Claims Quality Auditor
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
Employment Status: Permanent/ Full Time
Job Location: Florida
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