CA - Claims Adjuster, Workers Compensation
Core
Manage workers' compensation claims from setup to closure, conducting investigations, determining compensability, and negotiating settlements to mitigate exposure for small business customers.
Role type
Workers' compensation claims adjuster
Builds
Favorable claim outcomes and efficient claim file management for Pie's small business customers
Domain
Insurance / Workers' Compensation
Deliverable
client delivery
Required skills
Workers' compensation claims adjudication, claim investigation, reserve setting, litigation management, medical management, settlement negotiation, statutory compliance, claim status reporting
Preferred skills
G-Suite tools, Slack, CMS/MSA regulatory knowledge, conflict resolution
Technologies
G-Suite, Slack
Responsibilities
Independently handle all aspects of workers' compensation claims from set-up to closure; Conduct timely 3-point contact investigations; Mitigate claim exposure while achieving the best outcome; Determine timely and accurate compensability decisions; Set and adjust timely/accurate reserves; Administer statutory medical and indemnity benefits; Control legal activity with defense counsel; Prioritize early resolution opportunities and negotiate settlements; Serve as a point of contact for agents and customers; Provide claim status, coverage verification, and loss run reports.
Seniority
Individual Contributor, 2+ years experience
