Workers Compensation Claims Specialist, Complex & Settlement Focus CNA Financial Corp.Workers Compensation Claims Specialist, Complex & Settlement FocusWalnut Creek, CA$54,000–$103,000 / yearJOB DESCRIPTION: Essential Duties & Responsibilities: Performs a combination of duties in accordance with departmental guidelines: Manages an inventory of moderate to high complexity and exposure commercial claims by following company protocols to verify policy coverage, conduct investigations, develop and employ resolution strategies, and authorize disbursements within authority limits. Conducts focused investigation to determine compensability, liability and covered damages by gathering pertinent information, such as contracts or other documents, taking recorded statements from customers, claimants, injured workers, witnesses, and working with experts, or other parties, as necessary to verify the facts of the claim.
Complex Claims Consultant - Private & NFP D&O CNA Financial CorpComplex Claims Consultant - Private & NFP D&OWalnut Creek, CA$72,000–$141,000 / yearPerforms a combination of duties in accordance with departmental guidelines: Manages an inventory of highly complex Financial Lines claims, with large exposures that require a high degree of specialized technical expertise and coordination, by following company protocols to verify policy coverage, conduct investigations, develop and employ resolution strategies, and authorize disbursements within authority limits. Resolves claims by collaborating with internal and external business partners to develop, own and execute a claim resolution strategy, that includes management of timely and adequate reserves, collaborating with coverage experts, negotiating complex settlements, partnering with counsel to manage complex litigation and authorizing payments within scope of authority.
Sr. Claims Specialist, Professional Liability | Medical Malpractice | California Sedgwick Claims Management Services, Inc.Sr. Claims Specialist, Professional Liability | Medical Malpractice | CaliforniaConcord, CA$100,000–$125,000 / yearIdeal candidates demonstrate strong analytical and negotiation skills, exercise sound judgment, and are committed to delivering timely, cost‑effective claim resolutions while maintaining a high level of customer service. ESSENTIAL RESPONSIBLITIES MAY INCLUDE: Analyzes and processes complex or technically difficult medical malpractice claims by investigating and gathering information to determine the exposure on the claim; manages claims through well-developed action plans to an appropriate and timely resolution.
Electronic Data Interchange (EDI) Claims Assistant UCSF Medical CenterElectronic Data Interchange (EDI) Claims AssistantEmeryville, CAThe Electronic Data Interchange (EDI) Claims Assistant will work in the EDI unit and will be responsible for all aspects of EDI production for UCSF Health Patient Financial Services (PFS), Medical Group Business Services (MGBS), UCSF Benioff Children's Hospital Oakland (BCH Oakland), By the Bay Health, UCSF Physicians Group, Community Connect clinic, and Community Hospitals. The EDI production supports all electronic claim production to various payers and clearinghouses, including Medicare, Medi-Cal, Medi-Cal MC, Anthem Blue Cross, Blue Shield, Availity, Optum IEDI, Optum Exchange, Jopari, PNT, and Office Ally.
Medical Assistant/Front office – Plastic Surgery & Dermatology COREY S MAAS MD A MEDICAL CORPORATIMedical Assistant/Front office – Plastic Surgery & DermatologySAN FRANCISCO, CA$21–$30 / hourFull timeThis role is ideal for a motivated team player who is emotionally and professionally mature, detail-oriented, and comfortable navigating both patient care and insurance-related workflows in a fast-paced, high-touch medical environment. We are seeking an experienced, polished, and highly professional Medical Assistant with clinical, front office, and insurance experience to support both our plastic surgery and dermatology services.