Claims Adjuster

About Company:

Pronto Insurance is one of the fastest growing general agencies in South Texas. Our first agency was founded in 1997 and the managing general agency operations commenced in 2005. Pronto has emerged in the insurance market through its captive agencies, independent agents, and franchise locations. Today Pronto has over 160 captive locations in Texas and California  Our vision is to become the industry leader by making Pronto Insurance products a reality for all. 

About the Role:

As a Claims Adjuster, you will play a critical role in the insurance process by investigating, evaluating, and settling insurance claims in a timely and fair manner. Your primary objective is to ensure that claims are handled accurately and efficiently while maintaining compliance with company policies and regulatory requirements. You will work closely with claimants, insurance agents, and other stakeholders to gather necessary information and assess the validity and extent of claims. This role requires strong analytical skills to determine appropriate compensation and negotiate settlements when necessary. Ultimately, your work will help protect the financial interests of the insurance company while providing excellent service to policyholders.

Minimum Qualifications:

• High school diploma or equivalent; a bachelor’s degree in a related field is preferred.


• Proven experience in claims adjusting, insurance, or a related field.


• Strong knowledge of insurance policies, claims procedures, and relevant state and federal regulations.


• Excellent communication and negotiation skills.


• Ability to analyze complex information and make sound decisions.

Preferred Qualifications:

• Certification as a Chartered Property Casualty Underwriter (CPCU) or Associate in Claims (AIC).


• Experience with claims management software and databases.


• Background in legal or medical aspects of insurance claims.


• Strong organizational skills and attention to detail.


• Ability to manage multiple claims simultaneously in a fast-paced environment.

Responsibilities:

• Investigate insurance claims by interviewing claimants and witnesses, reviewing police reports, medical records, and other relevant documents.


• Evaluate the extent of the insurance company’s liability and determine the appropriate amount to be paid on claims.


• Negotiate settlements with claimants and their representatives to resolve claims efficiently and fairly.


• Prepare detailed reports and maintain accurate records of claim investigations and settlements.


• Collaborate with legal, medical, and other professionals as needed to support claim resolution.


• Ensure compliance with all applicable laws, regulations, and company policies throughout the claims process.


• Communicate clearly and professionally with claimants, agents, and internal teams to provide updates and resolve issues.

Skills:

In this role, your analytical skills will be essential for reviewing documentation and determining claim validity and appropriate compensation. Communication skills are used daily to interact with claimants, agents, and internal teams, ensuring clarity and professionalism. Negotiation skills help you reach fair settlements that satisfy both the claimant and the company. Organizational skills enable you to manage multiple cases efficiently while maintaining detailed and accurate records. Familiarity with claims management software enhances your ability to track claims progress and streamline workflows.