Claims Examiner - Workers Compensation (On-Site Ontario, California Or Remote In California) Sedgwick Claims Management Services, Inc.Claims Examiner - Workers Compensation (On-Site Ontario, California Or Remote In California)Ontario, CARemote$85,000–$95,000 / 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 | Brea, CA (Hybrid) Sedgwick Claims Management Services, Inc.Claims Examiner- Workers Compensation | Brea, CA (Hybrid)Brea, CARemote$85,000–$105,000 / yearPRIMARY 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. 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 Examiner - Workers Compensation (Hybrid - Ontario, CA) Sedgwick Claims Management Services, Inc.Claims Examiner - Workers Compensation (Hybrid - Ontario, CA)Ontario, CA$80,000–$90,000 / yearPRIMARY 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. Sedgwick is building a diverse, equitable, and inclusive workplace and recognizes that each person possesses a unique combination of skills, knowledge, and experience.
Claims Representative (IAP) - Workers Compensation Training Program (On-Site Orange, CA) Sedgwick Claims Management Services, Inc.Claims Representative (IAP) - Workers Compensation Training Program (On-Site Orange, CA)Orange, 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. Adjusting various levels of workers' compensation claims under close supervision, which includes: Processing and responding to incoming mail, emails and other claim related documents according to status of the claim.
NewClaims Representative (Iap) - Workers Compensation Training Program (On-Site Orange, CA) Sedgwick Claims Management Services, Inc.Claims Representative (Iap) - Workers Compensation Training Program (On-Site Orange, CA)Orange, 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. Adjusting various levels of workers' compensation claims under close supervision, which includes: Processing and responding to incoming mail, emails and other claim related documents according to status of the claim.
Claims Representative (IAP) - Workers Compensation Training Program | Riverside, CA Sedgwick Claims Management Services, Inc.Claims Representative (IAP) - Workers Compensation Training Program | Riverside, CARiverside, 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. Adjusting various levels of workers' compensation claims under close supervision, which includes: Processing and responding to incoming mail, emails and other claim related documents according to status of the claim.
NewClaims Assistant (Entry Level - On-Site Ontario, CA) Sedgwick Claims Management Services, Inc.Claims Assistant (Entry Level - On-Site Ontario, CA)Ontario, CA$18–$20 / hourMental: Clear and conceptual thinking ability; excellent judgment 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 Representative (IAP) - Workers Compensation Training Program, Long Beach, CA Sedgwick Claims Management Services, Inc.Claims Representative (IAP) - Workers Compensation Training Program, Long Beach, CALong Beach, 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. Adjusting various levels of workers' compensation claims under close supervision, which includes: Processing and responding to incoming mail, emails and other claim related documents according to status of the claim.
Analyst III, Epic Application Professional Billing and Claims Pacific Dental Services IncAnalyst III, Epic Application Professional Billing and ClaimsIrvine, CA$103,000–$133,000 / yearOwns highly complex projects, such as multi-module implementations or enterprise-wide systems upgrades; leads medium-scale projects, including scoping, design, implementation, testing and go-live support. This role ensures accurate and efficient billing workflows, claim generation, and revenue cycle operations by collaborating with finance, billing, and operational teams.
Manager, Schedule Delay Claims The Vertex Companies, LLCManager, Schedule Delay ClaimsIrvine, CA$85,000–$202,000 / yearFull timeThe salary ranges for this role are as follows: $85,000 - $202,000 USD annually (Geographical Tier AA - Sample Locations: NY Metro, San Franscisco, San Jose, Seattle) $78,000 - $186,000 USD annually (Geographical Tier A - Sample Locations: Irvine CA, Middlesex NJ, Tacoma WA, Boston, Alexandria) $72,000 - $171,000 USD annually (Geographical Tier B - Sample Locations - Baltimore, Chicago, Anchorage, Portland) Time away matters—so we provide a generous paid time off program, including vacation, sick time, and paid holidays (with prorated options for eligible part-time employees). The Vertex Companies, LLC (VERTEX) is a $180M global consulting firm that integrates strategic advisory, project management, and dispute resolution services for organizations facing complex challenges in a world of risk.
Claims Examiner - Workers Compensation eTeam Inc.Claims Examiner - Workers CompensationLong Beach, CA$45–$50 / 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.
Senior Claims Examiner BerkleySenior Claims ExaminerIrvine, California$110,000–$125,000 / yearThis role actively supports and participates in the company’s culture of continuous learning and innovation, including engagement in innovation groups focused on identifying opportunities for process improvement, enhancement, and transformational change. Key functions include but are not limited to: Adjust all aspects of complex claims and loss notices, including coverage and compensability analysis, reserve setting, reinsurance reporting, and coverage litigation.
General Liability Claims Consultant CNA Financial Corp.General Liability Claims ConsultantBrea, CA$72,000–$141,000 / yearThis individual contributor role operates under broad authority to manage commercial claims of high complexity and exposure within the Commercial Auto/General Liability/ Construction Auto and General Liability line(s) of business. Performs a combination of duties in accordance with departmental guidelines: Manages highly complex investigations of claims, including coverage issues, liability, compensability and damages.
Claims Team Manager - Auto Early Response AAAClaims Team Manager - Auto Early ResponseCosta Mesa, CaliforniaWith our national brand recognition, long-standing reputation since 1900, and constantly growing membership, we are seeking career-minded, service-driven professionals to join our team. Lead meetings in collaboration with unit management to communicate goals with direct reports and reinforce/monitor behavior that furthers technical and customer service performance expectations.
Claims Loss Reporting Specialist AAAClaims Loss Reporting SpecialistCosta Mesa, California$19.14–$25.50 / hourThe position receives and documents first notice of loss, takes overflow calls, and answers low complexity claims related questions for the Claims department while delivering a totally satisfying member experience through exceptional customer service. With our national brand recognition, long-standing reputation since 1900, and constantly growing membership, we are seeking career-minded, service-driven professionals to join our team.
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.
Claims Referral Specialist II LIBERTY Dental PlanClaims Referral Specialist IITustin, CA$20–$25 / hourThis position is ideal for someone who thrives in a fast-paced environment, enjoys working independently while supporting a collaborative team culture, and has a strong understanding of dental claims processing and benefit administration. Liberty Dental Plan commits to maintaining a work environment that acknowledges all individuals within the workplace and will continue to engage in practices that are inclusive of all backgrounds, experiences, and perspectives.
Analyst III, Epic Application Professional Billing and Claims PDS HealthAnalyst III, Epic Application Professional Billing and ClaimsIrvine, California$103,000–$133,000 / yearFull timeOwns highly complex projects, such as multi-module implementations or enterprise-wide systems upgrades; leads medium-scale projects, including scoping, design, implementation, testing and go-live support. This role ensures accurate and efficient billing workflows, claim generation, and revenue cycle operations by collaborating with finance, billing, and operational teams.
NewClaims Examiner - Workers Compensation (Hourly) ObjectWin TechnologyClaims Examiner - Workers Compensation (Hourly)Brea, CATo 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.
Claims Examiner - Workers Compensation IconmaClaims Examiner - Workers CompensationOrange, CA$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.