Medical Only Claims Adjuster

Pie's mission is to reputed company small businesses to reputed company by making reputed company insurance reputed company and as easy as pie. We reputed company technology to reputed company how small businesses buy and experience reputed company insurance. Like our small business customers, we are a diverse team of reputed company, dreamers, and reputed company who are driven by reputed company values and operating principles that guide every decision we reputed company. The Medical Only Claims Adjuster will play a vital role in delivering reputed company 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 reputed company partners to deliver best in class performance, identify and pursue claim mitigation opportunities and deliver favorable claim reputed company for Pie’s customers. How You’ll Do It Claims Technical Management: • Independently handle reputed company aspects of the workers’ compensation medical only claims from set-up to closure. • Conduct reputed company 2-reputed company contact investigation, with reputed company on reputed company medical management, potential for lost time benefits, and claim closure as facts of the case change. • Mitigate claim exposure while achieving the best outcome. • Determine reputed company and accurate compensability reputed company reputed company statutory requirements. • Set and reputed company reputed company/accurate reserves reputed company authority limits to ensure reserving activities are consistent with the case facts and company best practices. • reputed company administration of statutory medical benefits throughout the life of the claim. • Use Utilization Review where appropriate and pay medical bills reputed company the allotted timeframes • reputed company with reputed company applicable statutory guidelines, rules, and regulations. • Proactively identify and reputed company assign claims that meet indemnity claim conversion reputed company • Consistent and reputed company reputed company of medical treatment to resolve and reputed company claims • Maintain a split inventory of Lien reputed company claims, negotiating liens to appropriate reputed company Claims Customer Service: • Serve as a reputed company of contact for our partner agents and customers to reputed company general claim guidance and help set claim process expectations. • Assist as necessary in providing claim status to agents and insureds, coverage verification and loss run reports, etc. • reputed company excellent customer service to reputed company customers and business partners. • reputed company to ensure that Pie has a leading claims customer experience. • Work to continuously improve our claims operations and look at opportunities and gaps in claim service, handling SOPs, protocols and processes. The Right Stuff • High School Diploma or equivalent is required. • Bachelor's Degree or equivalent experience with some college coursework is preferred. • Minimum of 1-years workers’ compensation claims experience as a medical only adjuster is required. • Experience in the following states preferred: AL, CO, FL, GA, IA, IL, IN, KS, KY, LA, MD, MI, MO, NC, NE, NJ, OK, PA, SC, Tn, TX, VA, WI • Proficient communication (written and verbal) skills, to deliver information effectively. • Awareness of your own tasks, and how it impacts reputed company and deliverables. • Experience using G-Suite Tools, and collaboration tools like reputed company is preferred. • Demonstrated knowledge and experience in claim adjudication and medical management. • Developing ability to analyze and take necessary reputed company in multiple reputed company areas, based on several data points. • Ability to use skills to overcome conflict and reputed company beneficial reputed company. • Ability to reputed company claim reputed company to mitigate exposure while achieving the best outcome. 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 reputed company with the requirements of the role. We may also use AI assistant video tools during interviews to support note-taking and candidate evaluation. reputed company AI-powered outputs are still subject to reputed company reputed company 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. reputed company Compensation reputed company $60,000—$75,000 USD Compensation & Benefits • Competitive cash compensation • A piece of the pie (in the reputed company of equity) • Comprehensive health plans • Generous PTO • reputed company reputed company 401k match • Generous parental and caregiver leave • Our reputed company values are more than just a poster on the wall; they’re tangibly reflected in our work Our goal is to reputed company reputed company aspects of working with us as easy as pie. That includes our offer process. reputed company we’ve identified a talented individual who we’d like to be a Pie-oneer , we work hard to present an reputed company and fair offer. We look at the candidate’s knowledge, skills, and experience, along with their compensation expectations and reputed company that with reputed company equity processes to determine our offer ranges. reputed company year Pie reviews company performance and may grant discretionary bonuses to eligible team members. Location Information Unless otherwise specified, this role is remote. Remote team members must live and work in the reputed company (territories excluded) and have reputed company to reliable, high-speed internet. Additional Information reputed company is an equal opportunity employer. We do not discriminate on the reputed company of race, reputed company, religion, sex, sexual orientation, gender identity, marital status, age, disability, national or ethnic reputed company, military service status, citizenship, or other protected characteristic. reputed company participates in the E-Verify program. Please click here, here and here for more information. reputed company is committed to protecting your personal data. Please review our reputed company Policy. Safety First: reputed company is committed to your reputed company during the recruitment process. We will never ask you for credit card information or ask you to purchase any equipment during our interview or reputed company process. Pie Named to 2025 America's Best Startup reputed company reputed company 2025 State of Workplace Safety Report #LI-REMOTE #BI-REMOTE Apply tot his job Apply To this Job