Senior Claims Adjuster

Introduction Welcome to Gallagher - a global community of people who bring bold ideas, deep expertise, and a shared commitment to doing what’s right. We help clients navigate complexity with confidence by empowering businesses, communities, and individuals to thrive. At Gallagher, you’ll find more than a job; you’ll find a culture built on trust, driven by collaboration, and sustained by the belief that we’re better together. Whether you join us in a client-facing role or as part of our brokerage division, our benefits and HR consulting division, or our corporate team, you’ll have the opportunity to grow your career, make an impact, and be part of something bigger. Experience a workplace where you’re encouraged to be yourself, supported to succeed, and inspired to keep learning. That’s what it means to live The Gallagher Way. Overview 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. As a Senior Claims Adjuster, you will manage and supervise end‑to‑end claims processes including investigation, evaluation, negotiation, and settlement. You’ll work closely with US‑based teams and clients, ensuring compliance with US insurance regulations and delivering exceptional customer service. How you’ll make an impact 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. About you Bachelor’s degree (Business, Law, or related field). 5+ years of experience in insurance claims (motor, property, casualty). Fluent in English and Spanish (B2 or C1 level). Strong analytical, negotiation, and communication skills. Experience in the insurance or reinsurance industry. Preferred Tools & Systems: Guidewire, Claimonix, CFX, Avaya, Microsoft Office Suite. #J-18808-Ljbffr