally with repair facilities, dealership personnel, and agreement holders throughout the claims process.
- Review labor times and parts pricing to ensure estimate accuracy and cost control.
- Negotiate scope of work and pricing with shops when necessary.
- Escalate any gray-area coverage issues or concerns to management that may impact the customer or dealer experience.
- Work across multiple claims systems to research, document, and adjudicate claims efficiently. Ability to manage tasks across various platforms is essential.
- Review and approve TPA-submitted claims that exceed authority limits, ensuring proper documentation and contract alignment.
The above-cited duties and responsibilities describe the general nature and level of work performed by people assigned to the job. They are not intended to be an exhaustive list of all the duties and responsibilities that an incumbent may be expected or asked to perform.
Periodic Job Functions:
- Other duties and special projects as needed.
- Participate in quality audits or peer reviews to ensure adherence to claims handling standards.
- Provide feedback on claims trends, system issues, or process improvements.
- Assist in onboarding and training new hires, including shadowing and answering procedural questions.
- Help develop and maintain troubleshooting guides and job aids for junior adjusters.
- Follow up on pending claims to ensure timely resolution and customer satisfaction.
- Collaborate with internal departments (e.g., underwriting, compliance, product) on escalated or complex claim issues.
- Support volume spikes or special initiatives, such as new business launches or system migrations.
- Attend refresher training or calibration sessions to stay aligned with current policy and process updates.
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Life at Fortegra
Fortegra is a professional services firm specializing in business and technology consulting services for the energy and utility industries. Since 1996, Fortegra has been committed to delivering premier management consulting and systems integration solutions for many of the largest energy and utility companies across North America. With deep industry and business process knowledge, along with a proven track record, Fortegra serves its clients with significant product and technology expertise in CIS and billing, scheduling and settlements, and other systems supporting customer care and field operations.
Thrive Here & What We Value- Fast-paced, rapidly changing work environment- Full benefit package (medical, dental, vision, life insurance, short/long term disability, 401(k), tuition assistance)- Collaborative and results-driven culture- Entrepreneurial mindset with a focus on business growth- Strong analytical skills, empathy, service orientation, strategic thinking, proactivity, attention to detail, organizational skills- Celebrates diversity and inclusion- Prioritizes employee well-being- Confidentiality as per EEOC guidelines
