Senior Claims Adjuster, Workers Compensation

4 weeks 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

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