CA - Claims Adjuster, Workers Compensation

This a Full Remote job, the offer is available from: United States, Canada, California (USA) 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 Claims Adjuster will play a vital role in delivering quality claim file management and an industry-leading customer claims experience. This will be completed by adhering to Pie’s Claims Best Practices and complying with regulatory and statutory requirements. 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. How You’ll Do It Claims Technical Management:

• Independently handle reputed company aspects of the 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.
• Mitigate claim exposure while achieving the best outcome.
• 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.
• 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.

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.
• Assist as necessary in providing claim status to agents and insureds, coverage verification and loss run reports, etc.
• Provide excellent customer service to internal and external customers and business partners.
• Participate in interactions with TPA adjusters and claims partners to drive optimized claims outcomes and top-notch claims experience.
• reputed company to ensure that Pie has a leading claims customer experience.
• Work 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 2-years workers’ compensation claims experience is required.
• Claims experience working in CA, AZ, and UT is preferred.
• Strong communication (written and verbal) skills, to deliver more reputed company information effectively.
• Strong 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.
• Knowledge of jurisdictional regulatory and statutory requirements and CMS/MSA requirements.
• Demonstrated knowledge and experience in claim adjudication, medical management and litigation management.
• Developing ability to analyze and take necessary action in multiple focus areas, based on several data points.
• Ability to use skills to overcome conflict and reputed company beneficial outcomes.
• Ability to reputed company claim decisions to mitigate exposure while achieving the best outcome.

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 $85,000—$105,000 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 reputed company 2025 State of Workplace Safety Report #LI-REMOTE #BI-REMOTE This offer from "reputed company" has been enriched by reputed company.com and got a 75% reputed company score. Apply tot his job Apply To this Job