Remote Complex Claims Adjuster – Catastrophic Loss Expert

Pie Insurance; Northern (KY); Hybrid; 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

Core values reflected in work

Job summary

Pie Insurance is hiring a Complex Claims Adjuster to manage catastrophic and large loss workers’ compensation claims, from setup to closure. You’ll apply advanced negotiation skills, regulatory knowledge, and Medicare Set‑Aside requirements to deliver favorable outcomes for Pie’s customers.

The role emphasizes collaboration with claims leadership and the Complex Claims Practices Consultant to continually improve processes and protocols, while maintaining high service standards for agents and

Qualifications

• 7+ years workers’ compensation claim adjusting experience (carrier background preferred).
• 2+ years of catastrophic claim handling experience.
• Active licensing in applicable states.
• Advanced communication and problem-solving skills.
• Ability to mentor junior adjusters.

Responsibilities

• Independently handle catastrophic and large loss workers’ compensation claims from set-up to closure.
• Conduct timely investigations and determine compensability within statutory requirements.
• Set and adjust reserves within authority limits and present to stakeholders.
• Manage statutory medical/indemnity benefits and control legal activity through the lifecycle of the claim.
• Provide guidance to agents and customers, and improve claims processes and SOPs.

Skills

Catastrophic/large loss handling

Workers' compensation claims

Regulatory knowledge

Negotiation & settlement

Communication skills

Licensing in applicable states

G-Suite / Slack familiarity

Analytical thinking

Education

High School Diploma or equivalent

Bachelor's degree or equivalent

Tools

CMS/MSA systems

Litigation management software

G-Suite

Job description

Pie Insurance is hiring a Complex Claims Adjuster to manage catastrophic and large loss workers’ compensation claims, from setup to closure. You’ll apply advanced negotiation skills, regulatory knowledge, and Medicare Set‑Aside requirements to deliver favorable outcomes for Pie’s customers.

The role emphasizes collaboration with claims leadership and the Complex Claims Practices Consultant to continually improve processes and protocols, while maintaining high service standards for agents and