Claims Examiner, Bodily Injury | Commercial Trucking | Remote Sedgwick Claims Management Services, Inc.Claims Examiner, Bodily Injury | Commercial Trucking | RemoteCARemote$80,000–$85,000 / yearTo analyze complex auto bodily injury and commercial trucking claims on behalf of our valued clients by evaluating coverage, investigating liability, and managing damages, while ensuring timely resolution within service expectations, industry best practices, and specific client requirements. Education & Licensing: Five (5) years of claims management experience or equivalent combination of education and experience required to include in-depth knowledge of personal and commercial line auto policies, coverage's, principles, and laws.
Claims Examiner - Workers Compensation (HYBRID- West Hills, CA/3 Days Remote) Sedgwick Claims Management Services, Inc.Claims Examiner - Workers Compensation (HYBRID- West Hills, CA/3 Days Remote)West Hills, CARemote$80,000–$90,000 / 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.
Sr. Medical Claims Processor Ultimate Staffing ServicesSr. Medical Claims ProcessorPasadena, California$24–$29 / hourEnsure accuracy of claim details, including patient information, coding (ICD-10, CPT, HCPCS), and billing data prior to submission. Investigate and resolve denied, rejected, or pending claims by working with providers, payers, and internal departments.
Medical Claims Examiner Ultimate Staffing ServicesMedical Claims ExaminerPasadena, California$26–$29 / hourWe are seeking an experienced Medical Claims Examiner to review, analyze, and adjudicate medical claims for accuracy, compliance, and medical necessity. Identify coding discrepancies, overpayments, and potential fraud or abuse.
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 Counsel Capital Insurance GroupClaims CounselOrange County, CARemote$114,364–$190,607 / yearThis is a remote position, ideally with someone based in Orange County (Irvine, Costa Mesa, Newport Beach, Santa Ana, Anaheim, Orange, Huntington Beach, and Fullerton). Responsible for consultation with claims staff in a variety of claims issues, including but not limited to, coverage, indemnification, policy limit demand reviews, indemnity agreement review, release language review.
Claims Examiner - Workers Compensation -| Brea, CA Sedgwick Claims Management Services, Inc.Claims Examiner - Workers Compensation -| Brea, CABrea, CA$80,000–$100,000 / 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.
NewSenior Claims Counsel – Title Insurance (Hybrid) First AmericanSenior Claims Counsel – Title Insurance (Hybrid)Santa Ana, CaliforniaThe Senior Claims Counsel position with First American Title Insurance Company provides an excellent opportunity for counsel to engage in complex legal analysis, craft creative solutions to difficult problems, manage their own caseload, oversee outside litigation counsel, and engage in high-level problem solving, negotiation and legal analysis in a stimulating and collegial environment with an opportunity for long-term growth and advancement. First American reasonably believes that a criminal history may have a direct, adverse and negative relationship with the following material job duties for this position potentially resulting in the withdrawal of the conditional offer of employment: handling of confidential, proprietary or trade secret information belonging to First American or its customers, administrating or facilitating financial transactions, and the ability to meet customer-imposed criminal history requirements.
NewSenior Claims Examiner P&C - Public Entities Athens AdministratorsSenior Claims Examiner P&C - Public EntitiesOrange, CaliforniaAdditional duties may be assigned: Advanced knowledge in the following areas: 1) claims handling concepts, practices, and techniques specific to the California government code and regulations 2) functional knowledge of CA law and insurance regulations 3) demonstrated advanced verbal and written communications skills 4) demonstrated advanced analytical, decision making and negotiation skills Must have the experience and ability to organize and effectively manage a caseload of general liability claims and new loss assignments venued in California. ATHENS POSITION DETAILS Position Title: Senior Claims Examiner Department: Property & Casualty Reports To: Claims Supervisor FLSA Status: Exempt – CJPIA account Job Grade: 13 Career Ladder: Next step in progression could include Complex Claims Examiner ATHENS ADMINISTRATORS Explore the Athens Administrators difference: We have been dynamic, innovative leaders in claims administration since our founding in 1976.
NewCommercial Claims Insurance Analyst - Remote CSAA Insurance GroupCommercial Claims Insurance Analyst - RemoteCARemote$99,855–$110,950 / yearAlabama - Home Teleworkers, Alabama - Home Teleworkers, Arizona - Home Teleworkers, Arkansas - Home Teleworkers, Colorado - Home Teleworkers, Connecticut - Home Teleworkers, Delaware - Home Teleworker, District of Columbia - Home Teleworkers, Florida - Home Teleworkers, Georgia - Home Teleworkers, Idaho - Home Teleworkers, Illinois - Home Teleworkers, Indiana - Home Teleworkers, Iowa - Home Teleworkers, Kansas - Home Teleworker, Kentucky - Home Teleworkers, Louisiana - Home Teleworkers, Maine Home Teleworkers, Maryland - Home Teleworkers, Massachusetts - Home Teleworkers, Michigan - Home Teleworkers, Minnesota - Home Teleworkers, Mississippi - Home Teleworker, Missouri - Home Teleworker, Montana - Home Teleworkers {+ 15 more}. Your Work: Performs complex data analysis for assigned client groups, evaluating findings in relation to broader business objectives Collaborates with cross-functional partners outside of IPM/IPO to gather insights, validate findings, and gain alignment on recommended actions.
NewSr Claim Examiner-WC (CA) Crawford & CompanySr Claim Examiner-WC (CA)Brea, CARemoteFull timeEstablish 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. We're Hiring: Senior Claims Examiner - Workers Compensation (California) This is an exciting opportunity to join a global leader in claims management and make a meaningful impact through your expertise.
Claims 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.
Claims Specialist, Workers Compensation - West Region Liberty Mutual Holding Company IncClaims Specialist, Workers Compensation - West RegionGlendale, CARemoteResponsibilities: Plans and conducts investigations of claims (including such activities as interviewing insureds, witnesses and claimants, collecting and evaluating appropriate documentation and securing evidence and protecting the chain-of-custody) to analyze and confirm coverage and to determine liability, compensability and damages. As a Workers Compensation Claims Specialist, you will work within a Claims Team, using the latest technology to review, analyze, and process claims that are routinely characterized as moderately complex to complex within assigned authority limits.
NewClaims Specialist I Blue Cross and Blue Shield AssociationClaims Specialist ILos Angeles, CANecessary Contacts: In order to effectively fulfill this position, the Claims Specialist I must be in contact with personnel in other Units: Various internal departments and staff including, but not limited to, Provider Services, Legal, Internal Audit, IT, other Benefits Operations Management and staff, Enrollment and Billing, Administrative Services, and District Offices. Reviews, researches, and makes necessary updates to claims that may include the following: recalculation of benefits to previously processed claims, the processing of claims edits, or initiation of refund requests, according to contractual benefits or provider reimbursement rules, ultimately providing a high degree of customer satisfaction.
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.
NewStarr Associates Program - Claims Starr International Co IncStarr Associates Program - ClaimsLos Angeles, CA$68,000–$78,000 / yearThe Associates Program complements your department work by offering professional development opportunities, including direct exposure to senior leadership, technical training, and a comprehensive understanding of key functions throughout the organization. The 2027-2028 Starr Global Associates Program is a dynamic, accelerated training program designed to identify, cultivate, and retain high-potential college graduates.
Claims & Customer Service - Los Angeles Ca. Career StrategiesClaims & Customer Service - Los Angeles Ca.Los Angeles, CaliforniaThe Claims Specialist/Analyst will process health insurance claims and answers calls from the customer (participant members, providers, physicians, hospitals etc.) Adhere to eligibility, claims and call policies and procedures while making sound claim/call decisions. · Review and research incoming healthcare claims by navigating multiple computer systems and platforms and verify the data/information necessary for processing (e.g.
Bilingual Triage Specialist Argo Group International Holdings IncBilingual Triage SpecialistLos Angeles, CA$26.76–$30.80 / hourOur Adjusters and Managers are empowered to exercise their independent discretion and, within broad limits and authority, be creative in developing solutions and treat each case as the unique situation it is. Ability to develop and maintain productive relationships with clients, business partners and organizational peers with a focus on timely and meaningful exchanges of information.
Field Auto Appraiser AllstateField Auto AppraiserGlendale, CaliforniaPreferred candidates will have experience managing a variety of auto claims, conducting vehicle inspections, and using CCC ONE or similar estimating software to prepare accurate damage estimates while working closely with repair facilities and customers. Audatex Estimating, Auto Body Repair, Auto Estimating, Auto Insurance Claims, Automotive Body Repair, Business Acumen, Business Administration, Business Management, CCC ONE, Insurance Claim Handling, Process Consulting, Relationship Management .