Remote Fsa Claims Processor Jobs in Tennessee (NOW HIRING)

POSITION TITLE: Claims Adjuster I

JOB STATUS:Full-time/Hourly

DEPARTMENT: Claims

REPORTS TO:Claims Team Lead

TRAVEL REQUIRED:Asneeded

WORK SCHEDULE: Hybrid - 3 days in office, 2 days remote after training.

PAY: The expected hiring range for this position is from $21.69 to $27.11 plus additional bonus opportunity. The stated hiring range is based on experience, qualifications, and other relevant factors. Final compensation decisions will take into account a variety of considerations, including individual skills, internal equity, and organizational needs.

HomeFirst Agency is a leading insurance agency offering a wide range of insurance products from nationally-known insurance companies to protect your home, property and life. We strive to help customers find the right insurance products to fit their needs at competitive rates. Located in Maryville, Tennessee, we offer homeowners insurance to customers nationwide, and insurance to protect your other property and life in select states. For over 20 years, we have helped customers with their insurance needs. Today, we have more than 180,000 customers.

JOB SUMMARY

The Claims Adjuster Ireviewsclaims related to property damage or loss.This position reports to the Claims Team Lead andworks with various experts during the claims process to obtain accurate assessments and supportinclaims decisions.The Claims Adjuster Ipartners withClaims Trainer and Claims Team Leadtointerpret the terms and conditions ofinsurance policiesto determine coverage and exclusions applicable to each claim.This position also engages with policyholders to gather information, provide updates on the status of claims, and explain the claims process and decisions.

JOBFUNCTIONS:

ClaimsHandlingandInvestigating

• Maintainsaccurate 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 processesproperty damage claims submitted by policyholders.

• Reviews insurance policies to determine coverageby working with Claims Trainers and leadershiptointerpret and apply policy provisions to claimsunder considerationbased on coverage and investigation findings.

• Conducts,records, andinterviews withthoseinsuredtosecure information regardingpersonalloss.

• Workswith claimants orrepresentativesofclaimants(contractors, public adjusters,attorneys, or other legal representatives)to gather necessary information regarding the claim andto negotiate fair and equitable settlements, overseen by Claims Team Lead.

• Collaborateswith other insurancecarriers as needed regarding duplicate claims and coverage.

• Selects and assignsclaims for inspections.

• Requests and issues settlement checkswithexplanation lettersbased on policy terms and investigation findings,withlimitedauthority.

• Preparesand issuesdenial letters toclaimants, clearly outlining the reasons for denial based on policy terms and investigation findings.

• Identifiespotential fraudulent claims and refersfor additional investigation as warranted.

• Ensures claimshandling complies with company and regulatory policies.

• Escalates complex insurance claims tomanagementand legal teamsincludingthose subject to complaints and litigation.

• Consults withClaims TeamLeadstoresolve disagreements with a claim,utilizing alternative dispute resolutions(arbitration,appraisal, and mediation).

• Collaborateswith management on arbitration, appraisal, and mediations.

• Maintainsworkflow to ensure timely processing of claims.

• Partners withClaimsleadershipon difficult or unusual situations that arise onclaims.

• Prepares responselettersto complaints or legal issuesreceived.

Customer Service

• Provides excellent customer service bymaintainingprofessional and constant dialogue with claimantsin addition tohandling claims promptly, efficiently, and with empathy.

• Communicates regularlywith policyholders or other relevant partiesprovidingupdates on the status of claims and addressingany questions or concerns.

• Provides supporttorelated teams during high work volumeto meet or exceed established service levels.

• Educatespolicyholders on the claim process and coveragesby 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.

• Completesrequired state continuing education requirements to maintainand renewadjuster license.

Other duties as assigned

This job description is not an exhaustive list of all the functions that a team memberperformsand other duties may be assigned.

QUALIFICATIONS:

• Education:High School diploma or equivalentrequired, collegedegreepreferred.

• Experience:0-2 years of related experiencepreferred.

• Travel as needed.

• 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 makerelativelycomplex decisions.

Licenses/Certifications:A current Property & Casualty Adjuster license preferred but not required. Must obtain license within 90 days of hire if not currently licensedand maintain state licensing requirements through the completion of continuing education when required by the state.

Knowledge, Skills and Abilities (KSAs):

• Must have strong computer skills with ability to navigate Microsoft Office Suite

• Maintains excellent knowledge of state and federal laws and regulations

• Claims experience helpful, working knowledge of AS/400 and basic understanding of insurance a plus

• Ability to communicate effectively and efficiently via phone, email, and person to person

• Capable of gathering facts accurately, analyze causes, evaluate 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

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, andZoom.

• Must be able to exchange accurate information at all times.

• Must be able to identify and assess account status and determine appropriate process.

• Willprimarilywork in a state-of-the-art indoor temperature controlled, sealed window office environment, while working a hybrid schedule.

Here are some more reasons to choose HomeFirst Agency!

• 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.

HomeFirst Agency. Where you start a job and gain a career!

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