Remote Complex Claims Adjuster – Catastrophic & Large Loss

Pie Insurance; Denver (CO); On-site; USD 100,000 - 125,000; Full time

Benefits offered by this job

Competitive cash compensation

Generous PTO

Future-focused 401k match

Generous parental and caregiver leave

Job summary

Pie Insurance is seeking a Complex Claims Adjuster to manage catastrophic and large loss workers’ compensation claims from setup through closure. You will conduct investigations, determine compensability within statutory guidelines, and manage reserves while partnering with leadership to improve claims processes.

This role requires 7+ years of WC claim adjusting experience, active state licenses, and strong negotiation and communication skills to deliver favorable outcomes.

Qualifications

• Bachelor's degree or equivalent preferred with some college coursework.
• Minimum of 7 years workers’ compensation claim adjusting experience.
• 2+ years of catastrophic claim handling experience.
• Active licensing in applicable states.

Responsibilities

• Independently handle catastrophic and large loss workers’ compensation claims from set‑up to closure.
• Conduct timely 3-point contact investigation and update as facts change.
• Determine timely and accurate compensability decisions within statutory requirements.
• Set and adjust reserves within authority limits to align with case facts and best practices.
• Present claims to senior management and stakeholders.
• Administer statutory medical and indemnity benefits throughout the claim life cycle.
• Mitigate complex exposure and pursue favorable settlement opportunities.
• Collaborate with Claims Leadership to improve processes and SOPs.

Skills

Catastrophic claims handling

Negotiation

Regulatory awareness

Mentoring

Education

High School Diploma

Bachelor's degree (preferred)

Tools

G-Suite

Slack

Job description

Pie Insurance is seeking a Complex Claims Adjuster to manage catastrophic and large loss workers’ compensation claims from setup through closure. You will conduct investigations, determine compensability within statutory guidelines, and manage reserves while partnering with leadership to improve claims processes.

This role requires 7+ years of WC claim adjusting experience, active state licenses, and strong negotiation and communication skills to deliver favorable outcomes.