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Salary: USD 80,000 - 100,000 / annual
Pie Insurance is transforming commercial insurance for small businesses through technology. As a Claims Adjuster specializing in Workers Compensation, you will manage the complete lifecycle of workers' compensation claims from setup through closure, ensuring quality claim file management and delivering an industry-leading customer experience.
You will independently handle all aspects of workers' compensation claims while adhering to Pie's Claims Best Practices and regulatory requirements. Key responsibilities include conducting timely three-point contact investigations, making accurate compensability decisions within statutory requirements, setting and adjusting reserves within authority limits, and administering statutory medical and indemnity benefits throughout the claim lifecycle. You will manage claim exposure mitigation, control legal activity with defense counsel, and prioritize early resolution opportunities through settlement negotiation.
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 will work collaboratively with TPA adjusters and claims partners to optimize outcomes and advocate for Pie's leading claims customer experience. The role includes identifying opportunities to improve claims operations, SOPs, protocols, and processes.
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 jurisdictional regulatory and statutory requirements, CMS/MSA requirements, claim adjudication, medical management, and litigation management. A high school diploma or equivalent is required; a bachelor's degree or equivalent experience with some college coursework is preferred. Experience with G-Suite Tools and collaboration platforms like Slack is advantageous.
