Claims Adjuster

HomeFirst Agency, Inc.; United States; Hybrid; USD 29,880 - 37,346; Full time

Benefits offered by this job

Customizable health benefits

401(k) matching

Paid parental leave

Tuition reimbursement

Holistic wellness programs

Job summary

HomeFirst Agency, Inc. is looking for a full-time Claims Adjuster I who will review and process property damage claims, ensuring accurate assessments and compliance with regulations. This hybrid role includes 3 days in-office and 2 days remote flexibility after training.

Candidates should possess strong communication skills and a high school diploma, with additional insurance qualifications preferred. Benefits include customizable health plans, 401(k) matching, and wellness programs.

Qualifications

• 0–2 years of related experience preferred.
• Excellent knowledge of state and federal laws and regulations.
• Ability to manage multiple and/or conflicting responsibilities.

Responsibilities

• Reviews claims related to property damage and explains decisions to policyholders.
• Maintains accurate notes regarding claims interactions and decisions.
• Negotiates settlements with claimants or representatives.

Skills

Computer skills

Effective communication

Attention to detail

Time management

Education

High School diploma or equivalent

College degree preferred

Tools

Microsoft Office Suite

AS/400

Job description

BUSINESS 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: The expected base pay range for this position is $21.69 - $27.11 plus additional bonus opportunity. The hourly compensation is based on experience and qualifications, with considerations for skills, equity, and organizational needs.

JOB SUMMARY

The Claims Adjuster I reviews claims related to property damage or loss, works with experts to obtain accurate assessments and support claims decisions, interprets policies to determine coverage, and engages with policyholders to provide updates and explain decisions.

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, 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.
• Collaborates with other insurance carriers as needed 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 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.
• Consults with Claims Team Leads to resolve disagreements with a claim, utilizing alternative dispute resolutions (arbitration, appraisal, and mediation).
• Collaborates with management on arbitration, appraisal, and mediations.
• Maintains workflow to ensure timely processing of claims.
• Partners with Claims leadership on difficult or unusual situations that arise 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 while handling claims promptly, efficiently, and with empathy.
• Communicates regularly with policyholders or other relevant parties, providing updates on the status of claims and addressing any 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.
• 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.
• Capability 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.
• 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 completion of continuing education when required by the state.

Knowledge, Skills and Abilities

• 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.
• Accurate fact gathering, cause analysis, and solution evaluation to reach sound action conclusions.
• Managing multiple and/or conflicting responsibilities.
• Detail orientation, organization, and time management.
• Urgency and follow‑up mindset.
• Stress tolerance.
• Team collaboration.
• Adaptability to periodic changes.
• Complex decision making.

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 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.
• Competitive 401(k) programs with company matching after one year for full‑ and part‑time team members.
• Paid parental leave, tuition reimbursement, Employee Assistance Program, and more.
• Paid time to volunteer for meaningful causes through the Clayton Impact program.
• Holistic wellness programs (physical, nutritional, social, financial, spiritual, occupational) available online or in‑person.
• On‑site facilities including restaurant, fitness center, yoga/barre studio, courts, walking paths, and disc golf course.

EEO STATEMENT

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.