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Pie Insurance is transforming commercial insurance for small businesses through technology. As a Senior Claims Adjuster specializing in Workers Compensation, you will independently manage the full lifecycle of workers' compensation claims from setup through closure, with a focus on high-dollar, high-exposure, and complex cases.
You will be responsible for conducting thorough 3-point contact investigations, making timely and accurate compensability decisions within statutory requirements, and setting/adjusting reserves consistent with case facts and company best practices. Your technical expertise will include managing medical and indemnity benefits administration, controlling legal activity with defense counsel, and identifying early resolution and settlement opportunities to achieve favorable outcomes while mitigating exposure.
Beyond claims technical management, you will serve as a key point of contact for partner agents and customers, providing claim guidance, status updates, coverage verification, and loss run reports. You'll advocate for an industry-leading claims customer experience and work to continuously improve claims operations by identifying gaps and opportunities in service delivery, SOPs, and processes.
Required qualifications include a minimum of 5 years of workers' compensation claims adjusting experience (carrier background preferred), active licensing in applicable states, and advanced knowledge of jurisdictional regulatory and statutory requirements, CMS/MSA requirements, and claim adjudication/medical/litigation management. You should demonstrate strong problem-solving skills, the ability to analyze multiple data points and make sound decisions with minimal guidance, and excellent written and verbal communication skills. The role also values your ability to mentor junior adjusters and work collaboratively across internal and external teams.
