Claims Auditor MedPOINT ManagementClaims AuditorSherman Oaks, CARemoteFull timeMedPOINT Management is a leading Independent Practice Association (IPA) management company serving the greater Los Angeles area, dedicated to delivering high-quality, coordinated healthcare to patients across Southern California. Our team enjoys a collaborative work culture, opportunities for professional growth, and the satisfaction of making a meaningful impact in the healthcare industry.
Sr. Claims Counsel Sompo InternationalSr. Claims CounselLos Angeles, CA$125,000–$175,000 / yearOur business, your impact, our opportunity: What you'll be doing: Direct handle primary & excess Casualty claims involving emerging risks, potential long-term exposure, or significant coverage issues. Below is a summary of our current comprehensive U.S. benefit programs: Two medical plans to choose from, including a Traditional PPO & a Consumer Driven Health Plan with a Health Savings account providing a competitive employer contribution.
Sr. Claims Counsel Sompo International Holdings LimitedSr. Claims CounselLos Angeles, CA$125,000–$175,000 / yearOur business, your impact, our opportunity: What you'll be doing: Direct handle primary & excess Casualty claims involving emerging risks, potential long-term exposure, or significant coverage issues. Below is a summary of our current comprehensive U.S. benefit programs: Two medical plans to choose from, including a Traditional PPO & a Consumer Driven Health Plan with a Health Savings account providing a competitive employer contribution.
Claim Examiner- WC TPI Global (formerly Tech Providers, Inc.)Claim Examiner- WCBrea, CAEstablish reserves, using independent judgment and expertise and authorizes payments within scope of authority, settling claims in the most cost-effective manner and ensuring timely issuance of disbursements. Duties:Interprets and makes decisions using independent judgment on more complex and unusual policy coverages and determines if coverages apply to claims submitted.
Claims Examiner MedPOINT ManagementClaims ExaminerSherman Oaks, CARemoteFull timeMedPOINT Management is a leading Independent Physician Association (IPA) management company based in Sherman Oaks, CA, dedicated to delivering high-quality healthcare administrative services. We foster a collaborative and supportive work environment where employees are empowered to grow and make a meaningful impact in the healthcare industry.
Medical Malpractice Claims Specialist KI Executive GroupMedical Malpractice Claims SpecialistOrange, CaliforniaThe Medical Malpractice Claims Specialist is responsible for managing assigned medical malpractice claim files, including complex and high exposure matters. This role oversees claim investigation, litigation coordination, reporting, and documentation while working closely with defense counsel and internal stakeholders.
NewClaims Delegations Oversight Specialist MedPOINT ManagementClaims Delegations Oversight SpecialistSherman Oaks, CARemoteFull timeMedPOINT Management is a leading Independent Practice Association (IPA) management company serving the greater Los Angeles area, with decades of experience supporting physician organizations and health plan partnerships. Our clients trust us for our deep expertise in managed care operations, and our employees value the collaborative, mission-driven culture we've built.
Sr Claims Clerk Crawford & CoSr Claims ClerkCATo determine the actual offer, Crawford considers a wide range of factors including the candidate's previous experience and education, market rates, minimum pay requirements for the applicable jurisdiction, business segment, supply/demand, and scheduled hours. All resumes submitted by search firms to any employee at Crawford via-email, the Internet or in any form and/or method without a valid written Statement of Work in place for this position from Crawford HR/Recruitment will be deemed the sole property of Crawford.
Associate Claims Clinical/Care Advocacy Genworth Financial IncAssociate Claims Clinical/Care AdvocacyCA$55,800–$81,000 / yearUnlike other traditional Care Advocacy roles, your responsibilities will not stop there but will extend to working with digital product teams to help infuse your patient-centered knowledge into the design process and provide feedback that will help create incredible digital user experiences for millions of care-seekers and care-managers at a tremendous scale. Regular document key and frequent needs of users and report qualitative data (such as quotes and anecdotal stories that representative of user needs) and quantitative data (such as frequency of user needs and trends in gaps in local care environments and resources) to the digital product and design teams.
Claims Clinical Specialist Genworth Financial IncClaims Clinical SpecialistCAYou will be responsible for communicating with medical personnel at Long Term Care Facilities, Home Care Agencies, and/or individuals by conducting telephonic assessments for claimants to develop the plan of care and provide tax qualified certifications as required by the policy. At least two years' experience working in a role that required an understanding of single and cumulative medical conditions (particularly those common in the aging process), including their effect on physical/cognitive function, as well as their prognosis and rehabilitative potential.
Vice President-P&C Claims Edgewood Partners Insurance CenterVice President-P&C ClaimsNewport Beach, CA$175,000–$200,000 / yearFueled and driven by capable, committed people who share common beliefs and values and "bring it" every day, EPIC is always looking for people who have "the right stuff" - people who know what they want and aren't afraid to make it happen. Managed PTO for salaried/exempt employees (personal time off without accruals or caps); 22 PTO days starting out for hourly/non-exempt employees; 12 company-observed paid holidays; 4 early-close days.
Content Claims Specialist - Field - Level I Crawford & CoContent Claims Specialist - Field - Level IPasadena, CARemoteTo determine the actual offer, Crawford considers a wide range of factors including the candidate's previous experience and education, market rates, minimum pay requirements for the applicable jurisdiction, business segment, supply/demand, and scheduled hours. Communicate with adjusters/policyholders and industry vendors to explain their roles as Content Claims Specialists and their respective roles/contributions in the claims handling process.
Complex Claims Consultant - Private & NFP D&O CNA Financial CorpComplex Claims Consultant - Private & NFP D&OLos Angeles, 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.
Patient Account Collector - Fertility Claims 26-00237 Alura Workforce SolutionsPatient Account Collector - Fertility Claims 26-00237Pasadena, CAWith multiple locations across Los Angeles, Orange County, and the Inland Empire, their board-certified physicians and clinical teams have helped thousands of individuals and couples build families through personalized treatment and advanced technology. Committed to innovation, inclusivity, and patient-centered care, our client remains a trusted leader in reproductive medicine and family-building care.
Claims Recovery Director CNA Financial CorpClaims Recovery DirectorLos Angeles, CA$97,000–$189,000 / yearPerforms a combination of duties in accordance with departmental guidelines: Leads the work activities of Recovery Services professionals and/or managers and has full management responsibility for setting and communicating expectations, providing direction and coaching, facilitating ongoing training and development, managing employee performance and contributing to employee engagement. Responsibilities include managing direct staff, as well as outsourced vendor programs, while delivering superior business results through effective leadership of Recovery Services teams, driving continuous performance and operational improvements.
Workers Compensation Large Loss Claims Director CNA Financial Corp.Workers Compensation Large Loss Claims DirectorBrea, CA$97,000–$189,000 / yearWorking closely with claims leadership, disposition consultants, legal services, customers, brokers, and business partners, the Large Loss Director drives superior claim outcomes, technical excellence, operational effectiveness, and profitable growth while serving as a mentor and resource to claims professionals across the organization. This individual contributor role provides company-wide influence and leadership in the interpretation of complex policy coverages, litigation management, reserving, claim resolution strategies, regulatory compliance, and large loss methodologies.
Claims Quality Assurance Auditor PIH HealthClaims Quality Assurance AuditorWhittier, CA$23–$36.70Full timeThe fully integrated network is comprised of PIH Health Downey Hospital, PIH Health Good Samaritan Hospital, PIH Health Whittier Hospital, 37 outpatient medical office buildings, a multispecialty medical (physician) group, home healthcare services and hospice care, as well as heart, cancer, digestive health, orthopedics, women’s health, urgent care and emergency services. The organization is nationally recognized for excellence in patient care and patient experience, and the College of Healthcare Information Management Executives (CHIME) has identified PIH Health as one of the nation’s top hospital systems for best practices, cutting-edge advancements, quality of care and healthcare technology.
Facility Outpatient Surgical and Claims Edit Auditor (Remote) Cedars-Sinai Medical CenterFacility Outpatient Surgical and Claims Edit Auditor (Remote)Los Angeles, CARemoteMaintains appropriate open communication with internal and external partners and peer departments such as Coding Operations, Clinical Documentation Integrity (CDI), Payor Revenue Management (PRM), and Compliance Revenue Integrity (CRI). Auditors evaluate compliance with all coding guidelines including but not limited to: Internal Coding policies/procedures/handbook, American Hospital Association (AHA) and American Medical Association (AMA) coding references, local, State, and Federal Coding Guidelines.
Facility Inpatient Surgical and Claims Edit Auditor Cedars-Sinai Medical CenterFacility Inpatient Surgical and Claims Edit AuditorLos Angeles, CARemoteMaintains appropriate open communication with internal and external partners and peer departments such as Coding Operations, Clinical Documentation Integrity (CDI), Payor Revenue Management (PRM), and Compliance Revenue Integrity (CRI). Auditors evaluate compliance with all coding guidelines including but not limited to: Internal Coding policies/procedures/handbook, American Hospital Association (AHA) and American Medical Association (AMA) coding references, local, State, and Federal Coding Guidelines.
Claims Specialist Pavement Recycling Systems, IncClaims SpecialistJurupa Valley, California$85,000–$115,000 / yearFull timeThe Claims Specialist is responsible for evaluating, processing, and managing liability, property, auto, general liability claims, and employment claims in compliance with state regulations; documenting activities; conveying information regarding claims and/or benefits; and providing testimony in benefit disputes while exercising discretion, independent judgment, critical thinking skills and demonstrate exemplary customer services skills. Serve as the face of the company in providing frequent, proactive verbal communication with our claimants, customers and/or their representatives demonstrating empathy and active listening while providing clear updates, direction and explanations regarding the claim process, benefits, and other pertinent policy provisions.