Claims Adjuster I

POSITION TITLE: Claims Adjuster I JOB STATUS: Full-time/Hourly DEPARTMENT: Claims REPORTS TO: Claims Team Lead TRAVEL REQUIRED: As needed WORK SCHEDULE: Hybrid - 3 days in office, 2 days remote after training. PAY: Expected hiring range is $21.69 to $27.11 per hour plus additional bonus opportunity. Final compensation decisions will consider experience, qualifications, and other relevant factors. HomeFirst® Agency is a leading insurance agency offering a wide range of insurance products from nationally‑known insurers to protect homes, property, and life. Located in Maryville, Tennessee, we serve homeowners nationwide and provide insurance for other property and life in select states. For over 20 years, we have helped more than 180,000 customers. Job Summary The Claims Adjuster I reviews property damage or loss claims, works with experts and policyholders to obtain accurate assessments, and supports decision making. This role interprets insurance policy terms to determine coverage and exclusions, and communicates with policyholders to provide updates and explain the process. Job Functions Claims Handling and Investigating 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 property damage claims submitted by policyholders. Review insurance policies to determine coverage by working with Trainers and leadership to interpret and apply policy provisions. Conducts records and interviews to secure information regarding personal loss. Works with claimants or representatives (contractors, adjusters, attorneys) to gather necessary information and negotiate fair settlements, overseen by Claims Team Lead. Collaborates with other insurance carriers regarding duplicate claims and coverage. 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 reasons for denial based on policy terms. Identifies potential fraudulent claims and refers 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 disagreements using alternative dispute resolutions. Collaborates with management on arbitration, appraisal, and mediation. Maintains workflow to ensure timely processing of claims. Partners with Claims leadership on difficult or unusual situations on claims. Prepares response letters to complaints or legal issues received. Customer Service Provides excellent customer service by maintaining professional and constant dialogue with claimants in addition to handling claims promptly, efficiently, and with empathy. Communicates regularly with policyholders or other relevant parties providing updates on claim status and addressing questions or concerns. Provides support to related teams during high work volume to meet or exceed established service levels. Educates policyholders on the claim process and coverages by maintaining open communication throughout the claim duration. Sorts and responds to incoming emails. Training and Education Assists with one‑on‑one training or job shadowing for new hires. Completes required state continuing education requirements to maintain and renew adjuster license. Other duties as assigned. This job description is not an exhaustive list of all the functions that a team member performs and other duties may be assigned. Qualifications High School diploma or equivalent required; college degree preferred. 0–2 years of related experience preferred. Travel as needed. Strong computer skills with ability to navigate Microsoft Office Suite. Excellent knowledge of state and federal laws and regulations. Effective communication via phone, email, and person‑to‑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. Sense of urgency and follow‑up. Ability to handle stressful situations. Ability to work in a team environment. Ability to make relatively complex decisions. Licenses/Certifications A 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 through continuing education. Knowledge, Skills and Abilities (KSAs) Strong computer skills with ability to navigate Microsoft Office Suite. Excellent knowledge of state and federal laws and regulations. Claims experience helpful; working knowledge of AS/400 and basic understanding of insurance a plus. Effective communication via phone, email, and person‑to‑person. Capable of gathering facts accurately, analyzing causes, evaluating alternate solutions, and arriving at sound conclusions. Ability to manage multiple and/or conflicting responsibilities. Great attention to detail, organizational skills, and time management. 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. Physical Demands Must be able to remain in a stationary position 75% of the time. Will be constantly operating a computer and other office productivity machinery, such as a telephone, calculator, copy machine, and computer printer. Will be communicating via phone, Teams, and Zoom. Must be able to exchange accurate information at all times. Must be able to identify and assess account status and determine appropriate process. Will primarily work in a state‑of‑the‑art indoor temperature‑controlled, sealed window office environment while working a hybrid schedule. Benefits Full‑time team members can 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 team members achieve financial goals. Additional benefits include paid parental leave, tuition reimbursement, Employee Assistance Programs, and more. Team members receive paid time to volunteer through the Clayton Impact program. Holistic wellness programs are available online or in‑person, covering physical, nutritional, social, financial, spiritual, and occupational aspects. HomeFirst’s renovated home office campus offers an onsite restaurant, fitness facility with a full gym, 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. #J-18808-Ljbffr