Team Lead, Claims - Workers’ Compensation (California)
The Team Lead, Claims is responsible for leading a team of Adjusters and Specialists by monitoring their workloads, providing supervisory oversight for individual claim activities, and providing technical and jurisdictional direction on claims adjudication to ensure Pie is providing optimal claim outcomes and experiences for our clients. Additionally, this role is responsible for performance management and development of direct reports. The Team Lead will report to and work directly with the Claims Manager to achieve team and departmental goals. The Team Lead will need to be able and pivot quickly in a fast growing company and department.
How You’ll Do It
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.
- Resolve escalated agent, broker, policyholder complaints and/or concerns.
- Develop and manage operational processes for TPA oversight of claims and in-house handling of claims from a carrier perspective.
- Identify trends that could be problematic and take steps to develop processes to correct.
- Additional project assignments at managers discretion.
- Develop & lead a team of adjusters by ensuring the quality, accuracy, and timely resolution of claims that may include high exposure/complex cases. Oversee 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.
The Right Stuff
- 1-4 years of adjusting claims at a senior level.
- Comprehensive knowledge of workers compensation in multiple states along with general insurance policy coverage and the state case Laws.
- Requires a valid California Experienced Adjuster designation
- 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 with experience leading large or technical teams through complex deliverables.
- G-Suite Tools, Collaboration tools, Microsoft Office suite.
- High School diploma or GED required, Bachelor's Degree preferred.
Compensation & Benefits
- Competitive cash compensation
- A piece of the pie (in the form of equity)
- Comprehensive health plans
- Generous PTO
- Future focused 401k match
- Generous parental and caregiver leave
- Our core values are more than just a poster on the wall; they’re tangibly reflected in our work
Our goal is to make all aspects of working with us as easy as pie. That includes our offer process. When we’ve identified a talented individual who we’d like to be a Pie-oneer , we work hard to present an equitable and fair offer. We look at the candidate’s knowledge, skills, and experience, along with their compensation expectations and align that with our company equity processes to determine our offer ranges.
Each year Pie reviews company performance and may grant discretionary bonuses to eligible team members.
Unless otherwise specified, this role has the option to be hybrid or remote. Hybrid work locations provide team members with the flexibility of working partially from our Denver or DC office and from home. 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.