Claims Adjuster

Description

Job Summary: Documentary, technical, and regulatory analysis; negotiation of vehicle repairs; service authorization; and information and supplier management. Key Highlights: 1. Analysis and management of vehicle repair processes. 2. Negotiation and approval of services and parts with repair shops. 3. Guidance and resolution of inquiries for members and third parties. Receive, verify, analyze, monitor, record, communicate, and update information with involved parties; schedule repair processes until the vehicle is properly repaired. * Documentary analysis: Police report (BO), statements from involved parties, driver's license (validity, points, and category permitting vehicle operation), incident notification, images, dates, audio recordings, sketches, consistency among provided information, authenticity of documents; * Technical analysis: Causal relationship, road and vehicle speed, road signage, witness confrontations via phone or in person, verification of adherence inspection / re-inspection, number of incidents in the last 12 months, pre-existing damages; * Regulatory / Brazilian Traffic Code (CTB) analysis: Compliance with regulatory standards, active or inactive membership status, payment compliance, coverage under contracted products, adherence to CTB norms and rules; * Determine whether the incident is covered or not, communicate the decision to the member / third party, and perform appropriate records; * Identify and quote parts required to initiate and complete the repair; * Negotiate / approve with repair shops and intermediaries: labor and painting costs, parts supply, estimated repair completion date, and perform appropriate records; * Issue service and parts replacement (labor) authorization to commence work; * Analyze / negotiate / approve requests for additional parts and services; * Use operational systems SGA / CILIA to perform appropriate records, input information, send authorizations, and compare prices; * Request and evaluate legal analyses and respond to involved parties — (legal questions, claim denials, traffic laws, etc.); * Request and evaluate internal investigations and respond to involved parties; * Request, record, and update information regarding extrajudicial agreements / reimbursements / refunds to members and third parties; * Direct vehicles classified as PT (Total Loss) to the full indemnification department; * Guide, inform, resolve inquiries from members, third parties, internal teams, repair shops, etc., and perform appropriate records; * Monitor repair progress and update information in systems and with involved parties; * Identify new service providers (repair shops, auto-electricians, painters, body shops, upholstery shops, etc.); * Register suppliers as needed to meet demand in the region served by the association. In cases where no agreement is reached, notify the member / third party and convey that the process will remain on hold until a new supplier is identified; * Record and handle customer complaints. * Archive documentation related to settled incident cases. * Actively participate in daily routine meetings. * Conduct systematic audits to assess formal performance of partner repair shops. Minimum Education: Bachelor's Degree Driver's License Requirement: Category B * Senac Partnership * POP Services Discount * Partnerships with Educational Institutions * Clube Certo * POP Pharma * Igreen * SESC Benefit Program * Wellhub * Life Insurance * Dental Plan * Health Plan * Meal/food allowance * Mobility Allowance * Commuter Pass