Complex Claims Adjuster

Participate in Claims Roundtable meetings. Develop a collaborative plan of action for aggressive claims handling.

Create Claims Status Reports and establish timely, accurate reserves.

Present large loss updates to internal and external partners.

Collaborate with our Complex Claims Practices Consultant and Claims Leadership to continuously improve our claims operations and look at opportunities and gaps in claim service, handling SOPs, protocols and processes.

High School Diploma or equivalent is required.

Bachelor's Degree or equivalent experience with some college coursework is preferred.

Minimum of 7 years workers’ compensation claim adjusting experience is required (carrier background, preferred).

2+ years of catastrophic claim handling experience.

Ability to evaluate and identify high dollar, high exposure, complex claims.

Strong claims handling experience within the Southeast region preferred, with expertise in Florida & Georgia. Candidates should demonstrate a willingness to expand their jurisdictional knowledge and obtain additional state licenses as business needs evolve.

Requires active licensing in applicable states.

Advanced communication (written and verbal) skills, to deliver more complex information effectively.

Advanced problem-solving skills to be able to manage complex tasks and work through to solutions with little guidance and direction.

Awareness of your own tasks and how it impacts the team and deliverables.

Experience using G-Suite Tools and collaboration tools like Slack is preferred.

Advanced knowledge of jurisdictional regulatory and statutory requirements and CMS/MSA requirements.

Advanced knowledge and experience in claim adjudication, medical, and litigation management.

Advanced ability to analyze and take necessary action in multiple focus areas based on several data points.

Ability to make claim decisions to mitigate exposure while achieving the best outcome.

Ability to use skills to overcome conflict and reach beneficial outcomes.

Ability to mentor junior adjusters.

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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