AVP, Claims Quality Assurance & Performance Management Argo Group International Holdings IncAVP, Claims Quality Assurance & Performance ManagementLos Angeles, CA$137,496–$189,516 / yearQualifications / Experience Required: A specialized knowledge of managing Quality Assurance programs typically achieved through: Bachelor's degree required; JD, advanced degree, CPCU, AIC, SCLA, Six Sigma/Lean, PMP, Prosci, Guidewire certification, or similar insurance, claims, audit, process improvement, project management, or change management credential preferred. In addition, the role will expand QA output into a broader claims performance management capability by linking QA findings to Guidewire data, KPI trends, process assessment analytics, adjuster and manager performance evaluation, and senior leadership reporting across Argo's claims organization.
Avp, Claims Quality Assurance & Performance Management Argo Group International Holdings Ltd.Avp, Claims Quality Assurance & Performance ManagementLos Angeles, CA$137,496–$189,516 / yearQualifications / Experience Required: A specialized knowledge of managing Quality Assurance programs typically achieved through: Bachelor's degree required; JD, advanced degree, CPCU, AIC, SCLA, Six Sigma/Lean, PMP, Prosci, Guidewire certification, or similar insurance, claims, audit, process improvement, project management, or change management credential preferred. In addition, the role will expand QA output into a broader claims performance management capability by linking QA findings to Guidewire data, KPI trends, process assessment analytics, adjuster and manager performance evaluation, and senior leadership reporting across Argo's claims organization.
Claims Specialist Safety Department EMCOR Group IncClaims Specialist Safety DepartmentIrvine, CA$36–$40 / hourIt will actively manage the workers' compensation claims process from start to end, ensure compliance with regulatory requirements, collaborate with internal business partners on our injured workers'' health and claims status, and support the Management Team, HR, and safety with insurance claims. Support the root cause analysis meetings with managers/supervisors.• Prepare claim documentation for settlement and obtain EMCOR Risk Manager approval.•
Construction Consultant Allied Public AdjustersConstruction ConsultantLos Angeles, CASince 1997 we've worked on behalf of policyholders to demand what's right, and we're deliberate about the claims we take on, focusing on losses complex enough to warrant real investment: time in the field, deep investigation, and construction expertise most firms don't bring to bear. Collaborate with Public Adjusters on-site and by phone to inspect losses, identify all damage (including easily-missed items), and determine appropriate scope of repairs.
Senior Estimator Allied Public AdjustersSenior EstimatorGlendale, CASince 1997 we've worked on behalf of policyholders to demand what's right, and we're deliberate about the claims we take on, focusing on losses complex enough to warrant real investment: time in the field, deep investigation, and construction expertise most firms don't bring to bear. Collaborate with Public Adjusters on-site and by phone to inspect losses, identify all damage (including easily-missed items), and determine appropriate scope of repairs.
Claims Specialist II - Provider Claims Short-Term Assignment Inland Empire Health PlanClaims Specialist II - Provider Claims Short-Term AssignmentCalifornia, CAAdditional responsibilities include handling escalated claim-related telephone inquiries, assisting with cross-training as needed, performing complex claim adjustment projects, and processing Provider Disputes in accordance with regulatory requirements. The Claims Specialist II - Provider Claims is responsible for fulfilling the technical support needs of appeals and support staff, while ensuring that appeals and call center tasks are conducted consistently and accurately.
Outside Auto Appraiser TravelersOutside Auto AppraiserLos Angeles, CaliforniaAs an Outside Auto Appraiser, you are responsible for physically inspecting damaged vehicles, estimating repair costs, working closely with repair facilities, and determining and settling the actual cash value of total loss vehicles to ensure accurate and timely claim settlements. Inspect and assess vehicle damage resulting from accidents, weather events, or other covered losses by conducting thorough virtual or on-site inspections at body shops or customer locations.
Claims Team Supervisor - Dedicated Account Athens AdministratorsClaims Team Supervisor - Dedicated AccountOrange, CaliforniaATHENS POSITION DETAILS Position Title: Claims Supervisor Department: Workers’ Compensation Reports To: Division Claims Manager FLSA Status: Exempt Job Grade: 14 Career Ladder: Next step in progression could include Division Claims Manager ATHENS ADMINISTRATORS Explore the Athens Administrators difference: We have been dynamic, innovative leaders in claims administration since our founding in 1976. Provide direct supervision for 6-10 employees, typically consisting of Senior Claims Examiners, Future Medical Claims Examiners, Claims Examiners, Assistant Claims Examiners and Assistant Claims Examiner Trainees.
CA - Senior Claims Adjuster, Worker''s Compensation Pie Insurance Holdings IncCA - Senior Claims Adjuster, Worker''s CompensationCalifornia, CARemote$95,000–$120,000 / yearThis role will work with internal and external partners to deliver best in class performance, identify and pursue claim mitigation opportunities and deliver favorable claim outcomes for Pie's customers. The Senior Claims Adjuster will play a critical role in delivering quality claim file management and an industry-leading customer claims experience.,
Workers Compensation - Claims Adjuster | Brea, CA Sedgwick Claims Management Services, Inc.Workers Compensation - Claims Adjuster | Brea, CABrea, CARemote$85,000–$105,000 / 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 Adjuster Senior GallagherClaims Adjuster SeniorTorrance, CaliforniaRemoteFull timeBehaviors: Ability to think critically, solve problems, plan and organize activities, serve clients, negotiate, effectively communicate verbally and in writing and embrace new challenges. Introduction : At Gallagher, we help clients face risk with confidence because we believe that when businesses are protected, they’re free to grow, lead, and innovate.
Epic Denials Manager DeloitteEpic Denials ManagerInglewood, CARemote$140,000–$160,000 / yearAs an Epic Denials Manager, you will help deliver back-end revenue cycle management (RCM) services, including denials and claims submission, denials management, payment posting, and credits and refunds, A/R follow-up for health care provider client. Our purpose comes through in our work with clients that enables impact and value in their organizations, as well as through our own investments, commitments, and actions across areas that help drive positive outcomes for our communities.
Attorney-Represented Bodily Injury Associate Manager Allstate Insurance CompanyAttorney-Represented Bodily Injury Associate ManagerLos Angeles, CAKey responsibilities include developing and executing strategies to drive strong employee performance and consistent, expert claims handling; monitoring staffing levels and workloads; providing coaching and mentoring; and participating in performance management and reviews. The Team Leader is responsible for delivering exceptional claims and inquiry experiences for our Agents through chat‑based services, while effectively leading, motivating, and developing a team of 10-15 adjusters or vendor partners.
3rd Party Claims Adjuster/Examiner - HYBRID DB Insurance Co., Ltd.3rd Party Claims Adjuster/Examiner - HYBRIDAnaheim, CA$65,000–$100,000 / yearIn this role, you will handle claims involving third-party liability, specifically in commercial trucking and business policies, working to resolve them efficiently while ensuring fair settlements. Key Responsibilities: Investigate, evaluate, and resolve third-party claims including bodily injury, property damage, and liability claims including ones in litigation for commercial trucking and business policies.
Major Case Specialist, Auto Liability TravelersMajor Case Specialist, Auto LiabilityDiamond Bar, California$99,100–$163,400 / yearAs a Major Case Specialist, you are responsible for investigating, evaluating, reserving, negotiating, and resolving complex, serious and severe claims typically with full damage value for average claim $500,000 to over a multi-million dollar value. This role is eligible for a sign-on bonus of up to $20,000Be the Hero in Someone's StoryWhen life throws curveballs - storms, accidents, unexpected challenges - YOU become the beacon of hope that guides our customers back to stability.
Government Biller-Collector Per Diem Day Shift Pipeline HealthGovernment Biller-Collector Per Diem Day ShiftCerritos, CaliforniaWears nametag properly; follows dress code policy; answers phone correctly and promptly; is prepared for meetings; meets deadlines; does not participate in gossip; acts ethically and treats others with respect; respects customer’s and co-worker’s time; establishes and maintains effective relationships with customers and co-workers. Resolve DUR Medi-Cal inquiries with the Pharmacist for affected drugs/ patients prior to re-submission of relevant billings.
Complex Claims Consultant - Lawyers Professional Liability (Large Law) CNA Financial CorpComplex Claims Consultant - Lawyers Professional Liability (Large Law)Irvine, CA$72,000–$141,000 / yearPerforms a combination of duties in accordance with departmental guidelines: Manages an inventory of highly complex professional liability claims, with 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.
Major Litigation Unit Complex Claims Consulting Director CNA Financial Corp.Major Litigation Unit Complex Claims Consulting DirectorLos Angeles, CA$97,000–$189,000 / yearJOB DESCRIPTION: Essential Duties & Responsibilities: Performs a combination of duties in accordance with departmental guidelines: Manages an inventory of the most complex commercial claims, which are generally multi-year and have very significant loss exposure, by following company protocols to manage and oversee all aspects of the claim handling, including coverage determinations, investigations, and resolution strategies which may include pursuit of risk transfer, extensive negotiations and complex litigation management. Drives the resolution of 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.
Complex Claims Consultant - Medical Malpractice, Hospitals, Healthcare Facilities, Physicians And Dental Malpractice CNA Financial Corp.Complex Claims Consultant - Medical Malpractice, Hospitals, Healthcare Facilities, Physicians And Dental MalpracticeIrvine, CA$72,000–$141,000 / yearResolves 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. Performs a combination of duties in accordance with departmental guidelines: Manages an inventory of highly complex commercial 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.
Complex Claims Consulting Director - Mass Tort Unit CNA Financial CorpComplex Claims Consulting Director - Mass Tort UnitLos Angeles, CA$97,000–$189,000 / yearManages an inventory of the most complex commercial claims, which generally involve multiple years of coverage, have significant loss exposure, by following company protocols to manage and oversee all aspects of the claim handling, including coverage determinations, investigations, and resolution strategies which may include pursuit of risk transfer, extensive negotiations and management of complex litigation. Drives the resolution of claims by collaborating with internal and external business partners to develop, own and execute a claim resolution strategy, that often includes negotiating complex settlements, partnering with counsel to manage complex litigation and authorizing payments within scope of authority.