This is a workers’ comp medical-only adjuster role focused on medical management, fast closures, and preventing claims from converting to indemnity. If you’ve got CA WC exposure (especially liens and UR), this is a solid lane with a clear scope and a lower salary band than full-file indemnity handling.
About Pie Insurance
Pie helps small businesses buy and manage commercial insurance more simply through technology.
Schedule
- Remote (U.S. only, territories excluded)
- Full-time
- Base salary range: $60,000–$75,000
What You’ll Do
- Handle medical-only workers’ comp claims end-to-end: setup through closure
- Complete timely 2-point contact and keep investigating as facts change
- Drive medical management, watch for lost-time risk, and push toward closure
- Make compensability decisions within statutory timeframes
- Set and adjust reserves accurately within authority limits
- Administer statutory medical benefits throughout the life of the claim
- Use Utilization Review (UR) when appropriate
- Pay medical bills within required timelines
- Comply with all statutory guidelines, rules, and regulations
- Identify and assign claims that meet indemnity conversion criteria
- Resolve medical treatment issues quickly to close files
- Maintain a split inventory of lien resolution claims and negotiate liens to proper resolution
- Support agents/insureds with claim guidance, status, coverage verification, and loss runs
- Look for gaps in claim handling/SOPs and help improve processes
What You Need
- High school diploma/GED (some college/Bachelor’s preferred)
- 1+ year WC medical-only adjusting experience (required)
- Preferred higher-volume state experience: CA, AZ, UT, TX
- Strong written/verbal communication
- Solid claim adjudication + medical management knowledge
- Ability to analyze multiple inputs and act decisively
- Tools: G-Suite; Slack preferred
- Conflict navigation skills (getting to resolution without dragging the claim out)
Benefits
- Competitive cash comp + equity
- Comprehensive health plans
- Generous PTO
- 401(k) match
- Parental/caregiver leave
- Possible discretionary bonus (company performance dependent)
Happy Hunting,
~Two Chicks…