Claims Quality Auditor - Bodily Injury

Pronto Insurance is one of the fastest growing general agencies in South Texas and is now a member of Gallagher, a world wide expert in risk management solutions. 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 200 captive locations in Texas and recent expansion into California and Florida market. Our vision is to become the industry leader by making Pronto Insurance products a reality for all.

JOB DESCRIPTION: CLAIMS QUALITY AUDITOR

JOB DETAILS

• Employment Status: Permanent/ Full Time

   

  Job Location: Florida

   

PRIMARY RESPONSIBILITIES

• Assure closed files are to standard with no pending items

   

  Make sure pending items have been resolved by adjuster

   

  Ensure that procedure manuals are constantly evaluated and updated to reflect current company processes

   

  Report findings to Auditing Manager when scores are below standard

   

  Review open claims to ensure that company procedures are being followed

   

  Ensure that all files are closed according to company standards; procedure manuals should be followed at any time

   

  Proactively find and report on any issues encountered during audit of files

   

  Identify, document & communicate any training issues discovered

   

  Communicate to management when any procedures are not followed

   

  Set plans with trainers to find solutions and preventive actions

   

  Other duties as assigned

   

  Analyze and audit all types of claims

   

  Verify adjuster is consistent with company and state policies and professional standards.

   

  Identify workflow issues and suggest improvements to management

   

  Perform high quality audits on all types of claims.

   

  Provide feedback on areas identified that need improvement

   

KNOWLEDGE AND SKILL REQUIREMENT

• Experience in claims handling of Bodily Injury claims required

   

  Bachelor’s Degree preferred but not required

   

  Proficient in computer window-based programs with excellent navigation skills

   

  Excellent communication skills both oral and written.

   

  Pays great attention to detail

   

  Planning and Organizational Skills

   

U.S. Eligibility Requirements:

• Interested candidates must submit an application and resume/CV online to be considered
• Must be 18 years of age or older
• Must be willing to submit to a background investigation; any offer of employment is conditioned upon the successful completion of a background investigation
• Must have unrestricted work authorization to work in the United States.  For U.S. employment opportunities, Gallagher hires U.S. citizens, permanent residents, asylees, refugees, and temporary residents. Temporary residence does not include those with non-immigrant work authorization (F, J, H or L visas), such as students in practical training status. Exceptions to these requirements will be determined based on shortage of qualified candidates with a particular skill. Gallagher will require proof of work authorization
• Must be willing to execute Gallagher's Employee Agreement or Confidentiality and Non-Disclosure Agreement, which require, among other things, post-employment obligations relating to non-solicitation, confidentiality and non-disclosure

Gallagher offers competitive salaries and benefits, including: medical/dental/vision plans, life and accident insurance, 401(K), employee stock purchase plan, educational expense reimbursement, employee assistance program, flexible work hours (availability varies by office and job function) training programs, matching gift program, and more.