Claims Quality Auditor

Employer
Pronto Insurance
Location
Tampa, Florida
Salary
Not Specified
Posted
Jul 10, 2019
Closes
Aug 19, 2019
Ref
6389932#GIJtoGJS.1
Industry
Insurance
Category
Insurance

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

 

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