Claims Adjuster

HomeFirst® Agency is a leading insurance agency offering a wide range of insurance products from nationally-known insurance companies to protect homes, property, and lives. Based in Maryville, Tennessee, we provide homeowners insurance nationwide and additional property and life insurance in select states. With over 20 years of experience, we serve more than 180,000 customers.

About the role

The Claims Adjuster I reviews claims related to property damage or loss, working under the Claims Team Lead. This role involves collaborating with experts to assess claims, interpret insurance policies, and determine coverage. The position also includes engaging with policyholders to gather information, provide updates, and explain claims decisions.

Responsibilities

• Maintains accurate and detailed notes regarding interactions, decisions, and actions taken throughout a claim.
• Reviews, evaluates, and investigates photos, estimates, forms, receipts, inspection reports, and official reports presented on a claim in partnership with Claims Team Lead and Trainers.
• Processes property damage claims submitted by policyholders and reviews insurance policies to determine coverage, interpreting policy provisions based on investigation findings.
• Conducts and records interviews with insured parties to secure information regarding personal loss.
• Works with claimants or their representatives (contractors, public adjusters, attorneys, or other legal representatives) to gather information and negotiate fair settlements, overseen by the Claims Team Lead.
• Collaborates with other insurance carriers regarding duplicate claims and coverage.
• Assigns claims for inspections and requests/issues settlement checks with explanation letters based on policy terms and investigation findings, within limited authority.
• Prepares and issues denial letters to claimants, clearly outlining reasons for denial based on policy terms and investigation findings.
• Identifies potential fraudulent claims and refers them for additional investigation as warranted.
• Ensures claims handling complies with company and regulatory policies.
• Escalates complex claims to management and legal teams, including those subject to complaints and litigation.
• Consults with Claims Team Leads to resolve claim disagreements using alternative dispute resolutions (arbitration, appraisal, and mediation).
• Maintains workflow to ensure timely processing of claims and partners with leadership on difficult or unusual claim situations.
• Prepares response letters to complaints or legal issues received.
• Provides excellent customer service by maintaining professional and constant dialogue with claimants, handling claims promptly, efficiently, and with empathy.
• Communicates regularly with policyholders or relevant parties, providing updates on claim status and addressing questions or concerns.
• Supports related teams during high work volume to meet or exceed established service levels.
• Educates policyholders on the claim process and coverages through open communication.
• Sorts and responds to incoming emails.
• Assists with one-on-one training or job shadowing for new hires.
• Completes required state continuing education to maintain and renew adjuster license.
• Performs other duties as assigned.

Requirements

• High School diploma or equivalent required; college degree preferred.
• 0-2 years of related experience preferred.
• Strong computer skills with ability to navigate Microsoft Office Suite.
• Excellent knowledge of state and federal laws and regulations.
• Ability to communicate effectively via phone, email, and in person.
• Capability to gather facts accurately, analyze causes, evaluate alternate solutions, and arrive at sound conclusions.
• Ability to manage multiple and/or conflicting responsibilities.
• Great attention to detail, organizational skills, and time management.
• Good sense of urgency and follow-up.
• Ability to handle stressful situations and work in a team environment.
• Ability to make relatively complex decisions.

Qualifications

• Current Property & Casualty Adjuster license preferred but not required; must obtain license within 90 days of hire if not currently licensed and maintain state licensing requirements.
• Claims experience helpful; working knowledge of AS/400 and basic understanding of insurance a plus.

Physical Demands

• Must be able to remain in a stationary position 75% of the time.
• Constantly operates a computer and other office productivity machinery (telephone, calculator, copy machine, printer).
• Communicates via phone, Microsoft Teams, and Zoom to exchange accurate information.
• Must be able to identify and assess account status and determine appropriate processes.
• Primarily works in a state-of-the-art, indoor, temperature-controlled office environment with sealed windows, following a hybrid schedule.

Pay

The expected hiring range for this position is $21.69 to $27.11 per hour, plus bonus opportunities. Final compensation decisions will consider experience, qualifications, individual skills, internal equity, and organizational needs.

Schedule

Hybrid schedule: 3 days in office, 2 days remote after training.

Benefits

• Flexible health, dental, and vision benefits package for full-time team members.
• Competitive 401(k) programs with investment options and company matching after one year for full- and part-time team members.
• Paid parental leave.
• Tuition reimbursement.
• Employee Assistance Programs.
• Paid time off for volunteering through the Clayton Impact program.
• Holistic wellness programs covering physical, nutritional, social, financial, spiritual, and occupational well-being (available online or in-person).
• Onsite amenities at the newly renovated Home Office campus, including a restaurant, fitness facility with gym, in-person and virtual workout classes, yoga/barre studio, volleyball and basketball courts, walking paths, and a disc golf course.