About the job
Pie Insurance works to make commercial insurance more accessible and affordable for small businesses. By using technology, Pie streamlines how business owners purchase and manage their coverage.
The team brings together people from a range of backgrounds, including builders, dreamers, and entrepreneurs. Every decision at Pie is guided by the company’s core values and operating principles.
Role overview
The Claims Adjuster - Workers Compensation manages the entire lifecycle of workers’ compensation claims. This position emphasizes careful claim file management, strong customer service, and adherence to both Pie’s best practices and legal or regulatory standards. Adjusters collaborate with internal teams and external partners to achieve positive outcomes for clients and look for ways to reduce claims exposure.
Claims technical management
- Independently handle all phases of workers’ compensation claims from initiation to closure.
- Conduct prompt three-point contact investigations and adjust strategies as new details become available.
- Identify and act on opportunities to minimize claim exposure.
- Make timely, accurate compensability decisions in line with statutory requirements.
- Set and update reserves within authority, ensuring alignment with case facts and company guidelines.
- Administer statutory medical and indemnity benefits throughout the claim process.
- Maintain compliance with all applicable statutes, rules, and regulations.
- Oversee legal proceedings with counsel, managing legal costs and related expenses.
- Prioritize early resolution, assess exposure, and negotiate settlements when appropriate.
Claims customer service
- Act as a liaison for partner agents and clients, offering guidance and setting expectations for the claims process.
- Provide claim status updates, coverage verification, and loss run reports to agents and insureds as needed.
- Deliver strong customer service to both internal and external stakeholders.
- Work collaboratively with TPA adjusters and other partners to improve the claims process.
