Complex Claims Adjuster

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-starting with workers' compensation.
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 Complex Claims Adjuster will assist and collaborate with the Senior Specialty Claims Manager in the oversight and management of catastrophic and large loss claims nationwide. This position will work closely with Pie's internal claims team, Pie's TPA partner and other internal team members to continually seek out ways in which to improve claims processes and protocols. The Complex Claims Adjuster will participate in the hands-on handling of complex claims and evaluate for coverage, investigation, reserves and risk transfer opportunities. An advanced knowledge of negotiation strategy and structured settlements is preferred.
How You'll Do It

• Complex Claims Oversight
• Assess incoming new losses for catastrophic claims and reinsurance reportable incidents
• Recognize exposure and ensure reserving is appropriate and timely
• Adjust high exposure claims for multiple jurisdictions
• Evaluate for risk transfer opportunities in catastrophic claims
• Provide technical direction on claim decisions and resolution in partnership with our external Third Party Administrator (TPA) partner within the assigned authority level

• Claims Resolution Management
• Direct a proactive litigation strategy to increase settlement opportunities
• Asses claims for settlement value using rated ages, present value, Medicare set asides, medical cost projections and structured settlements. Obtain settlement authority as required.
• Obtain annuity and structured settlement quotes
• Attend virtual and in person mediations, informal settlement conferences and trials to represent Pie's interests

• Collaboration & Innovation
• Participate in Claims Roundtable meetings with external partners. Facilitate a collaborative plan of action for aggressive claims handling. Direct reserves and settlement discussions.
• Identify, track and alert internal and external stakeholders to new large loss claims. Follow up for Claims Status Reports and timely reserve increases.
• Present large loss updates to internal and external partners
• Participate in roundtable discussions and mentorship opportunities with Claims Team Pie-oneers
• Work to continuously improve our claims operations and look at opportunities and gaps in claim service, handling SOPs, protocols and processes

The Right Stuff

• 8+ years of Workers' Compensation claims adjusting experience (carrier background preferred)
• 2+ years of Large Loss experience
• In-depth knowledge of workers compensation claims across multiple jurisdictions
• Possess a high level of technical claim, legal knowledge and negotiation skills
• 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
• Demonstrated Collaboration: Strong ability to articulate issues, questions, and requirements. Must confidently and actively participate, listen, and share.
• Advanced communication (written, verbal and presentation) skills, to deliver complex information effectively and align people with the needs of the project/team.
• Strong multitasking and organization of work skills. Must be able to set priorities by using data, your knowledge and experience to figure things out.
• Keen focus on customer experience, we are looking to provide a first class claims experience.
• The ability to innovate is a must. Expect to constantly challenge the insurance industry status quo.
• High School diploma or GED required, Bachelor's Degree preferred

Compensation Range for position: $110,000 - $150,000
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Compensation & Benefits

• Competitive cash compensation
• A piece of the pie (in the form of equity)
• Comprehensive health plans
• Generous PTO, including paid sick leave
• 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

Our goal is to make all aspects of working with us as easy as pie. That includes our offer process. When we've identified a talented individual who we'd like to be a Pie-oneer , we work hard to present an equitable and fair offer. We look at the candidate's knowledge, skills, and experience, along with their compensation expectations and align that with our company equity processes to determine our offer ranges.
Each year Pie reviews company performance and may grant discretionary bonuses to eligible team members.
Location Information
Unless otherwise specified, this role has the option to be hybrid or remote. Hybrid work locations provide team members with the flexibility of working partially from our Denver or DC office and from home. 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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