Senior Claims Adjuster, Workers Compensation

The role

The Senior Claims Adjuster manages workers' compensation claims from set-up to closure. This role involves evaluating complex claims, determining compensability, and managing legal activity to deliver favorable outcomes.

What you will do

• Independently handle all aspects of workers' compensation claims from set-up to closure.
• Evaluate and handle high dollar, high exposure, complex claims.
• Conduct timely 3-point contact investigation.
• Determine timely and accurate compensability decisions within statutory requirements.
• Set and adjust timely/accurate reserves within authority limits.
• Present claims to senior management, internal and external stakeholders.
• Administer statutory medical and indemnity benefits.
• Control legal activity with defense counsel through the litigation process.
• Prioritize early resolution opportunities and negotiate settlement.
• Serve as a point of contact for partner agents and customers.

Required qualifications

• High School Diploma or equivalent
• Minimum of 5-years workers' compensation claim adjusting experience
• Active licensing in applicable states
• Strong communication (written and verbal) skills
• Strong problem-solving skills
• 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 make claim decisions to mitigate exposure while achieving the best outcome
• Ability to use skills to overcome conflict and reach beneficial outcomes
• Ability to mentor junior adjusters

Nice to have

• Bachelor's Degree or equivalent experience with some college coursework
• carrier background
• claims experience in FL, GA, NC, SC, and TN
• Experience using G-Suite Tools and collaboration tools like Slack

Benefits

• Competitive cash compensation
• Comprehensive health plans
• Generous PTO
• Future focused 401k match
• Generous parental and caregiver leave
• Discretionary bonuses may be granted each year based on company performance

Before you apply

• Remote team members must live and work in the United States (territories excluded)
• Remote team members must have access to reliable, high-speed internet
• By submitting your application, you acknowledge and consent to Pie utilizing AI technologies to assist in our evaluation process

About the company

Pie leverages technology to transform how small businesses buy and experience commercial insurance. The company aims to empower small businesses to thrive by making commercial insurance affordable and easy.