Manager, Claims - Workers’ Compensation
Pie Insurance (View all Jobs)
1. Phone screen with recruiter 2. Technical screen in the form of a pair-programming session to debug and test existing code 3. Final round is a multi-round session that typically includes demonstrations for backend, frontend, and design skills (and they are collaborative in nature) but are not odd Leetcode style questions. There is also a cultural/behavioral fit round, but that does not involve coding/design demonstrations.
Pie Insurance is seeking a Claims Manager to manage our workers’ compensation TPA and in-house claims program(s). This position will report to Pie’s VP of Claims, and work closely with Pie’s TPA as well as our internal claims, legal and compliance, underwriting, and customer success teams to understand, review, and guide decisions regarding claims statutory, regulatory, and quality compliance. As Manager, Claims you will be accountable for the operational results of your assigned region and will utilize operational reports, metrics, and data to analyze program performance to achieve Pie’s Claims Department objectives and to drive for exceptional results. You will partner with our TPA leadership and internal claims teams to ensure injured workers are receiving prompt and appropriate medical care, returning to work as effectively as possible, and receiving the very best claims experience. The Manager, Claims is also responsible for leading a group of Team Leads and/or Claims Specialists by providing oversight for regional 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 Manager, Claims will need to be able to pivot quickly in a fast growing company and department.
This role can work in our Denver or DC office or can work in a remote location.
How You’ll Do It
- Managing expectations within and outside Pie around the overall Workers Compensation (WC) claims program and/or other small business insurance claims by conducting recurring claims reviews, developing investigation and closure strategies, and ensuring compliance with TPA Service Instructions as well as internal procedures and guidelines.
- Performing monthly analysis to identify key drivers of claim severity and develop mitigating strategies.
- Partnering with our internal teams (Engineering, UX, Finance, Legal, Customer Care, Product, Underwriting) and TPA in order to facilitate diversity in thought and drive to deliver results.
- Completing all monthly, quarterly, and annual State Reporting requirements on time and ensuring compliance.
- Create a humanized claims process and manage the relationship with our TPA.
- Preparing analysis and business case justification for settlements requiring executive approval.
- This is an experienced hire role. As a leader at Pie, you will be as comfortable and content managing projects and programs as you are managing people.
- Team building and leadership are important in this role. You will manage our claims Team Leads and/or Specialists who are focused on providing a top notch claims experience through their daily interactions with all of the important stakeholders in a claim’s overall success
The Right Stuff
- High School diploma or equivalent is required.
- 8+ years of workers’ compensation experience with a minimum of 3 years of experience managing a TPA or in-house WC claims program directly.
- 3+ years of people management required, and experience leading leaders is preferred.
- Advanced attention to detail, experience and analytical competencies.
- Strong understanding of complexity of WC claims and why our relationship with a TPA is vital to our success.
- Demonstrated Collaboration: Strong ability to articulate issues, questions, and requirements. Must be able to communicate openly, freely, and frequently with colleagues, customers, vendors, and insurance partners. Must confidently and actively participate, listen, and share.
- Demonstrated ability to establish goals and empower your team to achieve them.
- Strong multitasking and organization of work skills, must be able to set priorities by using data, your knowledge and experience to figure things out.
- Keen focus on customer experience, we are looking to provide a first class claims experience. Ability to share perspective to come up with the best possible solutions, whether it's through TPA partnership or on our own.
- Advanced knowledge of workers’ compensation, with ability to quickly and readily identify new opportunities for Pie.
- The ability to innovate is a must. Expect to constantly challenge the insurance industry status quo.
Compensation range for position: $90,000 - $125,000
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.
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