Claims Adjuster - Puerto Rico

Sedgwick; San Juan (PR); Hybrid; USD 60,000 - 80,000; Full time

Job summary

Sedgwick seeks a seasoned Adjuster for property and casualty losses in Puerto Rico. The role requires examining policies, interviewing claimants, and inspecting damage to determine liability and coverage. The position supports bilingual communication and requires experience with complex liability claims in a Puerto Rico market.

The candidate will draft reports and negotiate settlements, with hybrid work arrangements and travel as needed. Proficiency in Spanish and English is essential.

Qualifications

• Must be bilingual in Spanish and English.
• Experience handling complex liability claims and claims investigations.
• Proficient in documenting and reporting findings promptly.

Responsibilities

• Examines policies and records to determine coverage.

Skills

Bilingual Spanish/English

Strong communication skills

Presentation skills

Timely reporting

Interpersonal skills

Attention to detail

Time management

Teamwork or independent work

Performance competencies

PC literate; MS Office

Education

Puerto Rico Adjuster license (All Lines)

Tools

Microsoft Office

Job description

To handle losses and claims for property and casualty insurers.

ESSENTIAL FUNCTIONS AND RESPONSIBILITIES

• Examines insurance policies and other records to determine insurance coverage.
• Interviews, telephones, and/or corresponds with claimants and witnesses regarding claims.
• Consults police and hospital records and inspects property damage to determine the extent of the company’s liability, using varying methods of investigation according to the type of insurance.
• Estimates the cost of repair, replacement, or compensation.
• Prepares reports of findings and negotiates settlements with claimants.
• Drafts reports in both Spanish and English.
• Participates in meetings conducted in both Spanish and English.
• Recommends litigation by the legal department when a settlement cannot be negotiated.
• Revises case reserves in assigned claims files to cover probable costs.
• Assists in preparing loss experience reports to help determine profitability and calculate adequate future rates.

ADDITIONAL FUNCTIONS AND RESPONSIBILITIES

• Performs other duties as assigned.
• Supports the organization’s quality program(s).
• Travels as required.

QUALIFICATIONS

Education and Licensing

• Current Adjuster (All Lines) license from the Office of Insurance Commissioner of Puerto Rico.

Experience

• Five to seven years of claims adjusting experience.
• Liability claims experience required.
• Strong experience working within the Puerto Rico insurance market.
• Experience investigating, evaluating, negotiating, and resolving complex claims.

Skills and Knowledge

• Must be proficient in both Spanish and English.
• Must be able to communicate verbally and in writing in both Spanish and English.
• Strong oral and written communication skills, including presentation skills.
• PC literate, including Microsoft Office products.
• Demonstrated commitment to timely reporting.
• Strong interpersonal skills.
• Attention to detail and accuracy.
• Good time management and organizational skills.
• Ability to work independently or in a team environment.
• Ability to meet or exceed Performance Competencies.

WORK ENVIRONMENT

This is a hybrid position based in Puerto Rico, with remote/in-office requirements established by management.

When applicable and appropriate, consideration will be given to reasonable accommodations.

Mental

Clear and conceptual thinking ability; excellent judgment and discretion; ability to handle work-related stress; ability to manage multiple priorities simultaneously; and ability to meet deadlines.

Physical

• Must be able to stand and/or walk for long periods of time.
• Must be able to kneel, squat, or bend.
• Must be able to work outdoors in hot and/or cold weather conditions.
• Must have the ability to climb, crawl, stoop, kneel, and reach or work overhead.
• Must be able to lift or carry up to 50 pounds.
• Must be able to push or pull up to 100 pounds.
• Must be able to drive up to four hours per day.
• Must have continual use of manual dexterity.

Auditory/Visual

Hearing, vision, and talking.

The statements contained in this document are intended to describe the general nature and level of work being performed by a colleague assigned to this description. They are not intended to constitute a comprehensive list of functions, duties, or local variances. Management retains the discretion to add or change the duties of the position at any time.