Claims Adjuster- ATR at Fred Loya Insurance Agency in McAllen, TX

Position Summary

The ATR Adjuster investigates, evaluates, negotiates, and resolves assigned casualty claims in accordance with policy provisions, applicable laws and regulations, and Company claims-handling standards. This role manages attorney-represented and unrepresented claims, provides timely and professional service to all parties, maintains accurate reserves and documentation, and works toward fair, efficient, and well-supported claim resolutions.

Essential Duties and Responsibilities

• Review and interpret insurance policies, endorsements, and related contract documents to confirm applicable coverage.

• Investigate claims and determine liability by analyzing reports and supporting documents, conducting telephone interviews, and evaluating negligence and damages.

• Manage attorney-represented bodily injury claims and as assigned, claims involving unrepresented parties.

• Evaluate claim exposure and negotiate fair, reasonable, and well-supported settlements with attorneys, claimants, and other authorized parties.

• Handle Medical Payments and Personal Injury Protection claims in accordance with policy provisions and applicable requirements.

• Establish and maintain appropriate reserves based on current claim exposure and update reserves as new information becomes available.

• Maintain a timely, accurate, and complete claim file by documenting contacts, evaluations, decisions, negotiations, and other activities.

• Communicate coverage, liability, claim status, and settlement decisions clearly and professionally.

• Deliver courteous, responsive, and solution-focused service throughout the claims process.

• Manage an assigned pending inventory, prioritize competing deadlines, and complete required follow-up within established service standards.

• Comply with all Company casualty claims practices, procedures, authority levels, confidentiality requirements, and applicable laws and regulations.

• Maintain all required adjuster licenses, continuing education requirements, and remain in good standing in each assigned jurisdiction.

• Perform other duties and special assignments as directed by management.

Qualifications and Requirements

• Ability to read, interpret, and apply insurance policies, contracts, statutes, regulations, and claims procedures.

• Strong analytical, investigative, decision-making, negotiation, and problem-solving skills.

• Excellent written and verbal communication skills, including the ability to discuss coverage, liability, damages, and bodily injury settlements with attorneys and other parties.

• Ability to work in a fast-paced environment, adapt to changing priorities, manage current pending inventory, and meet deadlines with limited supervision.

• Sound judgment, professionalism, discretion, and attention to detail when handling sensitive and confidential information.

• Proficiency with Microsoft Office applications, including Word, Excel, Outlook, and PowerPoint; ability to learn Company claims systems.

• Ability to obtain and maintain a Texas All-Lines Adjuster license and any additional licenses required for assigned jurisdictions.

• Maintain continuing education requirements to maintain adjuster licenses up to date.

Education and Experience

• Bachelor's degree from an accredited college or university or 2+ years casualty adjusting experience.

• Claims handling, insurance, legal, negotiation, or customer service experience preferred.

• Experience handling bodily injury or attorney-represented claims preferred.