VP, Claims Adjudication
Core
Lead Pie's claims adjudication function to ensure optimal claim outcomes and exceptional customer experiences for small business commercial insurance.
Role type
VP, Claims Adjudication (Senior Leadership)
Builds
Commercial insurance claims adjudication operations and strategy for small businesses
Domain
Insurance / Workers' Compensation
Deliverable
client delivery
Required skills
Workers' compensation claims adjudication, people management (15+ team), second-line manager leadership, disputed/litigated claims management, regulatory compliance, financial budgeting, strategic planning, data analytics, digital transformation, cross-functional collaboration
Preferred skills
Crisis communication, external stakeholder representation, AI adoption in claims, diverse/inclusive culture building
Technologies
AI-powered application review tools, claims automation platforms
Responsibilities
Lead and oversee claims adjudication across all jurisdictions; Plan and direct daily and long-term claims operations; Implement workers' compensation claims programs; Direct review and settlement of large loss and catastrophe claims; Develop claims adjudication procedures and policies; Collaborate on enterprise-wide claims strategy; Determine team organizational structure and KPIs; Build and coach a team of Directors and Senior Managers; Manage fiscal reporting and budgeting; Drive continuous improvement in loss ratios; Partner on claims technology roadmap and automation; Ensure compliance with multi-jurisdictional regulations; Manage fraud investigation oversight.
Seniority
VP, Executive Team member