Desk Adjuster recruiting form Step 1 of 3 - Page 1 0% Today's Date* MM slash DD slash YYYY (MM/DD/YYYY)What time zone are you located in?*Eastern (EST)Central (CST)Mountain (MST)Pacific (PST)AlaskaHawaiiYour Name* First Middle Last Suffix Business name (if applicable)Address* Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Cell Phone*Email Address* Enter Email Confirm Email Date of Birth* MM slash DD slash YYYY Primary Language*EnglishSpanishFrenchChineseJapanesePortugueseArabicHindi-UrduBengaliItalianGermanRussianSwedishPolishPersianMalaysianTurkishDutchSwahiliTamilOtherAdditional Languages Spoken English Spanish French Chinese Japanese Portuguese Arabic Hindi-Urdu Bengali Italian German Russian Swedish Polish Persian Malaysian Turkish Dutch Swahili Tamil Other If you speak a language not listed above, please specifyHow did you hear about TelaClaims?*LinkedInReferred by friendFound onlineInstructed by employerOtherOther SourceHave you been a member of The US Armed Forces?* Yes No Have you ever worked for TelaClaims before?* Yes No Please specify the time period and details when you worked with us.*Example: "I was a CAT Adjuster during Hurricane Irma in 2017" Deployment Preference* CAT Deployment Daily Claims Flexible to both options Do you have an active adjusters license?* Yes No Primary Adjuster Licensed State*AlabamaAlaskaArizonaArkansasCaliforniaConnecticutDelawareFloridaGeorgiaHawaiiIdahoIndianaKentuckyLouisianaMaineMichiganMinnesotaMississippiMontanaNevadaNew HampshireNew MexicoNew YorkNorth CarolinaOklahomaOregonPuerto RicoRhode IslandSouth CarolinaTexasUtahVermontWashingtonWest VirginiaWyomingPrimary Adjuster License Number*Primary Adjuster License Expiration Date (MM/YYYY)Enter your NPN (National Producer Number)Do you hold an adjuster's license in any additional states? If so, please select them below. Alabama Alaska Arizona Arkansas California Connecticut Delaware Florida Georgia Hawaii Idaho Indiana Kentucky Louisiana Maine Michigan Minnesota Mississippi Montana Nevada New Hampshire New Mexico New York North Carolina Oklahoma Oregon Puerto Rico Rhode Island South Carolina Texas Utah Vermont Washington West Virginia Wyoming What year did your adjusting career begin?*2025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950Your Adjuster Level*No ExperienceJr. Adjuster (1-3 years)Adjuster (4-6 years)Sr. Adjuster (7-10+ years)Line of Business (Select all that apply)* Residential Commercial Flood Auto Other Please list "other" insurance related lines of businessApproximate number of Homeowners property claims handled:*Never handled a claim1 to 100101 to 500501 to 15001500+Approximate number of Commercial properety claims handled:*Never handled a claim1 to 100100 to 500501 to 10001000+Approximate number of Auto claims handled:*Never handled a claim1 to 100100 to 500501 to 10001000+ Have you ever worked as a carrier staff adjuster?*NoYesList all carriers that you have worked for and in what position/role.*CarrierPosition/Role Carrier Certification(s) (If Applicable)Certification NameExpiration Date (MM/YYYY) Claims Management Platform(s) Used* Guidewire SIMS ClaimCenter FileTrac Symbility Claims Connect ClickClaims None Other Please Specify "Other" Claims Management Platform(s) Used*What estimating software(s) are you proficient in?* None Xactimate Symbility Audatex Mitchell CCC Other Please Specify "Other" Estimating Platform You Are Proficient In*Please list Microsoft Office applications you are proficient with: None Microsoft Teams Word Excel Outlook Do you have a CPCU Designation?*NoYesDo you have a Juris Doctorate Degree?*NoYesBy selecting this box, you authorize TelaClaims Adjusting LLC to remit your information for a full background check and share your resume as needed.* I agree to the privacy policy.Your information may be shared with insurance carriers for possible job opportunities. By selecting this box, you authorize TelaClaims Adjusting LLC to send you emails regarding upcoming job opportunities and updates. This is how we will stay in contact with you.Please upload your current resume.* Drop files here or Select files Accepted file types: pdf, Max. file size: 25 MB, Max. files: 4. Please only upload your resume in PDF formatUpload Adjuster Licenses or Certifications (optional)Accepted file types: pdf, Max. file size: 10 MB. Upload in PDF format only. Max file size: 10MBAdditional Notes or ClarificationsIs there anything you would like us to know? Δ
