CA - Claims Adjuster, Workers Compensation

<div class="content-intro"><div>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.</div> <div> <div>&nbsp;</div> <div>Like our small business customers, we are a diverse team of builders, dreamers, and entrepreneurs who are driven by&nbsp;<a class="postings-link" href="https://pieinsurance.com/culture">core values and operating principles</a>&nbsp;that guide every decision we make.</div> </div></div><p>The Claims Adjuster will play a vital role in delivering quality claim file management and an industry-leading customer claims experience. This will be completed by adhering to Pie’s Claims Best Practices and complying with regulatory and statutory requirements. This role will work with internal and external partners to deliver best in class performance, identify and pursue claim mitigation opportunities and deliver favorable claim outcomes for Pie’s customers.&nbsp;</p> <h3><strong>How You’ll Do It</strong></h3> <p><strong>Claims Technical Management:</strong></p> <ul> <li>Independently handle all aspects of the workers’ compensation claims from set-up to closure.</li> <li>Conduct timely 3-point contact investigation, with focus on continued investigation as facts of the case change.</li> <li>Mitigate claim&nbsp; exposure while achieving the best outcome.</li> <li>Determine timely and accurate compensability decisions within statutory requirements.</li> <li>Set and adjust timely/accurate reserves within authority limits to ensure reserving activities are consistent with the case facts and company best practices.</li> <li>Timely administration of statutory medical and indemnity benefits throughout the life of the claim.</li> <li>Comply with all applicable statutory guidelines, rules, and regulations.</li> <li>Control legal activity with defense counsel through the litigation process while managing legal fees and costs.</li> <li>Prioritize early resolution opportunities, evaluate claim exposure and negotiate settlement.</li> </ul> <p><strong>Claims Customer Service:</strong></p> <ul> <li>Serve as a point of contact for our partner agents and customers to provide general claim guidance and help set claim process expectations.</li> <li>Assist as necessary in providing claim status to agents and insureds, coverage verification and loss run reports, etc.</li> <li>Provide excellent customer service to internal and external customers and business partners.&nbsp;</li> <li>Participate in interactions with TPA adjusters an