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Pronto Insurance · 1 day ago

BI Direct Claims Adjuster

Brownsville, TX

Full-time

Onsite

Mid Level

4+ years exp

Pronto Insurance is a company focused on creating access, trust, and opportunity in the communities they serve. They are seeking a BI Direct Claims Adjuster who will investigate and resolve injury claims while ensuring compliance with Texas Tort Law and maintaining high standards of customer service.

Auto InsuranceFinancial ServicesInsurance

Responsibilities

Investigate, evaluate, negotiate and settle auto claims, in accordance with Texas Tort Law, in an assigned area to include verification of coverage, legal liability and extent of damage to persons, and property, which may require contact by telephone, correspondence or in person

May require the preparation of written or computerized estimates in loss settlement

Handle a high volume of claims in a virtual or centralized call center environment

Ensure integrity of investigations by developing accurate and relevant investigation material and data acquisition

Ensure that all compliance requirements for claims handling correspondence are met in a timely and professional manner

Issue payments as per discretionary settlement authority limits

Adjust reserves adequately on all new and existing claims

Assess comparative negligence

Adjust reserves properly and understand their impact on a claim

Issue payments within authority and request more as needed

Protect lienholders as needed

Handle claims in a timely manner and in accordance with Texas compliance rules

Refer files to SIU as needed

Send Reservation of Rights letters as needed

Qualification

Adjuster LicenseClaim Adjusting ExperienceInsurance LawComputer LiteracyBilingual SpanishEmpathyCommunicationOrganizational SkillsNegotiation Skills

Required

High school diploma and 4 years related claims experience required

Appropriately licensed and/or certified in all states in which claims are being handled

Knowledge of accepted industry standards and practices

Experience with related claims and business software

Bachelor's Degree in Business, Communications, Criminal Justice or equivalent work experience. (1-2 years of work experience per year of college education)

Two years of claim adjusting experience

Working knowledge of relevant statutes, case law and regulations relating to insurance

Current Adjuster License in Texas and other states (Candidate must otherwise be able to obtain a Texas Adjuster License)

Coordinates with outside sources to obtain information to aid in claim resolution

Recommends appropriate resolution of coverage issues to management

Uses in-depth knowledge of medical and liability issues to handle claims within authority

Applies knowledge of policies and procedures when determining coverage and concluding claims

Proficient in computer window-based programs with excellent navigation skills

Ability to multi-task and prioritize in a fast-paced, high volume call center environment

Excellent communication skills both oral and written