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 Quality Assurance Auditor will conduct regular audits and assessments of Pie's claims handling processes to ensure adherence to Claims Best Practices, regulatory standards, and internal guidelines. This role is responsible for reviewing claim files for compliance, identifying areas of non-compliance, and recommending corrective actions to improve claims quality. The auditor will collaborate with Claims teams, prepare detailed audit reports, and support the development of quality control policies and training programs that drive continuous improvement in claims performance and ensure regulatory compliance. How You’ll Do ItClaims Audit & Assessment: - Collaborate with Claims leadership to design, refine, and continuously improve the quarterly audit program and scoring methodology, ensuring alignment with operational realities while maintaining regulatory defensibility. - Partner with Claims to define: - Weighted scoring criteria - High-risk violation thresholds - File sampling strategy - Performance benchmarks tied to ≥95% compliance targets - Ensure the audit program reflects evolving statutory requirements, regulator audit trends, and internal risk drivers. - Conduct regular monthly and quarterly audits and assessments of quality management systems and claims handling processes - Review claim files to verify compliance with regulatory standards, statutory requirements, and internal guidelines - Evaluate claims for adherence to Pie's Claims Best Practices and quality standards - Assess claim documentation, investigation techniques, reserve adequacy, and settlement practices - Identify areas of non-compliance and recommend corrective actions to address deficiencies - Apply weighted scoring methodology to measure compliance performance and identify systemic risk patterns. - Apply established audit methodologies and sampling techniques to ensure comprehensive evaluations Documentation & Reporting: - Document monthly and quarterly audit findings with clear, detailed explanations of deficiencies and best practices observed - Prepare comprehensive audit reports for management that include findings, recommendations, and action items - Analyze data to identify trends, patterns, and areas for improvement across the claims organization - Provide timely feedback to adjusters and Claims leadership on audit results - Maintain accurate records of all audits, findings, and corrective action plans Quality Control & Process Development: - Collaborate with various departments to ensure quality standards are met consistently - Develop and update quality control policies and procedures based on audit findings and regulatory changes - Assist in developing quality assurance goals and objectives aligned with department strategies - Recommend process improvements to enhance claims quality and operational efficiency - Support the implementation of new quality standards and best practices Compliance & Corrective Action Monitoring - Monitor the implementation and effectiveness of corrective and preventive actions - Track remediation efforts to ensure deficiencies are addressed in a timely manner - Verify that corrective actions result in sustained improvements in claims quality - Coordinate with external auditors and facilitate external audit processes when needed - Stay current with regulatory changes and industry best practices that impact claims quality Training & Knowledge Sharing: - Train staff on quality assurance policies, procedures, and industry best practices - Provide coaching and guidance to adjusters on claim handling techniques and compliance requirements - Conduct training sessions on common audit findings and remediation strategies - Share knowledge of regulatory requirements and Claims Best Practices with Claims teams - Support Claims Learning & Development initiatives with quality-focused training content Cross-Functional Collaboration: - Partner with Claims Adjudication team to address quality issues and implement improvements - Work with Claims Regulatory Compliance team to ensure audits capture all compliance requirements - Collaborate with Claims Learning & Development team to develop targeted training based on audit findings - Coordinate with Claims Data & Analytics team to support quality reporting and trend analysis - Communicate with Claims leadership on quality trends and recommended actions The Right StuffRequired Experience & Education: - High School diploma or GED required; Bachelor's degree in Business Administration, Risk Management, or related field preferred - 5+ years of workers' compensation claims experience with strong understanding of claim handling practices - 2+ years of experience in claims auditing, quality assurance, or compliance roles preferred - Strong knowledge of Claims Best Practices and regulatory requirements across multiple jurisdictions - Experience conducting claim file reviews and documenting audit findings The use of AI in Application Review: To support a fair, efficient, and consistent hiring process, we use AI-powered tools to assist in the initial screening of applications. These tools help us identify qualifications and prior work experiences that align with the requirements of the role. We may also use AI assistant video tools during interviews to support note-taking and candidate evaluation. All AI-powered outputs are still subject to human oversight and decision-making at multiple stages of the process. By submitting your application, you acknowledge and consent to Pie utilizing these AI technologies to assist in our evaluation process. Base Compensation Range $75,000—$95,000 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 is remote. Remote team members must live and work in the United States (territories excluded) and have access to reliable, high-speed internet. Additional InformationPie 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. Safety First: Pie Insurance is committed to your security during the recruitment process. We will never ask you for credit card information or ask you to purchase any equipment during our interview or onboarding process. Pie Named to 2025 America's Best Startup Employers Pie Insurance 2025 State of Workplace Safety Report #LI-REMOTE #BI-REMOTE

• Review and audit medical claims for accuracy and compliance with company policies and benefit plan parameters. • Listen to customer service phone calls for accuracy and professionalism. • Provide feedback, coaching, and mentoring to claims and customer service staff members on results, best practices and compliance issues. • Assist in training efforts as needed. • Prepare summary and detailed reports on audit findings, trends, and recommendations for process enhancements. • Stay updated on industry changes in medical coding, billing regulations, and insurance policies. • Assist in developing and implementing audit policies and procedures. • Measure and report on performance guarantee results.

Posting Date 03/23/2026 2000 16th St, Denver, Colorado, 80202-5117, United States of America Job Description The Auditor, Clinical Quality performs internal audits that review the accuracy and effectiveness of internal controls, verifies completeness of patient medical records, and reviews compliance with standards, policies, and procedures. Essential Duties & Responsibilities: - Prepares and performs internal quality audits, including but not limited to, electronic and paper medical records, recordings, and live audits - Communicates and works with the team to resolve issues identified in the audit in a timely manner - Assists with results interpretation and communication to market leadership - Provides continuous quality improvement suggestions to leadership based on audit and reporting findings - Other duties, as assigned Minimum Qualifications: - A.D.N degree from accredited school of nursing; B.S.N preferred; three-year diploma from accredited diploma program may be substituted for nursing degree - Licensed Registered Nurse required - Minimum of three (5) years’ nursing experience; clinical operations experience preferred - Dialysis experience strongly preferred - Minimum of 2 years of direct patient care experience - Prior audit or quality experience preferred - Intermediate computer skills and proficiency in MS Word, Excel, PowerPoint presentations, and Outlook required - Travel required: up to 25% What We’ll Provide: More than just pay, our DaVita Rewards package connects teammates to what matters most. Teammates are eligible to begin receiving benefits on the first day of the month following or coinciding with one month of continuous employment. Below are some of our benefit offerings. Comprehensive benefits: Medical, dental, vision, 401(k) match, paid time off, PTO cash out Support for you and your family: Family resources, EAP counseling sessions, access Headspace®, backup child and elder care, maternity/paternity leave and more Professional development programs: DaVita offers a variety of programs to help strong performers grow within their career and also offers on-demand virtual leadership and development courses through DaVita’s online training platform StarLearning. #LI-CM5 At DaVita, we strive to be a community first and a company second. We want all teammates to experience DaVita as "a place where I belong." Our goal is to embed belonging into everything we do in our Village, so that it becomes part of who we are. We are proud to be an equal opportunity workplace and comply with state and federal affirmative action requirements. Individuals are recruited, hired, assigned and promoted without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, protected veteran status, or any other protected characteristic. This position will be open for a minimum of three days. The Salary Range for the role is $78,000.00 - $119,000.00 per year. If a candidate is hired, they will be paid at least the minimum wage according to their geographical jurisdiction and the exemption status for the position. New York Exempt: New York City and Long Island: $66,300.00/year, Nassau, Suffolk, and Westchester counties: $66,300.00/year, Remainder of New York state: $62,353.20/year New York Non-exempt: New York City and Long Island: $17.00/hour, Nassau, Suffolk, and Westchester counties: $17.00/hour, Remainder of New York state: $16.00/hour Washington Exempt: $80,168.40/year Washington Non-exempt: Bellingham: $19.13/hour, Burien: $21.63/hour, Everette: $20.77/hour, Unincorporated King County: $20.82/hour, Renton: $21.57/hour, Seattle: $21.30/hour, Tukwila: $21.65/hour, Remainder of Washington state: $17.13/hourFor location-specific minimum wage details, see the following link: DaVita.jobs/WageRates Compensation for the role will depend on a number of factors, including a candidate’s qualifications, skills, competencies and experience. DaVita offers a competitive total rewards package, which includes a 401k match, healthcare coverage and a broad range of other benefits. Learn more at https://careers.davita.com/benefits Colorado Residents: Please do not respond to any questions in this initial application that may seek age-identifying information such as age, date of birth, or dates of school attendance or graduation. You may also redact this information from any materials you submit during the application process. You will not be penalized for redacting or removing this information.

• Conduct audits of medical records for compliance • Collaborate with healthcare teams to ensure accurate billing • Provide feedback and training to staff on audit findings