Claims Adjuster, Workers’ Compensation - Medical Only - Remote

Overview

The Claims Medical Only Adjuster will play a vital role in delivering quality claim file management and an industry-leading customer claims experience by adhering to Pie’s Claims Best Practices and complying with regulatory requirements.

In Short

• Independently handle all aspects of the workers’ compensation medical only claims.
• Conduct timely investigations and focus on medical management.
• Mitigate claim exposure and achieve favorable outcomes.
• Determine compensability decisions within statutory requirements.
• Set and adjust reserves accurately.
• Administer statutory medical benefits throughout the claim.
• Provide excellent customer service to agents and insureds.
• Continuously improve claims operations and service.
• Serve as a point of contact for claim guidance.
• Advocate for a leading claims customer experience.

Requirements

• High School Diploma or equivalent required.
• Bachelor's Degree or equivalent experience preferred.
• Minimum of 1-year workers’ compensation claims experience required.
• Proficient communication skills.
• Experience using G-Suite Tools and collaboration tools.
• Knowledge in claim adjudication and medical management.
• Ability to analyze and take necessary actions based on data.
• Ability to resolve conflicts and reach beneficial outcomes.

Benefits

• Competitive cash compensation.
• Equity options.
• Comprehensive health plans.
• Generous PTO.
• 401k match.
• Parental and caregiver leave.
• Core values reflected in work.