CA - Team Lead, Claims - Workers Compensation

Pie Insurance; United States; Remote; USD 110,000 - 135,000; Full time

Benefits offered by this job

Competitive cash compensation

Comprehensive health plans

Generous PTO

Future focused 401k match

Generous parental and caregiver leave

Job summary

Pie Insurance is seeking a Claims Team Lead to guide a team of Adjusters and Specialists, overseeing claim activity, audits, and workload management. You will provide technical direction on adjudication, drive performance, and partner with the Claims Manager to achieve departmental goals.

The role emphasizes leadership, process improvement, and delivering optimal claim outcomes for clients, with remote work available across the United States.

Qualifications

• 2+ years of senior-level claim adjusting experience.
• California workers’ compensation claim experience required; multi-state experience a plus.
• Strong knowledge of workers’ compensation and state laws.
• Excellent written and verbal communication skills.
• Strong problem-solving abilities for complex scenarios.
• Bachelor’s Degree preferred.

Responsibilities

• Review and approve claim denials, payments, settlements, trials, and reserve requests.
• Perform claim audits for compliance and quality.
• Ensure reserves reflect probable outcomes.
• Lead and mentor a team of adjusters.
• Identify trends and improve processes.
• Resolve escalated complaints and concerns.

Skills

Advanced communication

Leadership

Problem solving

Team management

Process improvement

Multi-state workers’ comp knowledge

Education

High School diploma or GED

Bachelor’s Degree preferred

Tools

G-Suite

Microsoft Office

Job description

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 Team Lead is responsible for leading a team of Adjusters and Specialists by monitoring their workloads, providing supervisory oversight for individual claim activities, and providing technical and jurisdictional direction on claims adjudication to ensure Pie is providing optimal claim outcomes and experiences for our clients. Additionally, this role is responsible for performance management and development of direct reports. The Team Lead will report to and work directly with the Claims Manager to achieve team and departmental goals. The Team Lead will need to be able and pivot quickly in a fast growing company and department.

How You’ll Do It

Claims Technical Oversight:

• Review and approve claim denials, payments, settlements, trials, and reserve requests.
• Perform claim audits to ensure consistency and accuracy in statutory/regulatory compliance, internal procedures and guidelines, and quality expectations.
• Ensure reserves are adequately set for the ultimate probable outcome of the claim
• Perform regular leader reviews and provide feedback and recommendations for individual claims files.

Operational Management:

• Resolve escalated agent, broker, policyholder complaints and/or concerns.
• Identify trends that could be problematic and take steps to develop processes to correct.
• Additional project assignments at manager’s discretion.

People Management:

• Develop & lead a team of adjusters by ensuring the quality, accuracy, and timely resolution of claims that may include high exposure/complex cases. Oversee of all claim activity.
• Promote department goals and objectives to the team of Adjusters and Specialists.
• Monitor workflows, claims processes, claim metrics, claim triage and caseloads
• Build and promote customer service excellence.
• Hire and develop adjusters by identifying opportunities to grow and strengthen new skills.

The Right Stuff

• 2+ years of adjusting claims at a senior level.
• California workers’ compensation claims experience is required. Additional experience in AZ, NM, NV, OR, or UT is a plus.
• Comprehensive knowledge of workers compensation in multiple states along with general insurance policy coverage and the state case Laws.
• Advanced communication (written, verbal and presentation) skills, to deliver complex information effectively and align people with the needs of the project/team.
• Advanced problem solving skills, to be able to manage complex situations with multiple layers, and resolve to solution anticipating needs now and into the future.
• Intermediate awareness of your own tasks, and how it impacts the team and deliverables
• Advanced leadership skills, focusing on the growth and development of direct reports.
• 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

$110,000—$135,000 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 Information

Pie 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.

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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.

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