Pie Insurance
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Remote

Claims Adjuster - Workers’ Compensation (Midwest)

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Employer Provided Salary: $60,000-$80,000 Annually
Salary data is provided by the employer. Please note this is not a guarantee of compensation.

Pie's mission is to empower small businesses to thrive by making commercial insurance affordable and as easy as pie. We leverage 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 make.

The Claims Adjuster will play a critical role in ensuring quality claim file management, service level agreements are met, and regulatory requirements are satisfied all while helping to create and provide an industry leading customer claims experience. This will be completed by working with internal and external partners to drive performance, identify trends, and report findings to internal Pie Leaders. The Claims Adjuster role does not currently involve active claim handling. However, this position will require direct claim handling activities as our program grows. 

How You’ll Do It

  • Claims Technical Management
    • Independently handle all aspects of the workers’ compensation claims from set-up to closure.
    • Conduct timely 3-point contact investigation, with focus on continued investigation as facts of the case change.
    • Mitigate claim exposure while achieving the best outcome.
    • Determine timely and accurate compensability decision within statutory requirements.
    • Set and adjust timely/accurate reserves within 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.
    • Comply with all 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 Quality Assurance (QA)
    • Responsible for ensuring claims are handled in accordance with established guidelines and service instructions. 
    • Ensures timely completion of file reviews, calibration sessions and analysis reports.
    • Identify claim handling trends by applying industry knowledge of the claims process, policies & procedures, and regulatory environment.
    • Meet regularly with Claims Leadership to provide QA results and recommendations for opportunities for improvement.
  • Claims Technical Oversight
    • Provide technical direction on claim decisions and resolution in partnership with our external Third Party Administrator (TPA) partner within the assigned authority level.
    • Assist as necessary in providing claim status to agents and insureds, coverage verification and loss run reports, etc.
  • Claims Customer Service
    • Serve as a point of contact for our partner agents and customers to provide general claim guidance and help set claim process expectations.
    • 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.
    • Advocate 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. 
  • Analytics 
    • Support Pie’s efforts to gather data to better inform our decisions, reporting and overall performance. 
    • Use data to generate reports to inform on claims program trends and performance to goals.
    • Work collaboratively with Pie leaders and teams in Product, Underwriting, Compliance, Sales, and Customer Success to analyze data and metrics.

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.  
  • Requires at least one Claims Adjuster License in one of the following states: CA, NY, IL, IN, MO, NE, WI, FL, GA (multiple states preferred)
  • Strong communication (written and verbal) skills, to deliver more complex information effectively.
  • Strong  problem solving skills to be able to manage complex 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 Slack is preferred.
  • Developed 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 reach beneficial outcomes.
  • Ability to make claim decisions to mitigate exposure while achieving the best outcome.

#LI-MW1 #LI-JF1

Base Compensation Range

$65,000$90,000 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 make all aspects of working with us as easy as pie. That includes our offer process. When we’ve identified a talented individual who we’d like to be a Pie-oneer , we work hard to present an equitable 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 has the option to be hybrid or remote. Hybrid work locations provide team members with the flexibility of working partially from our Denver or DC office and from home. Remote team members must live and work in the United States* (*territories excluded), and have access to reliable, high-speed internet.

Additional Information

Pie Insurance 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 origin, military service status, citizenship, or other protected characteristic.

Pie Insurance participates in the E-Verify program. Please click here, here and here for more information.

Pie Insurance is committed to protecting your personal data. Please review our Privacy Policy.  

Pie Insurance Announces $315 Million Series D Round of Funding

Built In honors Pie in its 2023 Best Places to Work Awards

Pie Insurance Named a Leading Place to Work in Colorado

 

#LI-REMOTE

#BI-REMOTE

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Candidate Location Eligibility:
Albuquerque, NM
Ann Arbor, MI
Atlanta, GA
Austin, TX
Baltimore, MD
Baton Rouge, LA
Birmingham, AL
Boise, ID
Boston, MA
Buffalo, NY
Charleston, SC
Charlotte, NC
Chicago, IL
Cincinnati, OH
Cleveland, OH
Colorado, CO
Columbus, OH
Dallas-Fort Worth, TX
Dayton, OH
Des Moines, IA
Detroit, MI
Fayetteville-Springdale-Rogers, AR
Greensboro, NC
Hampton Roads, VA
Hartford, CT
Houston, TX
Huntsville, AL
Indianapolis, IN
Jacksonville, FL
Kansas City, MO
Las Vegas, NV
Lexington, KY
Lincoln, NE
Little Rock, AR
Los Angeles, CA
Louisville, KY
Madison, WI
Memphis, TN
Miami, FL
Milwaukee, WI
Minneapolis–Saint Paul, MN
Nashville, TN
New Orleans, LA
New York City, NY
Ogden, UT
Oklahoma City, OK
Omaha, NE
Orlando, FL
Other US Location
Palm Bay-Melbourne-Titusville
Pensacola, FL
Peoria, IL
Philadelphia, PA
Phoenix – Mesa – Scottsdale, AZ
Pittsburgh, PA
Portland, ME
Portland, OR
Providence, RI
Provo, UT
Raleigh-Durham, NC
Reno, NV
Richmond, VA
Rochester, NY
Sacramento, CA
Salt Lake City, UT
San Antonio, TX
San Diego, CA
San Francisco, CA
San Luis Obispo, CA
Santa Cruz, CA
Seattle, WA
Spokane, WA
St. Louis, MO
Tallahassee, FL
Tampa Bay, FL
Tucson, AZ
Tulsa, OK
Washington DC
Wichita, KS
Wilmington, NC

What are Pie Insurance Perks + Benefits

Culture
Volunteer in local community
Partners with nonprofits
Open door policy
OKR operational model
Pair programming
Open office floor plan
Employee-led culture committees
Flexible work schedule
Pie provides employees with a flexible work schedule that includes Core hours.
Remote work program
Diversity
Highly diverse management team
Health Insurance & Wellness Benefits
Flexible Spending Account (FSA)
Disability insurance
Dental insurance
Vision insurance
Health insurance
Life insurance
Pet insurance
Wellness programs
Mental health benefits
Financial & Retirement
401(K)
401(K) matching
Company equity
Performance bonus
Pay transparency
Child Care & Parental Leave Benefits
Generous parental leave
We provide up to 16 weeks of parental leave for the primary caretaker. Pie also provides 16 weeks of leave for the secondary caretaker.
Family medical leave
Return-to-work program post parental leave
Fertility benefits
Vacation & Time Off Benefits
Unlimited vacation policy
Generous PTO
Generous PTO policy
Paid volunteer time
Paid holidays
Paid sick days
Bereavement leave benefits
Office Perks
Commuter benefits
Company-sponsored outings
Free snacks and drinks
Some meals provided
Company-sponsored happy hours
Onsite office parking
We offer team members a parking subsidy.
Relocation assistance
Home-office stipend for remote employees
Onsite gym
Professional Development Benefits
Lunch and learns
Promote from within
Mentorship program
Continuing education available during work hours
Online course subscriptions available
Customized development tracks

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