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A resource from RocketLevel, backed by decades of experience in the trade. Starting points to adapt to your shop.
For owners whose insurance work has outgrown the office manager's spare hours. On most residential jobs you get paid when the claim moves, so these three seats own the carrier, third-party administrator (TPA), and adjuster side of the work: the claim keeps moving, the file holds up to carrier review, and the company keeps its standing on the programs it works. When these seats are empty, the cost shows up as days in accounts receivable.
Reports to: Office Manager or Production Manager. Purpose: manage carrier, TPA, and adjuster communication and the flow of the claim, so jobs move forward without stalling on insurance.
Key responsibilities: open and track claims, communicate with carriers, TPAs, and adjusters, chase approvals and authorizations, keep the file moving through each insurance milestone, escalate stalled claims, keep production and the customer informed on claim status.
Where the seat stops. This person documents your scope, submits it, and answers questions about the work your company performed. They do not adjust, negotiate, or settle the policyholder's claim on the policyholder's behalf. That is public adjusting, and whether and how it is licensed is state law, so look up yours.
Texas Ins. Code 4102.163(a) prohibits a contractor from acting as a public adjuster, or advertising to adjust claims, on property the contractor is providing or may provide contracting services for, even if that contractor holds a public adjuster license, and the Texas Supreme Court upheld the statute in Texas Department of Insurance v. Stonewater Roofing, Ltd. Co. (Tex. 2024). Florida makes acting as a public adjuster without a license a third-degree felony on any insurance claim, commercial included (Fla. Stat. 626.8738), and on residential and condominium unit owner policies it also bars a licensed contractor from public adjuster services unless it holds that license (Fla. Stat. 626.854(16), limited to those policies by 626.854(19)).
Put this boundary in the written job description and in the training, and route anything past it to the policyholder's own licensed public adjuster or counsel. Check your own state before you hire into this seat, because the line moves state to state. What a Contractor May and May Not Do on a Claim walks the line in more depth.
Scorecard (what good looks like): claims moving without insurance-side stalls; approval and authorization turnaround; clean adjuster communication; status visible to the team; cycle time from claim to closeout; zero instances of the seat crossing into adjusting the customer's claim.
Reports to: Office Manager or Production Manager. Purpose: own the documentation package to carrier standard, so every file is complete, accurate, and defensible before and after submission.
Key responsibilities: assemble the documentation package to carrier and program standard, audit files for completeness and accuracy, confirm photos, readings, scope, and forms are present, flag gaps back to the field, keep files audit-ready, maintain the file through close.
Scorecard: files complete and to carrier standard; audit exceptions low; missing documents caught early; files defensible on review; submission and closeout readiness.
Reports to: Office Manager or General Manager. Purpose: keep the shop compliant with TPA and program service level agreements (SLAs) and key performance indicators (KPIs), so the company protects its standing and the work that comes with it.
Key responsibilities: track program SLAs and KPIs, monitor compliance against each program's requirements, manage program portals and updates, surface and resolve compliance gaps before they cost score, prepare for program audits and reviews, keep leadership informed on program standing.
Scorecard: SLA and KPI compliance held; program scores at or above threshold; audit and review readiness; compliance gaps resolved before penalty; program standing protected.