Pie Insurance logo
Pie Insurance

Pie Insurance wants to make purchasing workers’ compensation insurance “easy as pie” for small businesses. Since its founding in 2017, the Washington, DC, startup—with a se

Claims Adjuster, Workers Compensation

Location

United States

Posted

34 days ago

Salary

$70K - $90K / year

Seniority

Junior

Bachelor Degree2 yrs expEnglishG-Suite ToolsSlack

Job Description

Claims Adjuster, Workers Compensation

Pie Insurance

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 Adjuster will play a vital role in delivering quality claim file management and an industry-leading customer claims experience. This will be completed by adhering to Pie’s Claims Best Practices and complying with regulatory and statutory requirements. This role will work with internal and external partners to deliver best in class performance, identify and pursue claim mitigation opportunities and deliver favorable claim outcomes for Pie’s customers. How You’ll Do ItClaims Technical Management: - 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. Claims Customer Service: - 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. The Right Stuff - High School Diploma or equivalent is required. - Bachelor's Degree or equivalent experience with some college coursework is preferred. - Minimum of 2-years workers’ compensation claims experience is required. - Claims experience working in at least two of these states is preferred: Alabama, Arkansas, Colorado, Connecticut, Delaware, DC, Indiana, Iowa, Kansas, Kentucky, Louisiana, Minnesota, Mississippi, Nebraska, New Hampshire, Rhode Island, Vermont, West Virginia, Wisconsin. - 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. - Experience using G-Suite Tools, and collaboration tools like Slack is preferred. - 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 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 $70,000—$90,000 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

Benefits

  • 401(K), 401(K) matching, Commuter benefits, Company equity, Company-sponsored outings, Customized development tracks, Dental insurance, Disability insurance, Volunteer in local community, Family medical leave, Flexible Spending Account (FSA), Flexible work schedule, Generous parental leave, Generous PTO, Company-sponsored happy hours, Health insurance, Highly diverse management team, Open door policy, Life insurance, Mentorship program, Paid volunteer time, Online course subscriptions available, Onsite gym, Open office floor plan, Paid holidays, Pair programming, Paid sick days, Onsite office parking, Partners with nonprofits, Performance bonus, Pet insurance, Promote from within, Lunch and learns, Relocation assistance, Remote work program, Return-to-work program post parental leave, Free snacks and drinks, Team based strategic planning, OKR operational model, Continuing education available during work hours, Unlimited vacation policy, Vision insurance, Wellness programs, Some meals provided, Mental health benefits, Home-office stipend for remote employees, Fertility benefits, Employee-led culture committees, Pay transparency, Mother's room, Floating holidays, Bereavement leave benefits

Related Categories

Related Job Pages

More Claims Specialist Jobs

Full TimeRemoteTeam 1,001-5,000H1B No Sponsor

Role Description Examines claims data and conducts investigations into routine and moderately complex claims to determine coverage, compensability, subrogation and benefits under moderate supervisory direction. Adjusts and manages claims within the limit of assigned authority. This is a fully remote position, but high priority for candidates in the Pacific Time Zone. What you will do for C&F: - Must be well versed in California Compensation statute claims. - Receives lost time and complex medical only assignments. - Verifies and determines applicability of coverage. - Initiate 24-hour contact with employer, employee and 48-hour contact with attending physician. - Handles catastrophic claims with supervisory oversight. - Conducts telephone investigations as required by company claims handling manual and procedures. - Evaluates and adjusts claims within the limits of authority. - Consults with Claim Manager on those claims where assistance and consultation is needed. - Make assignments to nurse case management when indicated, monitoring their billing and performance. - Sets reserves for anticipated exposure up to authority limits. - Completes mandatory Reserve Worksheets. - Establishes reserves requiring complex analysis with lifetime pharmacy and cost inflation. - Coordinates return to work (RTW) and set target dates. - Maintain diaries on maximum three (3) month intervals. - Documents files in the claims system. - Reviews medical bills for causal relationship, medical bill charges for appropriateness and approves payments. - Adheres to special account handling (SHI) instructions. - Attend account meetings by telephone and in-person. - Manages litigation on the files. Qualifications - College degree, B.A. or equivalent experience. - Minimum of 3 years’ experience handling workers compensation claims. - Strong organizational skills. - Good time management skills. - Bilingual language a big plus. - Excellent verbal and written communication skills are essential. - Strong aptitude and knowledge of Microsoft Office programs and the ability to quickly learn new programs. - Will abide by departmental policies and procedures, including authority levels, to comply with C&F’s risk management controls. Benefits - Competitive compensation package. - Generous 401K employer match. - Employee Stock Purchase plan with employer matching. - Generous Paid Time Off. - Excellent benefits that go beyond health, dental & vision, focused on your whole family’s wellness, including physical, mental and financial wellbeing. - A wealth of ways for you to keep learning, including tuition reimbursement, industry-related certifications and professional training. - A dynamic, ambitious, fun and exciting work environment. - Encouragement of social and community responsibility, matching donation program, volunteer opportunities, and an employee-driven corporate giving program.

California + 1 moreAll locations: California | PST (UTC-8)
$55.8K - $104.9K / year
Arrive Logistics logo

Claims Analyst

Arrive Logistics

We Deliver, So You Can. 📍Austin | San Antonio | Chicago | Tampa | Guadalajara 🔜 Phoenix & Columbus

Full TimeRemoteTeam 1,001-5,000Since 2014H1B No Sponsor

Who We Are Arrive Logistics is a leading transportation and technology company in North America with plans to grow significantly year over year. Our success is a testament to our remarkable team and what we’re building together. We’re committed to providing employees with a meaningful work experience and have established an award-winning culture that supports personal and career development in a fun, casual, and collaborative environment. Who We Want As a Claims Analyst, you will serve as a subject matter expert and critical problem solver, taking full ownership of a portfolio of complex and high-value cargo claims (frequently exceeding $100,000). You will drive comprehensive claim management from initiation to resolution, integrating strategic analysis of claims trends to identify risks and develop proactive solutions. This role demands astute financial oversight, a deep understanding of legal and financial instruments, and leadership in external communications and stakeholder relationships. You will leverage advanced industry knowledge and business acumen to optimize claims operations, ensure financial integrity, and mentor junior team members, acting as a key cross-functional leader to protect the company's interests and drive strategic outcomes. What You'll Do - Advanced Claims Operations & Trend Analytics: Independently manage a portfolio of complex cargo claims from initial filing to final resolution, ensuring efficient, accurate, and timely handling. This includes skillfully negotiating settlements, precisely processing all related financial transactions, and analyzing claims trends to identify recurring issues and significant financial exposure, with actionable findings presented to leadership. - High-Level External Relations & Advocacy: Lead and manage all high-level external communications and relationships with minimal management assistance. Independently lead scheduled meetings with external parties, addressing complex inquiries, driving resolutions, and identifying actionable items to bring back to management for strategic consideration. - Financial Integrity & Legal Compliance: Comprehensively manage and reconcile all financial aspects of a claims portfolio, ensuring accurate balancing of all receivables and payables. Possess a deep understanding of the distinctions between various payment methods and the strategic reasons for issuing legal documents like releases and assignments of rights in advance of cash payments. Utilize financial insights from claim trends to inform proactive strategies and protect the company's financial interests. - Expert Claim Resolution & Mentorship: Master the management of complex and high-value claims, frequently exceeding $100,000. Leverage deep industry knowledge to navigate intricate investigations and apply a comprehensive understanding of regulations, terms, and conditions to all claim values. Provide mentorship and guidance to junior team members on processing claims across the full range of values. - Operational Strategy & Cross-Functional Synergy: Leverage deep business acumen and a comprehensive understanding of the transportation industry to strategically oversee claim operations, optimizing efficiency and ensuring adherence to time standards across the team. Drive and foster highly effective, cooperative working relationships with all internal departments, acting as a key liaison to streamline processes and mentor others in collaborative best practices. Qualifications - Bachelor’s degree in Business Administration, Finance, Accounting, or related field, or 3 years of professional experience in customer service, administrative support, or the insurance industry. - 5+ years of experience managing claims required. Experience in cargo claims in a 3PL environment preferred. - Exceptional organization skills and high attention to detail. - Proficient in Google Suite; conduct basic risk analysis and general data reporting. - Superior written and verbal communication skills. You understand that proactive communication is key. - Ability to work both independently and collaboratively. - Strong critical thinking, judgment, and decision-making skills. The Perks of Working With Us - Take advantage of our comprehensive benefits package, including medical, dental, vision, life, disability, and supplemental coverage. - Invest in your future with our matching 401(k) program. - Build relationships and find your home at Arrive through our Employee Resource Groups. - Maximize your wellness with free counseling sessions through our Employee Assistance Program - Take time to manage your physical and mental health - we offer company paid holidays, paid vacation time and wellness days. - Receive 100% paid parental leave when you become a new parent. - Get paid to work with your friends through our Referral Program!

Texas
Arrive Logistics logo

Claims Analyst

Arrive Logistics

We Deliver, So You Can. 📍Austin | San Antonio | Chicago | Tampa | Guadalajara 🔜 Phoenix & Columbus

Full TimeRemoteTeam 1,001-5,000Since 2014H1B No Sponsor

Who We Are Arrive Logistics is a leading transportation and technology company in North America with plans to grow significantly year over year. Our success is a testament to our remarkable team and what we’re building together. We’re committed to providing employees with a meaningful work experience and have established an award-winning culture that supports personal and career development in a fun, casual, and collaborative environment. Who We Want As a Claims Analyst, you will serve as a subject matter expert and critical problem solver, taking full ownership of a portfolio of complex and high-value cargo claims (frequently exceeding $100,000). You will drive comprehensive claim management from initiation to resolution, integrating strategic analysis of claims trends to identify risks and develop proactive solutions. This role demands astute financial oversight, a deep understanding of legal and financial instruments, and leadership in external communications and stakeholder relationships. You will leverage advanced industry knowledge and business acumen to optimize claims operations, ensure financial integrity, and mentor junior team members, acting as a key cross-functional leader to protect the company's interests and drive strategic outcomes. What You'll Do - Advanced Claims Operations & Trend Analytics: Independently manage a portfolio of complex cargo claims from initial filing to final resolution, ensuring efficient, accurate, and timely handling. This includes skillfully negotiating settlements, precisely processing all related financial transactions, and analyzing claims trends to identify recurring issues and significant financial exposure, with actionable findings presented to leadership. - High-Level External Relations & Advocacy: Lead and manage all high-level external communications and relationships with minimal management assistance. Independently lead scheduled meetings with external parties, addressing complex inquiries, driving resolutions, and identifying actionable items to bring back to management for strategic consideration. - Financial Integrity & Legal Compliance: Comprehensively manage and reconcile all financial aspects of a claims portfolio, ensuring accurate balancing of all receivables and payables. Possess a deep understanding of the distinctions between various payment methods and the strategic reasons for issuing legal documents like releases and assignments of rights in advance of cash payments. Utilize financial insights from claim trends to inform proactive strategies and protect the company's financial interests. - Expert Claim Resolution & Mentorship: Master the management of complex and high-value claims, frequently exceeding $100,000. Leverage deep industry knowledge to navigate intricate investigations and apply a comprehensive understanding of regulations, terms, and conditions to all claim values. Provide mentorship and guidance to junior team members on processing claims across the full range of values. - Operational Strategy & Cross-Functional Synergy: Leverage deep business acumen and a comprehensive understanding of the transportation industry to strategically oversee claim operations, optimizing efficiency and ensuring adherence to time standards across the team. Drive and foster highly effective, cooperative working relationships with all internal departments, acting as a key liaison to streamline processes and mentor others in collaborative best practices. Qualifications - Bachelor’s degree in Business Administration, Finance, Accounting, or related field, or 3 years of professional experience in customer service, administrative support, or the insurance industry. - 5+ years of experience managing claims required. Experience in cargo claims in a 3PL environment preferred. - Exceptional organization skills and high attention to detail. - Proficient in Google Suite; conduct basic risk analysis and general data reporting. - Superior written and verbal communication skills. You understand that proactive communication is key. - Ability to work both independently and collaboratively. - Strong critical thinking, judgment, and decision-making skills. The Perks of Working With Us - Take advantage of our comprehensive benefits package, and supplemental coverage. - Invest in your future with our matching 401(k) program. - Build relationships and find your home at Arrive through our Employee Resource Groups. - Maximize your wellness with free counseling sessions through our Employee Assistance Program. - Take time to manage your physical and mental health - we offer company paid holidays, paid vacation time and wellness days. - Receive 100% paid parental leave when you become a new parent. - Get paid to work with your friends through our Referral Program!

Ohio
$100K / year
Arrive Logistics logo

Claims Analyst

Arrive Logistics

We Deliver, So You Can. 📍Austin | San Antonio | Chicago | Tampa | Guadalajara 🔜 Phoenix & Columbus

Full TimeRemoteTeam 1,001-5,000Since 2014H1B No Sponsor

Who We Are Arrive Logistics is a leading transportation and technology company in North America with plans to grow significantly year over year. Our success is a testament to our remarkable team and what we’re building together. We’re committed to providing employees with a meaningful work experience and have established an award-winning culture that supports personal and career development in a fun, casual, and collaborative environment. Who We Want As a Claims Analyst, you will serve as a subject matter expert and critical problem solver, taking full ownership of a portfolio of complex and high-value cargo claims (frequently exceeding $100,000). You will drive comprehensive claim management from initiation to resolution, integrating strategic analysis of claims trends to identify risks and develop proactive solutions. This role demands astute financial oversight, a deep understanding of legal and financial instruments, and leadership in external communications and stakeholder relationships. You will leverage advanced industry knowledge and business acumen to optimize claims operations, ensure financial integrity, and mentor junior team members, acting as a key cross-functional leader to protect the company's interests and drive strategic outcomes. What You'll Do - Advanced Claims Operations & Trend Analytics: Independently manage a portfolio of complex cargo claims from initial filing to final resolution, ensuring efficient, accurate, and timely handling. This includes skillfully negotiating settlements, precisely processing all related financial transactions, and analyzing claims trends to identify recurring issues and significant financial exposure, with actionable findings presented to leadership. - High-Level External Relations & Advocacy: Lead and manage all high-level external communications and relationships with minimal management assistance. Independently lead scheduled meetings with external parties, addressing complex inquiries, driving resolutions, and identifying actionable items to bring back to management for strategic consideration. - Financial Integrity & Legal Compliance: Comprehensively manage and reconcile all financial aspects of a claims portfolio, ensuring accurate balancing of all receivables and payables. Possess a deep understanding of the distinctions between various payment methods and the strategic reasons for issuing legal documents like releases and assignments of rights in advance of cash payments. Utilize financial insights from claim trends to inform proactive strategies and protect the company's financial interests. - Expert Claim Resolution & Mentorship: Master the management of complex and high-value claims, frequently exceeding $100,000. Leverage deep industry knowledge to navigate intricate investigations and apply a comprehensive understanding of regulations, terms, and conditions to all claim values. Provide mentorship and guidance to junior team members on processing claims across the full range of values. - Operational Strategy & Cross-Functional Synergy: Leverage deep business acumen and a comprehensive understanding of the transportation industry to strategically oversee claim operations, optimizing efficiency and ensuring adherence to time standards across the team. Drive and foster highly effective, cooperative working relationships with all internal departments, acting as a key liaison to streamline processes and mentor others in collaborative best practices. Qualifications - Bachelor’s degree in Business Administration, Finance, Accounting, or related field, or 3 years of professional experience in customer service, administrative support, or the insurance industry. - 5+ years of experience managing claims required. Experience in cargo claims in a 3PL environment preferred. - Exceptional organization skills and high attention to detail. - Proficient in Google Suite; conduct basic risk analysis and general data reporting. - Superior written and verbal communication skills. You understand that proactive communication is key. - Ability to work both independently and collaboratively. - Strong critical thinking, judgment, and decision-making skills. The Perks of Working With Us - Take advantage of our comprehensive benefits package, including medical, dental, vision, life, disability, and supplemental coverage. - Invest in your future with our matching 401(k) program. - Build relationships and find your home at Arrive through our Employee Resource Groups. - Maximize your wellness with free counseling sessions through our Employee Assistance Program - Take time to manage your physical and mental health - we offer company paid holidays, paid vacation time and wellness days. - Receive 100% paid parental leave when you become a new parent. - Get paid to work with your friends through our Referral Program!

Arizona
$100K / year