• Investigating and confirming the facts of loss for advanced automobile accidents • Determines coverage, liability, damages and otherwise adjusts and negotiates claims within limit of authority • Applying advanced understanding of insurance policies • Handling investigations regarding all aspects of advanced auto claims • Learning how to review, evaluate, and negotiate basic to moderate injury claims • Identifying customer needs and working to meet those needs using appropriate customer service skills

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 - Subrogation will favorably impact claim cost containment and overall Claims recovery goals by managing a caseload of subrogation claims through quality and efficient claims service, proactive negotiations, and the achievement of prompt and appropriate claim recoveries. How You’ll Do ItClaim Analysis - Conduct additional investigation, including securing newly developed evidence, to maximize subrogation recoveries cost-effectively for all lines of business. - Determine the amount of potential subrogation recovery. - Develop and implement a subrogation strategy and action plan for each assigned subrogation claim. - Evaluate liability and conduct additional investigations, as warranted, in order to settle claims at optimal levels. Communication - Collaborate and communicate with front line adjusters to determine the most appropriate outcome, providing new facts as they become available and an analysis of their impact on the liability and settlement options. - Issue subrogation notices in accordance with state specific regulations. - Provide detailed updates on subrogation status to relevant stakeholders. - Maintain proactive and collaborative contact with insureds, claimants, adverse third parties, attorneys, and front-line adjusters to optimize the recovery process. - Document subrogation action plan and recovery status in claim notes. Negotiation and Recovery - Negotiate worker’s compensation and commercial auto subrogation claims with carriers, other responsible party(s), and other legal representatives or attorneys on liability and/or damages. - Assist in the recovery of claim overpayments. - Negotiate and compromise claim/lien settlement amounts based on the facts of each case. The Right Stuff - 2+ years experience in Workers' Compensation Subrogation. - Strong knowledge of insurance claim procedures. - Strong written and verbal communication skills. - Strong decision making and critical thinking skills. - Strong negotiation skills. - Ability to work in a fast paced environment with accuracy. - Ability to learn quickly and take on new challenges and responsibilities. - G-Suite Tools, Collaboration tools, Microsoft Office suite. - High School diploma or GED required, Bachelor's Degree preferred. 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 - 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 Making every part of working with us "Easy as Pie" - including our offer process. When we find someone we'd like as a Pie-oneer (a member of our team), we move quickly to put together a fair offer based on your skills, experience, location, and compensation expectations. 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

Role Description The Senior Claim Specialist position at Golden State Claims Services reports to a Claims Supervisor, Claims Manager or Senior Claims Manager. The chief duty of the Senior Claims Specialist is to adjust complex or high exposure construction defect claims for the program(s) to which they are assigned. - Contribute to a collaborative environment by consistently demonstrating teamwork, high motivation, positive behavior and effort to achieve goals and objectives. - Build and maintain productive relationships with internal and external customers, including clients, underwriting and service teams, and agents. - Research applicable coverage for our insureds. Document coverage dates, limits, and restrictions. - Identify and resolve any potential coverage questions. Draft reservation of rights and coverage denials for review and approval by their Supervisor/Manager. - Investigate facts of the loss by securing statements and supporting documentation such as contracts, cost of repair estimates, expert reports, photos, correspondence, etc. - Document activities in writing within claim files. - Exercise judgment in applying legal liability to assigned claims and will have settlement authority up to their specific authority, which may vary from carrier to carrier. - Assign defense counsel to answer and defend lawsuits where appropriate. Monitor and direct defense counsel, independent adjusters, and experts. - Identify claims with potential exposure in excess of authority and advise their Supervisor/Manager. - Evaluate, set, or recommend reserves for each file they are handling. - Prepare written reports as dictated by company policy and procedures. - Handle claims within guidelines of the Fair Claims Practices 790.03. - Provide insureds, claimants, underwriters, and carriers with regular updates on status of file handling. - Discuss unique and complex files with Supervisor/Manager. Qualifications - 5+ years of construction defect claims management experience preferred. - College degree or equivalent claims management experience required. - 10+ years litigation management experience preferred. - Must hold an individual adjusting license for a designated home State and be willing to secure additional required adjusting licenses as needed. - Proficient computer skills including Microsoft Outlook, Word and Excel. Requirements - The starting annual pay scale for this position is listed below. Actual starting pay will be based on factors such as skills, qualifications, training, and experience. - ISC's salary ranges are determined by role and level. The range displayed on each job posting reflects the minimum and maximum target for new hire salaries for the position across all US locations and could be higher or lower based on a multitude of factors, including job-related skills, experience, and relevant education or training. - National Pay Range: $83,000 — $104,000 USD. Benefits - Employee Ownership Program - every eligible employee shares in the financial rewards that grow when the company grows. - Professional development opportunities. - Owner Referral Program. - Work from home reimbursement for remote/hybrid roles. - Canary emergency financial assistance program. - Comprehensive medical, dental, vision. - Life/AD&D Insurance. - Confidential, Employee Assistance Program. - Health Savings Account, includes company contribution. - Short-term disability. - Voluntary benefits - supplemental accident, critical illness, hospital insurance. - Employee discounts. - 401(k) Plan with company match contribution. - Addition Wealth Financial Wellness Program. - Various Time Off Programs. - 11 company paid holidays.

• Perform detailed clinical and coding review of facility claims, including review of the detailed itemized statement, the UB-04, and all medical records. • Assess all clinical aspects of the claim, including the appropriateness of the level of care billed throughout the claim. • Research client specific medical policies, manufacturer information, clinical and coding guidelines to identify experimental and investigation charges, such as treatments, procedures, and supplies. • Provide internal and external partners with evidence and references supporting industry standards, auditing guidelines, and review stances. • Analyze all medication charges to determine correct pharmacy utilization and potential off-label use. • Review all items billed on an itemized bill in comparison to what is documented in a medical record to determine accuracy from a billing, coding, and clinical perspective. • Assess the claim for charges related to Do Not Bill Events or Hospital Acquired Conditions. • Review, expand, and cultivate resources to build up complex claims review content. • Contribute as a SME to new client initiatives by participating in sales calls and coordinating the completion of test claims. • Responsible for driving value, including content development, reference expansion, and managing the appeal language for client requested response letters. • Collaborate and assist in staff training processes and development of training material as needed. • Comply with company standards regarding productivity and audit accuracy to manage daily assignments and meet client turnaround times. • Assists in special projects and perform other duties as needed. • Act as a subject matter expert for the overall product. • Attends all required meetings.