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Salary: USD 80,000 - 100,000 / annual
Pie Insurance is seeking a Claims Adjuster specializing in Workers Compensation to join their claims team in California. This role is responsible for managing the full lifecycle of workers' compensation claims from setup through closure, ensuring quality claim file management and delivering an industry-leading customer claims experience.
Key responsibilities include independently handling all aspects of workers' compensation claims, conducting timely three-point contact investigations, and making accurate compensability decisions within statutory requirements. You will set and adjust reserves within authority limits, administer statutory medical and indemnity benefits, and manage legal activity with defense counsel throughout litigation. The role requires prioritizing early resolution opportunities, evaluating claim exposure, and negotiating settlements to achieve favorable outcomes while mitigating exposure.
Beyond technical claims management, you will serve as a primary point of contact for partner agents and customers, providing claim guidance, status updates, coverage verification, and loss run reports. You'll work collaboratively with TPA adjusters and claims partners to optimize outcomes and continuously improve claims operations by identifying service gaps and process improvements.
Required qualifications include a minimum of 2 years of workers' compensation claims experience with specific experience working in California. You must have strong written and verbal communication skills, excellent problem-solving abilities, and demonstrated knowledge of claim adjudication, medical management, and litigation management. Familiarity with G-Suite tools and collaboration platforms like Slack is preferred. A high school diploma is required; a bachelor's degree or equivalent experience with college coursework is preferred.
