CA - Team Lead, Claims - Workers Compensation

Claims Technical Oversight:

Review and approve claim denials, payments, settlements, trials, and reserve requests.

Perform claim audits to ensure consistency and accuracy in statutory/regulatory compliance, internal procedures and guidelines, and quality expectations.

Ensure reserves are adequately set for the ultimate probable outcome of the claim

Perform regular leader reviews and provide feedback and recommendations for individual claims files.

Operational Management:

Resolve escalated agent, broker, policyholder complaints and/or concerns.

Identify trends that could be problematic and take steps to develop processes to correct.

Additional project assignments at manager's discretion.

People Management:

Develop & lead a team of adjusters by ensuring the quality, accuracy, and timely resolution of claims that may include high exposure/complex cases. Oversee of all claim activity.

Promote department goals and objectives to the team of Adjusters and Specialists.

Monitor workflows, claims processes, claim metrics, claim triage and caseloads

Build and promote customer service excellence.

Hire and develop adjusters by identifying opportunities to grow and strengthen new skills.

2+ years of adjusting claims at a senior level.

California workers’ compensation claims experience is required. Additional experience in AZ, NM, NV, OR, or UT is a plus.

Comprehensive knowledge of workers compensation in multiple states along with general insurance policy coverage and the state case Laws.

Advanced communication (written, verbal and presentation) skills, to deliver complex information effectively and align people with the needs of the project/team.

Advanced problem solving skills, to be able to manage complex situations with multiple layers, and resolve to solution anticipating needs now and into the future.

Intermediate awareness of your own tasks, and how it impacts the team and deliverables

Advanced leadership skills, focusing on the growth and development of direct reports.

G-Suite Tools, Collaboration tools, Microsoft Office suite.

High School diploma or GED required, Bachelor's Degree preferred.

The use of AI in Application Review: To support a fair, efficient, and consistent hiring process, we use AI-powered tools to assist in the initial screening of applications. These tools help us identify qualifications and prior work experiences that align with the requirements of the role. We may also use AI assistant video tools during interviews to support note-taking and candidate evaluation. All AI-powered outputs are still subject to human oversight and decision-making at multiple stages of the process. By submitting your application, you acknowledge and consent to Pie utilizing these AI technologies to assist in our evaluation process.

Base Compensation Range$110,000—$135,000 USD

Competitive cash compensation

Comprehensive health plans

Generous PTO

Future focused 401k match

Generous parental and caregiver leave

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Making every part of working with us "Easy as Pie" - including our offer process. When we find someone we'd like as a Pie-oneer (a member of our team), we move quickly to put together a fair offer based on your skills, experience, location, and compensation expectations.

Each year Pie reviews company performance and may grant discretionary bonuses to eligible team members.

Unless otherwise specified, this role is remote. Remote team members must live and work in the United States ( territories excluded ) and have access to reliable, high-speed internet.

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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