CA - Claims Adjuster, Workers Compensation
$80,000–$100,000 year
Remote · United States
Job Summary
Claims Adjuster for Workers’ Compensation handling end-to-end claim management from setup to closure, including 3-point contact investigations, reserving within authority, medical and indemnity benefits administration, regulatory compliance, and negotiation to mitigate exposure and achieve favorable outcomes. Serves as a primary contact for partner agents and insureds, provides status updates and guidance, collaborates with internal/external partners and TPA adjusters, and drives continuous improvements in claims operations to deliver a leading customer experience. The role emphasizes adherence to Pie’s best practices, regulatory rules, and a data-driven approach to early resolution opportunities, with remote eligibility within the United States.
Required Qualifications
- High School Diploma or equivalent
- 2-years workers’ compensation claims experience
- Claims experience working in CA
- Strong communication skills (written and verbal)
- Knowledge of jurisdictional regulatory and statutory requirements and CMS/MSA requirements
- Experience in claim adjudication, medical management and litigation management
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