Senior Claims & Participant Services Specialist Ultimate Staffing ServicesSenior Claims & Participant Services SpecialistBurbank, California$55,000–$65,000 / hourThis highly visible role serves as a key point of contact for health plan participants, providers, hospitals, and physicians while also supporting process improvement initiatives across claims operations. This position offers the opportunity to make a meaningful impact by improving participant experiences, resolving complex claims issues, and contributing to operational excellence.
Claims Technical Director - Excess Claims Great American Insurance Group (DBA)Claims Technical Director - Excess ClaimsLos Angeles, CA$123,280–$168,820 / yearOperates at the highest authority level on complex, high-impact assignments, possessing extensive technical knowledge and skills in both product and industry. To support this, employees in this role are expected to be on-site at our Downtown Los Angeles office four days a week, with the flexibility to work one day remotely.
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.
NewClaims Appraiser - Auto Estimatics State FarmClaims Appraiser - Auto EstimaticsSan Fernando, CA$69,398.62–$91,000 / yearWith the opportunity to initially earn up to 20 days annually plus parental leave, paid holidays, celebration day, life leave (40 hours/year), bereavement leave, and community service/education support days, there will be plenty of time for you! Additional Details: Employees must successfully complete all required training, including applicable proficiency, licensing exam(s), Motor Vehicle Record (MVR) checks, and background checks required of various state(s).
Claims Examiner, General Liability Claims GallagherClaims Examiner, General Liability ClaimsTorrance, 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.
Claims Follow-Up Lead-CA WellPsycheClaims Follow-Up Lead-CALos Angeles, CARemote$25–$30 / hourWe are a lean and fast-growing organization , which means every team member plays a meaningful role in improving operations, strengthening revenue cycle performance, and supporting our mission to help patients become the best version of themselves. The Claims Follow-Up Lead is a senior, hands-on revenue cycle professional responsible for resolving complex denials, accelerating accounts receivable, and supporting daily claims workflow execution.
Claims Representative- Healthcare Billing Vista Del MarClaims Representative- Healthcare BillingLos Angeles, California$28–$30 / hourIf TIER data is complete, submits the call to update CWS; Monthly, runs Non-Final Saved Notes reports for programs assigned, reviews notes for action required., and disseminates to programs; Reviews Final Saved Charge reports before batching claims for electronic submission to DMH. Completes any updates or corrections required, and manually updates services charges and ‘final save’ so that claims can be batched; Daily, reviews Diagnosis and Financial Update Reports and Client Action Forms submitted for any client information that requires updating in CWS.
NewProfessional Liability Claims Advisor Sedgwick Claims Management Services, Inc.Professional Liability Claims AdvisorCARemote$100,000–$145,000 / 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. Analyzes and processes complex or technically difficult liability 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.
NewLiability Claims Examiner Sedgwick Claims Management Services, Inc.Liability Claims ExaminerWest Hills, CA$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: To address and handle high end General Liability cases with serious injuries, complex coverage scenarios and legal inquiries or disputes; to develop a strategy to bring a case to satisfactory resolution.
Claims Examiner - Workers Compensation (Hourly) Iconma LLCClaims Examiner - Workers Compensation (Hourly)CAResponsibilities: 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. Manages claim recoveries, including but not limited to: subrogation, Second Injury Fund excess recoveries and Social Security and Medicare offsets.
Claims Manager (West Coast) Ledgebrook IncClaims Manager (West Coast)CARemoteWe're looking for someone with: 10+ years handling Commercial General Liability (CGL) Bodily Injury, Property Damage, and Personal & Advertising Injury claims 5+ years managing litigated CGL claims, developing and executing defense strategies 3+ years handling non-admitted market Excess & Surplus Lines claims 2+ years overseeing claims handled by Third-Party Administrators (TPAs) 2+ years supervising claim professionals - coaching, mentoring, and driving performance Proven ability to analyze coverage and prepare reservation of rights or coverage decision letters Strong litigation management skills - selecting, directing, and evaluating defense counsel Experience participating in quality assurance claim file reviews and process improvements Analytical mindset: You dissect complex claims, evaluate exposure, and create actionable strategies Coverage expertise: You interpret and apply policy language with precision and clarity Collaborative communicator: You build alignment across underwriting, legal, product, and operations teams Technology & innovation: You're proficient with modern claims systems, data, and analytics tools - and eager to implement workflow improvements that drive speed, accuracy, and customer satisfaction Customer focus: You combine empathy and responsiveness with professionalism Entrepreneurial drive: You take ownership, challenge the status quo, and help build scalable, forward-thinking solutions Decisive leadership: You make informed, timely decisions with confidence and accountability Exposure to Allied Healthcare and/or Professional Liability claims (a plus) Important - note is only for candidates applying from the U.S. Please note: This position is open only to candidates who are authorized to work in the United States without the need for current or future employer-sponsored work authorization. You bring: A passion for delivering world-class service to both internal and external customers Intellectual curiosity and a desire for innovation, rather than following the status quo A hunger for continuous learning and personal growth Agile prioritization skills and a sense of urgency - you balance getting it right with getting it done A strong drive to win together as a high-performing team A moral compass to "do the right thing, period."
EPIC Applications Analyst (1-4): Hospital Billing Admin and Hospital Billing Claims - IT Services - Full Time SolutionHealthEPIC Applications Analyst (1-4): Hospital Billing Admin and Hospital Billing Claims - IT Services - Full TimeCAEpic Application Analysts 2-4 require current Epic training status (certification, accreditation, and/or proficiency) in primary application required, with a combination of current Epic training statuses in additional area(s) in application maintenance and development required in upper levels. Ideal candidates will possess strong experience as analyst with expert knowledge and experience in leading system analysis with special emphasis on system methodologies, projects management and business process reengineering related to information systems required.
NewClaims Team Lead I Workers Compensation I CA experience required Sedgwick Claims Management Services, Inc.Claims Team Lead I Workers Compensation I CA experience requiredCA$75,000–$100,000 / yearTo supervise the operation of multiple teams of examiners and technical staff for workers compensation for clients; to monitor colleagues' workloads, provide training, and monitor individual claim activities; to provide technical/jurisdictional direction to examiner reports on claims adjudication; and to maintain a diary on claims in the teams including frequent diaries on complex or high exposure claims. Supervises multiple teams of examiners, multiple product line examiners and/or several (minimum seven) technical operations colleagues for a wide span of control; may delegate some duties to others within the unit.
Workers'''' Compensation Claims Examiner | CA WC Experience Required Sedgwick Claims Management Services, Inc.Workers'''' Compensation Claims Examiner | CA WC Experience RequiredCARemote$80,000–$105,000 / yearPRIMARY PURPOSE OF THE ROLE To analyze complex or technically difficult California 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. Mental: 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.
Claims Edit Coder Cedars-Sinai Medical CenterClaims Edit CoderLos Angeles, CAWhat you will be doing in this role: The Claims Edit Coder (Coder II) operated under the general direction of an audit supervisor and involves responsibilities across various work units, as well as duties specific to the reporting team. Communicates with physicians, providers, and external departments regarding documentation clarity, specificity, ensure the completeness of documentation required for code assignment within area(s) of assignment or specialty.
Health Claims Examiner Ultimate Staffing ServicesHealth Claims ExaminerPasadena, California$23–$27 / hourCommunicate professionally with members and providers to address inquiries, follow up on pended claims, and complete necessary corrections or adjustments. Strong working knowledge of medical terminology, billing practices, and coding systems, including CPT, ICD-9/ICD-10, HCPCS, DRG, and revenue codes.
Healthcare Claims Examiner Ultimate Staffing ServicesHealthcare Claims ExaminerEl Monte, California$25–$28 / hourResearch and resolve claim discrepancies, including making payment corrections, recovering overpayments, and reprocessing claims as needed. Evaluate claims for potential fraud, waste, abuse, Workers' Compensation, hospital-acquired conditions, and third-party liability; escalate issues appropriately.
Healthcare Claims Analyst Ultimate Staffing ServicesHealthcare Claims AnalystPasadena, California$56,000–$62,000This role handles claims processing, inbound customer inquiries, eligibility and benefits research, issue resolution, process improvement, and staff training while delivering exceptional customer service. Seeking an experienced customer service and claims professional to support participants, providers, and healthcare partners.
Worker''''s Compensation Claim Counsel The Travelers Companies IncWorker''''s Compensation Claim CounselGlendale, CA$106,300–$175,400 / yearAs a Counsel with Travelers you will be responsible for high quality, proactive case handling and will have the opportunity to use your legal expertise and litigation skills to handle a caseload of predominantly low to moderate complexity and deliver optimal results for Travelers'' insured customers. Travelers offers the strength of a national legal organization committed to your professional development while maintaining a local focus, positioning you as a strong business partner and trusted advisor who delivers exceptional value through local expertise and outstanding client service.
Traffic & Revenue Junior Engineer Ferrovial SETraffic & Revenue Junior EngineerManassas, VAOnce completed, the project will include three toll-free general-purpose lanes in each direction and two express lanes in each direction with a state-of-the-art open-road electronic toll collection system. About us: In 2016, the Commonwealth of Virginia selected a Cintra-led consortium to finance, design, build, operate and maintain the express lanes on Interstate 66 Outside the Beltway.