Peer Review Specialist 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 State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country 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 Source*Have 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 Peer Review Specialist from August - November in 2022" 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)What year did you preform your first peer review?2025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950What field do you have experience working in prior to practicing peer reviews?* Water Restoration Fire/Smoke Restoration Mold Remediation Contamination Remediation Field Adjuster General Contractor No experience Other Please specify "Other" (If Applicable)What is your professional background prior to practicing peer review work?*Please be in depth with previous professional work experienceWhat area(s) are you most confident reviewing?* Water Mitigation Fire/Smoke Remediation Mold Remediation Reconstruction Estimates Personal Property Inventories ALE Calculations Other Please specify "Other" focus areasApproximate number of homeowner peer reviews performed:*1 to 5051 to 100101 to 300301 to 500501+Approximate number of commercial peer reviews performed:*1 to 5051 to 100101 to 300301 to 500501+What estimating software(s) are you proficient in?* Xactimate Symbility Simsol Audatex Mitchell CCC Other What "Other" estimating software(s) are you proficient in?Please list Microsoft office applications you are proficient with:* None Microsoft Teams Word Excel Outlook Do you have a Haag Roofing Certificate?*NoYesPlease upload a copy of your Haag Roofing CertificateAccepted file types: pdf, jpg, png, Max. file size: 25 MB.This is optionalDo you have a Rope And Harness Certification?*NoYesDo you have a IICRC Certification? If so, select your active certifications.* Not Applicable AMRT (Applied Microbial Remediation Technician) ASD (Applied Structural Drying Technician) BMI (Building Moisture Inspection) CCMT (Commercial Carpet Maintenance Technician) CCT (Carpet Cleaning Technician) CDS (Commercial Drying Specialist) CPT (Contents Processing Technician) CRT (Color Repair Technician) FCT (Floor Care Technician) FSRT (Fire and Smoke Damage Restoration Technician) HCT (House Cleaning Technician) HST (Health and Safety Technician) ISSI (Introduction to Substrate and Subfloor Inspection) LCT (Leather Cleaning Technician) MRS (Mold Remediation Specialist) OCT (Odor Control Technician) RCT (Rug Cleaning Technician) RFI (Resilient Flooring Inspector) RFMT (Resilient Flooring Maintenance Technician) RRT (Carpet Repair and Reinstallation Technician) SCI (Senior Carpet Inspector) SMT (Stone, Masonry and Ceramic Tile Cleaning Technician) TCST (Trauma and Crime Scene Technician) UFT (Upholstery and Fabric Cleaning Technician) WFMT (Wood Floor Maintenance Technician) WLFI (Wood and Laminate Flooring Inspector) WRT (Water Damage Restoration Technician) 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: 15 MB, Max. files: 4. Please only upload your resume in PDF formatUpload a redacted peer review report (optional)Accepted file types: pdf, jpg, png, Max. file size: 15 MB.Is there anything else you'd like us to know? Δ
