VP, Claims Adjudication

Job not on LinkedIn

🔥 22 minutes ago

🇺🇸 United States – Remote

💵 $200k - $260k / year

⏰ Full Time

🔴 Lead

👔 Vice President

🦅 H1B Visa Sponsor

This company has sponsored H1B visas in the past.

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Pie Insurance

WebsiteLinkedInAll Job Openings

201 - 500 employees

🛡️ Insurance

💳 Fintech

🤝 B2B

Insurance • Fintech • B2B

Pie Insurance is transforming small business insurance by making it less expensive, simpler, and more transparent for small business owners. With a team of seasoned technology and insurance experts, Pie Insurance is dedicated to enhancing the insurance experience, particularly focused on workers' compensation and InsureTech innovations.

📋 Description

• Lead and oversee Pie's claims adjudication function across all jurisdictions • Plan and direct daily and long-term claims adjudication operations • Implement workers' compensation claims programs • Serve as lead claims adjudication authority and advise the Pie Executive Team • Direct quarterly review and settlement of large loss and catastrophe claims • Develop claims adjudication procedures and policies • Collaborate with the Chief Claims Officer on overall claims strategy • Inform enterprise-wide claims initiatives and departmental objectives • Determine organizational structure, expectations, span of control, role expectations, and KPIs • Develop, measure, and coach performance and productivity goals • Build claims talent and cultivate a diverse, equitable, and inclusive team culture • Lead and develop Directors and Senior Managers through goal-setting, performance management, coaching, and mentoring • Manage fiscal reporting, budgeting, headcount planning, and operational expenses • Monitor claims metrics and performance trends • Drive continuous improvement in loss ratios and claims outcomes • Align claims adjudication operations with profitable growth and underwriting objectives • Collaborate on the claims technology roadmap and automation vision • Champion innovative technologies and processes • Partner with Product and Enterprise Tech on claims technology investments • Lead digital transformation initiatives • Participate in Claims and Pie Executive Team strategic planning and decision-making • Collaborate with Claims, Underwriting, Actuarial, Reinsurance, Product, Finance, Legal, and other departments • Represent claims adjudication in product development, pricing, and risk management decisions • Represent Pie externally as a claims subject matter expert • Ensure regulatory compliance across multiple jurisdictions • Oversee fraud investigation efforts with Claims Regulatory Compliance • Manage regulatory relationships and reporting • Develop and maintain claims adjudication risk management protocols

🎯 Requirements

• 15+ years of experience with workers' compensation claims, field claims operations, and claims adjudication • 10+ years of people management experience with a track record of developing next-generation leaders • Experience building and managing claims adjudication teams of 15+ • Experience managing second-line managers (Directors and Senior Managers) • Expert knowledge of managing disputed and litigated claims across multiple jurisdictions • Strong industry leadership track record with experience in senior leadership roles across the insurance industry • Broad knowledge of workers' compensation claims and claims adjudication best practices • Expert proficiency in analytical skills and understanding of claims metrics • Proven ability to contribute strategic insight to enterprise claims strategy • Superior oral and written communication skills with ability to present to C-suite executives and external stakeholders • Proven ability to represent the organization externally as claims subject matter expert • Experience in crisis communication and managing high-stakes stakeholder relationships • Must live and work in the United States (territories excluded) • Access to reliable, high-speed internet

🏖️ Benefits

• Competitive cash compensation • Comprehensive health plans • Generous PTO • Future focused 401k match • Generous parental and caregiver leave • Discretionary bonuses may be granted annually to eligible team members

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