Workers Compensation Claims Team Lead | Hybrid |Brea, CA Sedgwick Claims Management Services, Inc.Workers Compensation Claims Team Lead | Hybrid |Brea, CABrea, CAMental: Clear and conceptual thinking ability; excellent judgment, troubleshooting, problem solving, analysis, and discretion; ability to handle work-related stress; ability to handle multiple priorities simultaneously; and ability to meet deadlines. Sedgwick is building a diverse, equitable, and inclusive workplace and recognizes that each person possesses a unique combination of skills, knowledge, and experience.
Workers Compensation Claims Examiner | Hybrid | Orange, CA Sedgwick Claims Management Services, Inc.Workers Compensation Claims Examiner | Hybrid | Orange, CAOrange, CA$80,000–$100,000 / yearMental: Clear and conceptual thinking ability; excellent judgment, troubleshooting, problem solving, analysis, and discretion; ability to handle work-related stress; ability to handle multiple priorities simultaneously; and ability to meet deadlines. PRIMARY PURPOSE OF THE ROLE: To analyze workers' compensation claims on behalf of our valued clients to determine benefits due, while ensuring ongoing adjudication of claims within service expectations, industry best practices, and specific client service requirements.
Claims Supervisor, Complex General Liability GallagherClaims Supervisor, Complex General LiabilityTorrance, CaliforniaRemoteFull timeAbility to actively review work of others via file reviews; identify coaching opportunities, act on needed coaching opportunities and position subordinates for successful development leading to advancement within the organization. As part of Gallagher, a global leader in insurance, risk management, and consulting, you’ll be joining a team that’s passionate about helping individuals and organizations thrive.
Workers Compensation - Claims Associate | Orange, CA Sedgwick Claims Management Services, Inc.Workers Compensation - Claims Associate | Orange, CAOrange, CA$22–$24 / hourMental: Clear and conceptual thinking ability; excellent judgment, troubleshooting, problem solving, analysis, and discretion; ability to handle work-related stress; ability to handle multiple priorities simultaneously; and ability to meet deadlines. Sedgwick is building a diverse, equitable, and inclusive workplace and recognizes that each person possesses a unique combination of skills, knowledge, and experience.
NewWorkers Compensation Claims Examiner | Orange, CA Sedgwick Claims Management Services, Inc.Workers Compensation Claims Examiner | Orange, CAOrange, CARemote$85,000–$100,000 / yearMental: Clear and conceptual thinking ability; excellent judgment, troubleshooting, problem solving, analysis, and discretion; ability to handle work-related stress; ability to handle multiple priorities simultaneously; and ability to meet deadlines. PRIMARY PURPOSE OF THE ROLE: To analyze Workers Compensation claims on behalf of our valued clients to determine benefits due, while ensuring ongoing adjudication of claims within service expectations, industry best practices, and specific client service requirements.
Claims Examiner - Workers Compensation (Hourly) eTeam Inc.Claims Examiner - Workers Compensation (Hourly)Brea, CARemote$45–$48.57 / hourPRIMARY PURPOSE: To analyze complex or technically difficult workers' compensation claims to determine benefits due; to work with high exposure claims involving litigation and rehabilitation; to ensure ongoing adjudication of claims within service expectations, industry best practices and specific client service requirements; and to identify subrogation of claims and negotiate settlements. Analyzing and processing claims through well-developed action plans to an appropriate and timely resolution by investigating and gathering information to determine the exposure on the claim.
Claims Specialist Diversity Caree HubClaims SpecialistOrange, CaliforniaManage medical malpractice claims, including the assignment, direction, and control of defense counsel, under supervision and in compliance with the Claims Technical Manual, the Defense Attorney Guidelines, and the MPT Agreement. Minimum five years of medical malpractice claims management experience and/or three years CAP claims experience.
Medical Claims Resolution Specialist Kinetic Personnel Group, Inc.Medical Claims Resolution SpecialistOrange, CA$25–$31 / hourA full time permanent position includes a pay raise, telecommute options, a CalPERS Pension and excellent government benefits including generous holiday, PTO and sick pay days off, year one! Job duties: Addresses provider inquiries, questions, and concerns in all areas including enrollment, claims submission and payment, benefit interpretation, and referrals/authorizations for medical care.
Claims Examiner - Workers Compensation MindlanceClaims Examiner - Workers CompensationPasadena, CARemote$52.57–$53.57 / hourPRIMARY PURPOSE: To analyze complex or technically difficult workers' compensation claims to determine benefits due; to work with high exposure claims involving litigation and rehabilitation; to ensure ongoing adjudication of claims within service expectations, industry best practices and specific client service requirements; and to identify subrogation of claims and negotiate settlements. Subject matter expert of appropriate insurance principles and laws for line-of-business handled, recoveries offsets and deductions, claim and disability duration, cost containment principles including medical management practices and Social Security and Medicare application procedures as applicable to line-of-business.
Program Manager - Workers Compensation Claims | CA Claims Exp. Preferred (Hybrid - California) Sedgwick Claims Management Services, Inc.Program Manager - Workers Compensation Claims | CA Claims Exp. Preferred (Hybrid - California)Brea, CA$95,000–$120,000 / yearMental: Clear and conceptual thinking ability; excellent judgment, troubleshooting, problem solving, analysis, and discretion; ability to handle work-related stress; ability to handle multiple priorities simultaneously; and ability to meet deadlines. Sedgwick is building a diverse, equitable, and inclusive workplace and recognizes that each person possesses a unique combination of skills, knowledge, and experience.
Claims Clerk (Part-Time) Astiva HealthClaims Clerk (Part-Time)Orange, CADemonstrated proficiency in MS Office (Excel, Word, Outlook and Power Point). Misdirected claims are filed on SFTP folders according to the IPA of the member.
GLOVIS: Temp Analyst, Claims Revenue and Cost Integration Elevated ResourcesGLOVIS: Temp Analyst, Claims Revenue and Cost IntegrationIrvine, CaliforniaThis role will focus on collecting, organizing, validating, and analyzing claims-related data to help develop an AI solution that can review claim photos, inspection reports, repair estimates, and other documentation to identify damages, estimate severity, and assist with determining liability. Collect, organize, and maintain claim photos, inspection reports, repair estimates, invoices, incident reports, and supporting documentation.
Assistant Director, Claims Operations Impresiv HealthAssistant Director, Claims OperationsHuntington Beach, CA$95,000–$120,000 / yearThe Assistant Director will provide operational, analytical, administrative, and project support across claims processing, 837 file oversight, payment integrity, issue resolution, provider and IPA coordination, reporting, audit readiness, system initiatives, and process improvement. Track, document, escalate, and help resolve complex claims issues involving providers, IPAs, delegated entities, vendors, and internal departments.
NewSenior Claims Specialist Macpower Digital Assets Edge Private LimitedSenior Claims SpecialistOrange, CA$110,000–$130,000 / yearJob Summary: Seeking a Senior Claims Specialist to manage a complex caseload of medical malpractice claims, supervise junior claims specialists, and contribute to ongoing training efforts. Key Responsibilities: Manage medical malpractice claims , including assigning and directing defense counsel, following Claims Technical Manual, Defense Attorney Guidelines, and MPT Agreement.
Claims Examiner - Workers Compensation ICONMA, LLCClaims Examiner - Workers CompensationOrange, CARemote$47–$52 / hourSubject matter expert of appropriate insurance principles and laws for line-of-business handled, recoveries offsets and deductions, claim and disability duration, cost containment principles including medical management practices and Social Security and Medicare application procedures as applicable to line-of-business. Responsibilities: Analyzes and processes complex or technically difficult workers' compensation 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.
Claims Examiner - Workers Compensation (Hourly) MindlanceClaims Examiner - Workers Compensation (Hourly)Brea, CARemote$47–$48 / hourDuties: PRIMARY PURPOSE: To analyze complex or technically difficult workers' compensation claims to determine benefits due; to work with high exposure claims involving litigation and rehabilitation; to ensure ongoing adjudication of claims within service expectations, industry best practices and specific client service requirements; and to identify subrogation of claims and negotiate settlements. Analyzes and processes complex or technically difficult workers' compensation 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.
Patient Account Representative - Commercial Claims GuidehousePatient Account Representative - Commercial ClaimsEl Segundo, CA$38,000–$64,000 / yearCompensation decisions depend on a wide range of factors, including but not limited to skill sets, experience and training, security clearances, licensure and certifications, and other business and organizational needs. All communication regarding recruitment for a Guidehouse position will be sent from Guidehouse email domains including @guidehouse.com or guidehouse@myworkday.com.
Claims (Billing) Specialist / Patient Account Representative - Healthcare GuidehouseClaims (Billing) Specialist / Patient Account Representative - HealthcareEl Segundo, CA$34,000–$56,000 / yearRepresentatives are responsible for maintaining knowledge, skills, and abilities that contribute to various accounting/administrative tasks involved in preparing billing data for agencies Guidehouse works with. Compensation decisions depend on a wide range of factors, including but not limited to skill sets, experience and training, security clearances, licensure and certifications, and other business and organizational needs.
Senior Claims Examiner, Complex General Liability GallagherSenior Claims Examiner, Complex General LiabilityTorrance, CaliforniaRemoteFull timeThe actual compensation will be influenced by a wide range of factors including, but not limited to previous experience, education, pay market/geography, complexity or scope, specialized skill set, lines of business/practice area, supply/demand, and scheduled hours. Behaviors: Ability to think critically, solve problems, plan and organize activities, serve clients, negotiate, effectively communicate verbally and in writing and embrace new challenges.
Senior Claim Examiner I AmTrust Financial Services, Inc.Senior Claim Examiner IIrvine, California$49–$54 / hourFull timeSalaries are based upon a wide range of factors considered in making the compensation decision, including, but not limited to, candidate skills, experience, education and training, the scope and responsibilities of the role, as well as market and business considerations . Your ability to effectively interact with insureds, claimants, and their legal representatives will be essential in driving timely settlements while adhering to AmTrust’s mission, vision, and values.