Claims Adjuster I

About the role

The Claims Adjuster I position at HomeFirst® Agency is a full-time/hourly role reporting to the Claims Team Lead. The department is located in Maryville, Tennessee, serving customers nationwide. The expected hiring range for this position is from $21.69 to $27.11 per hour, plus an additional bonus opportunity. Final compensation decisions will consider individual skills, internal equity, and organizational needs.

Responsibilities

• Maintains accurate and detailed notes regarding interactions, decisions, and actions taken throughout a claim.
• Partners with Claims Team Lead and Trainers to review, evaluate, and investigate photos, estimates, forms, receipts, inspection reports, and official reports presented on a claim.
• Reviews, partners, and processes property damage claims submitted by policyholders.
• Reviews insurance policies to determine coverage by working with Claims Trainers and leadership to interpret and apply policy provisions to claims under consideration based on coverage and investigation findings.
• Conducts, records, and interviews with those insured to secure information regarding personal loss.
• Works with claimants or representatives of claimants (contractors, public adjusters, attorneys, or other legal representatives) to gather necessary information regarding the claim and to negotiate fair and equitable settlements, overseen by Claims Team Lead.
• Selects and assigns claims for inspections. Requests and issues settlement checks with explanation letters based on policy terms and investigation findings, with limited authority.
• Prepares and issues denial letters to claimants, clearly outlining the reasons for denial based on policy terms and investigation findings.
• Identifies potential fraudulent claims and refers for additional investigation as warranted.
• Ensures claims handling complies with company and regulatory policies.
• Escalates complex insurance claims to management and legal teams including those subject to complaints and litigation.
• Collaborates with management on arbitration, appraisal, and mediations.
• Maintains workflow to ensure timely processing of claims.
• Presents response letters to complaints or legal issues received.

Qualifications

• A high school diploma or equivalent required, college degree preferred.
• 0-2 years of related experience preferred.
• Must have strong computer skills with ability to navigate Microsoft Office Suite.
• Maintains excellent knowledge of state and federal laws and regulations.
• Ability to communicate effectively and efficiently via phone, email, and person to person.
• Capable of gathering facts accurately, analyzing causes, evaluating alternate solutions, and arriving at sound conclusions on action to be taken.
• 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.
• Ability to work in a team environment.
• Capable of dealing with changes that can and will occur periodically.
• Ability to make complex decisions.

Skills

• Strong computer skills with ability to navigate Microsoft Office Suite.
• Maintains excellent knowledge of state and federal laws and regulations.
• Working knowledge of AS/400 and basic understanding of insurance a plus.
• Effective communication via phone, email, and person to person.
• Gathering facts accurately, analyzing causes, evaluating alternate solutions, and arriving at sound conclusions on action to be taken.
• Managing multiple and/or conflicting responsibilities.
• Attention to detail, organizational skills, and time management.
• Handling stressful situations.
• Working in a team environment.
• Dealing with changes that can and will occur periodically.
• Making complex decisions.

Benefits

Full-time team members have the flexibility to create their own health, dental, and vision benefits package. HomeFirst Agency provides competitive 401(k) programs, including investment options and company matching for full and part-time team members after one year to help our team members achieve their financial goals. Additional benefits include paid parental leave, tuition reimbursement, Employee Assistance Programs, and more. As part of HomeFirst’s commitment to Opening Doors to a Better Life, HFA is now providing paid time for Team Members to volunteer to causes that are meaningful to them through the Clayton Impact program. At HFA, we encourage holistic wellness with physical, nutritional, social, financial, spiritual, and occupational programs available online or in-person for team members. Our newly renovated Home Office campus offers an onsite restaurant, onsite fitness facility with full gym, in-person and virtual workout classes, yoga/barre studio, volleyball, and basketball courts, walking paths, and a disc golf course. Clayton is committed to creating an inclusive workplace. HomeFirst Agency is an equal opportunity employer and does not discriminate on the basis of race, national origin, gender, gender identity, sexual orientation, protected veteran status, disability, age, or other legally protected status.