Pie Insurance · 12 hours ago
(OR, NV, CA) Claims Adjuster, Workers Compensation
United States
Full-time
Remote
Entry, Mid Level
$70K/yr - $90K/yr
2+ years expPie Insurance is dedicated to empowering small businesses by making commercial insurance affordable and accessible. The Claims Adjuster will manage all aspects of workers' compensation claims, ensuring compliance with regulations while providing excellent customer service and optimizing claims outcomes.
Financial ServicesInsuranceInsurTechSmall and Medium Businesses
Responsibilities
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 decisions 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
Serve as a point 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
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
Qualification
Required
High School Diploma or equivalent is required
Minimum of 2-years workers' compensation claims experience is required
Claims experience working in OR or NV required, and CA is 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
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
Preferred
Bachelor's Degree or equivalent experience with some college coursework is preferred
Experience using G-Suite Tools, and collaboration tools like Slack is preferred
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
Company
Pie Insurance
Pie Insurance is an insurance company specializing in small business.
201-500 employees
Funding
Current Stage
Late StageTotal Funding
$621MKey Investors
Gallatin Point CapitalSVB CapitalGreycroft
2022-09-21Series D· $315M
2021-03-25Series C· $118M
2020-05-28Series B· $127M
Leadership Team
John Swigart
Co-Founder and CEO
Audra Foglietta
Chief Financial Officer
Recent News
Hartford Business Journal
2025-08-14
The Philadelphia Inquirer
2025-08-13
Company data provided by crunchbase