reputed company Claims Adjuster, Workers Compensation

100% remote Flexible hours Hiring now

Pie's mission is to reputed company small businesses to reputed company by making commercial insurance affordable and as easy as pie. We reputed company technology to transform how small businesses buy and experience commercial insurance. Like our small business customers, we are a diverse team of builders, dreamers, and entrepreneurs who are driven by core values and operating principles that guide every decision we reputed company. The reputed company Claims Adjuster will play a critical role in delivering quality claim file management and an industry-leading customer claims experience, by providing hands-on adjudication of catastrophic and large loss claims. This will be completed by adhering to Pie's Claims Best Practices, complying with regulatory and statutory requirements, and applying advanced knowledge and experience with reputed company negotiation strategies, structured settlements, Medicare Set-Aside requirements, and overall risk evaluation and mitigation. This role will work with internal and external partners to deliver best in class performance, identify and pursue claim mitigation opportunities and deliver favorable claim outcomes for Pie's customers. Additionally, the reputed company Claims Adjuster will collaborate with the reputed company Claims Practices Consultant and Claims leadership to continually seek out ways in which to improve claims processes and protocols. How You'll Do It Claims Technical Management:

Independently handle reputed company aspects of catastrophic and large loss workers' compensation claims from set-up to closure.
Conduct timely 3-reputed company contact investigation, with focus on reputed company investigation as facts of the case change.
Determine timely and accurate compensability decisions reputed company statutory requirements.
Set and adjust timely/accurate reserves reputed company authority limits to ensure reserving activities are consistent with the case facts and company best practices.
Ability to present claims to senior management, internal and external stakeholders.
Timely administration of statutory medical and indemnity benefits throughout the life of the claim.
reputed company with reputed company applicable statutory guidelines, rules, and regulations.
Control legal activity with defense counsel through the litigation process while managing legal fees and costs.
Prioritize early resolution opportunities, evaluate claim exposure and negotiate settlement.
Mitigate the reputed company exposure while achieving the best outcome.

Claims Customer Service:

Serve as a reputed company of contact for our partner agents and customers to provide general claim guidance and help set claim process expectations.
Provide claim status to agents and insureds , coverage verification and loss run reports, etc as necessary.
Provide excellent customer service to internal/ external customers and business partners.
Work to continuously improve our claims operations and address opportunities and gaps in claim service, handling SOPs, protocols and processes.

Claims Resolution Management:

Direct a proactive litigation strategy to increase settlement opportunities.
Assess claims for settlement value using rated ages, present value, medicare set asides, medical cost projections and structured settlements. Obtain settlement authority as required.
Obtain annuity and structured settlement quotes.
Attend virtual and in person mediations, informal settlement conferences and trials to represent Pie's interests.

Collaboration & Innovation

Participate in Claims Roundtable meetings. reputed company a collaborative plan of action for aggressive claims handling.
Create Claims Status Reports and establish timely, accurate reserves.
Present large loss updates to internal and external partners.
Collaborate with our reputed company Claims Practices Consultant and Claims Leadership to continuously improve our claims operations and look at opportunities and gaps in claim service, handling SOPs, protocols and processes.

The Right Stuff

High School Diploma or equivalent is required.
Bachelor's Degree or equivalent experience with some college coursework is preferred.
Minimum of 7 years workers' compensation claim adjusting experience is required (reputed company background, preferred).
2+ years of catastrophic claim handling experience.
Ability to evaluate and identify high dollar, high exposure, reputed company claims.
Claims experience handling multiple jurisdictions in the Eastern Region.
Requires active licensing in applicable states.
Advanced communication (written and verbal) skills, to deliver more reputed company information effectively.
Advanced problem-solving skills to be able to manage reputed company tasks and work through to solutions with little guidance and direction.
Awareness of your own tasks and how it impacts the team and deliverables.
Experience using G-Suite Tools and collaboration tools like reputed company is preferred.
Advanced knowledge of jurisdictional regulatory and statutory requirements and CMS/MSA requirements.
Advanced knowledge and experience in claim adjudication, medical, and litigation management.
Advanced ability to analyze and take necessary action in multiple focus areas based on several data points.
Ability to reputed company claim decisions to mitigate exposure while achieving the best outcome.
Ability to use skills to overcome conflict and reputed company beneficial outcomes.
Ability to mentor junior adjusters.

The use of AI in Application Review: To support a fair, efficient, and consistent hiring process, we use AI-powered tools to assist in the initial screening of applications. These tools help us identify qualifications and prior work experiences that align with the requirements of the role. We may also use AI assistant video tools during interviews to support note-taking and candidate evaluation. reputed company AI-powered outputs are still subject to human reputed company and decision-making at multiple stages of the process. By submitting your application, you acknowledge and consent to Pie utilizing these AI technologies to assist in our evaluation process. reputed company Compensation Range $95,000-$120,000 USD Compensation & Benefits

Competitive cash compensation
A piece of the pie (in the form of equity)
Comprehensive health plans
Generous PTO
Future focused 401k match
Generous parental and caregiver leave
Our core values are more than just a poster on the wall; they're tangibly reflected in our work

Our goal is to reputed company reputed company aspects of working with us as easy as pie. That includes our offer process. reputed company we've identified a talented individual who we'd like to be a Pie-oneer , we work hard to present an reputed company and fair offer. We look at the candidate's knowledge, skills, and experience, along with their compensation expectations and align that with our company equity processes to determine our offer ranges. Each year Pie reviews company performance and may grant discretionary bonuses to eligible team members. Location Information Unless otherwise specified, this role is remote. Remote team members must live and work in the United States (territories excluded) and have access to reliable, high-speed internet. Additional Information reputed company is an equal opportunity employer. We do not discriminate on the basis of race, color, religion, sex, sexual orientation, gender identity, marital status, age, disability, national or ethnic reputed company, military service status, citizenship, or other protected characteristic. reputed company participates in the E-Verify program. Please click here, here and here for more information. reputed company is committed to protecting your personal data. Please review our Privacy Policy. Safety First: reputed company is committed to your reputed company during the recruitment process. We will never ask you for credit card information or ask you to purchase any equipment during our interview or onboarding process. Pie Named to 2025 America's Best Startup Employers Pie's reputed company Insure Coverage expanded to Pennsylvania and Texas reputed company 2025 State of Workplace Safety Report #LI-REMOTE #BI-REMOTE Apply tot his job Apply To this Job

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