Senior Complex Claims Adjuster - Remote

Pie Insurance; United States; On-site; USD 100,000 - 125,000; 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 in the United States is seeking a Complex Claims Adjuster to independently manage catastrophic and large loss workers’ compensation claims from setup through closure. You will assess settlements, apply Medicare Set-Aside requirements, negotiate favorable outcomes, and mentor junior adjusters while collaborating with leadership to improve processes.

This role requires active state licenses, 7 years’ experience, and proven ability to handle high dollar exposures within the Southeast,

Qualifications

• Minimum 7 years workers’ compensation claim adjusting experience.
• 2+ years of catastrophic claim handling experience.
• Active licensing in applicable states.
• Ability to evaluate high dollar, high exposure, complex claims.
• Experience in Southeast region incl. Florida & Georgia; expand jurisdiction.
• Advanced communication and problem-solving skills.
• Mentor junior adjusters.

Responsibilities

• Independently handle catastrophic and large loss workers’ compensation claims from set-up to closure.
• Conduct timely investigation and adjust reserves.
• Present claims to senior management and stakeholders.
• Provide excellent customer service to agents and insureds.
• Direct a proactive litigation strategy to increase settlement opportunities.
• Collaborate to improve claims processes and SOPs.

Skills

Complex negotiation

Claims adjudication

Regulatory compliance

CMS/MSA knowledge

Communication skills

Mentoring

G-Suite/Slack

Education

High School Diploma or equivalent

Bachelor's Degree or equivalent experience

Tools

G-Suite

Slack

Job description

Pie Insurance in the United States is seeking a Complex Claims Adjuster to independently manage catastrophic and large loss workers’ compensation claims from setup through closure. You will assess settlements, apply Medicare Set-Aside requirements, negotiate favorable outcomes, and mentor junior adjusters while collaborating with leadership to improve processes.

This role requires active state licenses, 7 years’ experience, and proven ability to handle high dollar exposures within the Southeast,