Bilingüal Senior Claims Adjuster

Gallagher; Bogotá; Vor Ort; Confidencial; Vollzeit

Zusammenfassung

Gallagher GCoE LatAm is seeking a diligent Claims Adjuster to lead and process insurance claims, ensuring timely, fair settlements and excellent customer service. You will coordinate with repair shops, review medical bills, and detect potential fraud while maintaining detailed documentation of every step in the claims process.

The role offers growth in a dynamic LatAm Center of Excellence environment and requires a strong mix of analytical skills, communication, and independent work ethic.

Qualifikationen

• Bachelor’s degree in Business, Finance, or a related field preferred.
• 3-5 years of experience in insurance, with exposure to claims handling preferred.
• Strong analytical and problem-solving skills.
• Excellent communication and social skills.
• Ability to work independently and as part of a team.
• Proficiency in Microsoft Office Suite and claims management software.

Aufgaben

• Receive and review the initial claim report from the policyholder or claimant.
• Verify the policyholder's coverage, including limits, deductibles, and exclusions.
• Gather preliminary information about the incident, such as the date, time, location, and parties involved.
• Scene analysis or site visit to gather evidence and document conditions.
• Interview policyholders, other drivers, passengers, and witnesses.
• Obtain and review police or accident reports for additional information.
• Coordinate with third parties, such as repair shops or medical providers.
• Inspect damaged vehicles and estimate repair costs.
• Determine repairability or total loss of the vehicle.
• Analyze evidence to determine fault and apply relevant laws.
• Coordinate with repair shops to finalize estimates and authorize repairs.
• Negotiate settlements and issue payments for repairs or medical bills.

Kenntnisse

Strong analytical and problem-solving

Excellent communication

Independent and team player

Ausbildung

Bachelor’s degree in Business, Finance, or related field

Tools

Microsoft Office Suite

Claims management software

Jobbeschreibung

About Gallagher GCoE LatAm:

Gallagher GCoE LatAm is part of Gallagher’s global network of Centers of Excellence, designed to deliver scalable, high-quality, and cost-effective solutions. Guided by enterprise priorities and a commitment to long-term value creation, GCoE LatAm positions itself as a dynamic and future-ready partner for our businesses and our people.

What makes us different is The Gallagher Way, our shared commitment to doing business the right way, supporting each other, and creating opportunities to learn and grow.

Through strategic service planning and the power of global talent, we drive operational efficiency, innovation, and sustainable growth across the region while fostering a collaborative environment where every colleague is valued, respected, and encouraged to explore new ideas.

At GCoE LatAm, you’ll find more than a place to work. You’ll discover a culture where curiosity is celebrated, career journeys are supported, and the impact of your contributions can be seen around the world.

We are seeking a diligent and proactive Claims Adjuster to join our claims team. The ideal candidate will be responsible for efficiently leading and processing claims, ensuring timely and fair settlements, and maintaining excellent customer service. This role is an excellent opportunity for individuals looking to grow their career in the insurance industry.

Responsibilities:

1. 1. Claim Intake and Review
   • Receive and review the initial claim report from the policyholder or claimant.
   • Verify the policyholder's coverage, including limits, deductibles, and exclusions.
   • Gather preliminary information about the incident, such as the date, time, location, and parties involved.
2. 2. Investigation
   • Scene Analysis: Visit the accident scene (if necessary) to gather evidence, take photographs, and document the conditions.
   • Interviewing Parties: Speak with the policyholder, other drivers, passengers, and witnesses to understand the details of the incident.
   • Police Reports: Obtain and review police or accident reports for additional information.
   • Third-Party Involvement: Contact third parties, such as other insurance companies, repair shops, or medical providers, to gather relevant details.
3. 3. Damage Assessment
   • Inspect the damaged vehicle(s) to assess the extent of the damage.
   • Take photographs and document the condition of the vehicle.
   • Estimate repair costs using specialized software or by consulting with repair shops.
   • Determine whether the vehicle is repairable or a total loss.
4. 4. Liability Determination
   • Analyze the evidence to determine who is at fault for the accident.
   • Apply state-specific laws (e.g., comparative negligence or no-fault laws) to assign liability.
   • Communicate findings to all parties involved.
5. 5. Coordination with Repair Shops
   • Work with approved or preferred repair shops to finalize repair estimates.
   • Authorize repairs and ensure they are completed to the policyholder’s satisfaction.
   • Arrange for a rental car if the policyholder has rental reimbursement coverage.
6. 6. Medical Claims Review (if applicable)
   • Review medical bills and records if there are injuries involved.
   • Coordinate with medical providers to verify the necessity and reasonableness of treatments.
   • Evaluate claims for bodily injury, including pain and suffering, lost wages, and future medical expenses.
7. 7. Fraud Detection
   • Identify and investigate any signs of potential fraud, such as exaggerated damages or staged accidents.
   • Collaborate with the Special Investigations Unit (SIU) if fraud is suspected.
8. 8. Negotiation and Settlement
   • Negotiate with claimants, policyholders, or third parties to reach a fair settlement.
   • Resolve disputes over liability, damages, or settlement amounts.
   • Issue payment for repairs, medical bills, or other covered expenses.
9. 9. Documentation and Reporting
   • Maintain detailed records of all communications, evidence, and decisions made during the claims process.
   • Prepare reports summarizing the claim's status and resolution.
   • Ensure compliance with company policies, state regulations, and industry standards.
10. 10. Customer Service
    • Provide clear and timely communication to policyholders and claimants throughout the process.
    • Address questions, concerns, and complaints in a professional manner.
    • Educate policyholders about their coverage and the claims process.
11. 11. Subrogation and Recovery
    • If another party is at fault, pursue subrogation to recover costs from the responsible party or their insurer.
    • Collaborate with legal teams if litigation is necessary.
12. 12. Closing the Claim
    • Ensure all aspects of the claim are resolved, including payments and documentation.
    • Close the claim in the system once all parties are satisfied and obligations are met.

Qualifications:

• Bachelor’s degree in Business, Finance, or a related field preferred.
• 3-5 years of experience in the insurance industry, with exposure to claims handling preferred.
• Strong analytical and problem-solving skills.
• Excellent communication and social skills.
• Ability to work independently and as part of a team.
• Proficiency in Microsoft Office Suite and claims management software.

Preferred Experience:

• Experience with property and casualty claims.
• Familiarity with insurance regulations and compliance standards.
• Previous experience in a customer service role is a plus.