Senior Claims Adjuster, Workers Compensation

4 hours, 31 minutes ago
Full-time
Senior
Operations
Pie Insurance

Pie Insurance

Pie Insurance is a company that specializes in providing affordable and easy-to-access small business insurance, including workers' compensation and commercial auto coverage. Their data-driven technology ensures excellent coverage at competitive prices...

Insurance
251-1K
Founded 2017
$630M raised

Description

  • Independently handle workers’ compensation claims from set-up through closure.
  • Evaluate and manage high-dollar, high-exposure, complex claims.
  • Conduct timely investigation and continue fact development as claim details change.
  • Determine compensability decisions within statutory requirements.
  • Set and adjust reserves accurately within authority limits.
  • Administer statutory medical and indemnity benefits throughout the life of the claim.
  • Control litigation activity with defense counsel while managing legal fees and costs.
  • Prioritize early resolution, evaluate exposure, and negotiate settlements.
  • Serve as a point of contact for partner agents and customers on claim guidance and expectations.
  • Improve claims operations, SOPs, protocols, and service processes.

Requirements

  • High school diploma or equivalent required.
  • Bachelor’s degree or equivalent experience with some college coursework preferred.
  • Minimum 5 years of workers’ compensation claim adjusting experience required.
  • Carrier background preferred.
  • Experience in 3 or more jurisdictions from FL, GA, NC, SC, TN, and AL preferred, with emphasis on NC, TN, and AL.
  • Active licensing in applicable states required.
  • Advanced knowledge of jurisdictional regulatory and statutory requirements and CMS/MSA requirements.
  • Advanced knowledge and experience in claim adjudication, medical, and litigation management.
  • Experience using G-Suite tools and collaboration tools like Slack preferred.
  • Strong written and verbal communication skills and strong problem-solving ability.

Benefits

  • Base compensation range of $85,000 to $110,000 USD.
  • Competitive cash compensation.
  • Comprehensive health plans.
  • Generous PTO.
  • Future-focused 401(k) match.
  • Generous parental and caregiver leave.
  • Eligible for discretionary bonuses based on company performance.
  • Remote role for U.S.-based candidates with reliable high-speed internet.

Interested in this position?

Apply directly on the company website

Apply Now

Similar Roles

Assistant Manager, Professional Chapter Communities

American Marketing Association 1K-5K Professional Services

The American Marketing Association is hiring an Assistant Manager, Professional Chapter Communities to support and strengthen the operations, engagement, and volunteer leadership of its Professional Chapters across the U.S.

Salesforce WordPress
4 hours, 16 minutes ago

Shared Services Specialist

Private Health Management 201-500 Healthcare

Private Health Management is hiring two remote Shared Services Specialists to support provider network, partner benefits, and medical records operations across the U.S. as part of a flexible team focused on improving care-team support and operational turnaround.

4 hours, 31 minutes ago

Events Manager

Launch Potato 51-250 Professional Services

Launch Potato is hiring an Events and Partnerships Program Manager to own its external conference and trade show program for revenue teams, ensuring each event is strategically selected, tightly executed, and tied to business outcomes.

4 hours, 31 minutes ago

Virtual Patient Coordinator (Mandarin Speaking)

Spring Fertility 251-1K Health Care Providers & Services

Spring Fertility is hiring a full-time remote Virtual Patient Coordinator to serve as the first point of contact for patients and support their registration and consultation journey.

4 hours, 46 minutes ago

You're on a roll! Sign up now to keep applying.

Sign Up

Already have an account? Log in

Used by 14,729+ remote workers