About the job
At Pie Insurance, we are dedicated to empowering small businesses to flourish by making commercial insurance both affordable and straightforward. Through innovative technology, we are transforming the way small enterprises purchase and interact with commercial insurance.
Like our small business clients, our team embodies diversity with a mix of builders, dreamers, and entrepreneurs, all guided by our core values and operating principles that shape every decision we make.
The Claims Adjuster will be crucial in ensuring comprehensive claim file management and delivering an exceptional customer claims experience. This role involves adhering to Pie's best practices for claims and complying with regulatory and statutory guidelines. You will collaborate with internal and external stakeholders to achieve top-tier performance, discover claim mitigation opportunities, and secure favorable outcomes for our clients.
Your Responsibilities
Claims Technical Management:
- Manage all facets of workers’ compensation claims from initiation to resolution independently.
- Conduct timely three-point contact investigations while adapting as case facts evolve.
- Mitigate claim exposure to achieve optimal results.
- Make timely and accurate compensability decisions in line with statutory requirements.
- Set and adjust reserves promptly and accurately within authority limits, ensuring alignment with case facts and company best practices.
- Administer statutory medical and indemnity benefits throughout the claim lifecycle.
- Ensure compliance with relevant statutory guidelines, rules, and regulations.
- Oversee legal proceedings with counsel, managing legal expenses and costs effectively.
- Prioritize opportunities for early resolution, assess claim exposure, and negotiate settlements.
Claims Customer Service:
- Act as a liaison for our partner agents and clients, providing guidance and setting expectations for the claims process.
- Assist in offering claim status updates, coverage verification, and loss run reports to agents and insureds as needed.
- Deliver outstanding customer service to both internal and external stakeholders.
- Engage in collaboration with TPA adjusters and other partners to enhance the claims process.