NewClaims Examiner - Workers Compensation (Hourly) IconmaClaims Examiner - Workers Compensation (Hourly)Brea, CA$43–$48 / hourResponsibilities: 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 Examiner - Workers Compensation IconmaClaims Examiner - Workers CompensationRancho Cucamonga, CA$45–$50 / hourResponsibilities: 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. 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.
NewSr Claim Examiner- WC Epitec StaffingSr Claim Examiner- WCFolsom, CAThis role requires strong analytical, investigative, and decision-making skills to evaluate coverage, manage litigation activities, establish reserves, negotiate settlements, and ensure timely claim resolution. The ideal candidate will thrive in a fast-paced environment and be comfortable handling complex claims independently while collaborating with legal counsel, clients, and other stakeholders.
Claims Auditor Health Source MSOClaims AuditorAlhambra, CAFull timeResponsibilities include, but not limited to: Maintain up-to-date knowledge of procedures for all ICD-10, CPT, HCPC codes including: Contractual agreement rates. Job Description : Claims Auditor will be responsible for auditing claims processed by Claims Examiners.
NewHealthcare Collections Representative JobotHealthcare Collections RepresentativeLos Angeles, CA$24–$28 / hourInformation collected and processed as part of your Jobot candidate profile, and any job applications, resumes, or other information you choose to submit is subject to Jobot's Privacy Policy, as well as the Jobot California Worker Privacy Notice and Jobot Notice Regarding Automated Employment Decision Tools which are available at jobot.com/legal. The successful candidate will be responsible for the accurate and timely data entry, review, and adjudication of professional, ancillary, and institutional claims for services rendered in various healthcare settings.
NewPersonal Injury Defense (Remote with CA and/or NV Bar) JobotPersonal Injury Defense (Remote with CA and/or NV Bar)Los Angeles, CARemote$165,000–$185,000 / yearInformation collected and processed as part of your Jobot candidate profile, and any job applications, resumes, or other information you choose to submit is subject to Jobot's Privacy Policy, as well as the Jobot California Worker Privacy Notice and Jobot Notice Regarding Automated Employment Decision Tools which are available at jobot.com/legal. Assist with document reviews for responsiveness, case issues, and privilege responses to discovery requests and to identify privileged documents, documents for redaction, case issues in context.
NewPartner/Senior Attorney - Civil Litigation Defense (Remote with CA or NV Bar) JobotPartner/Senior Attorney - Civil Litigation Defense (Remote with CA or NV Bar)West Los Angeles, CARemote$190,000–$235,000 / yearInformation collected and processed as part of your Jobot candidate profile, and any job applications, resumes, or other information you choose to submit is subject to Jobot's Privacy Policy, as well as the Jobot California Worker Privacy Notice and Jobot Notice Regarding Automated Employment Decision Tools which are available at jobot.com/legal. We strongly value a collegial environment and work-life balance, with a billing requirement of 1800 hours annually and remote work flexibility as well as a generous quarterly bonus structure for non-equity partners.
NewWorker's Compensation Defense Legal Secretary - Direct Placement TalentBurst, Inc.Worker's Compensation Defense Legal Secretary - Direct PlacementGlendale, CA$65,000–$75,000 / yearThe Workers' Compensation Defense Legal Secretary supports our in-house staff counsel in defending workers' compensation claims. Document Preparation: Draft and format legal documents such as Answers, Objections to PTP reports, DORs, and Trial Exhibits.
Associate Bond Claims Examiner HCC Life InsuranceAssociate Bond Claims ExaminerLos Angeles, CA$29.44–$40.46 / hourTokio Marine HCC - Surety Group, a member of the Tokio Marine Group of Companies, has an exciting opportunity for an Associate Claims Examiner position on-site at our office in Los Angeles, California. We are looking for motivated individuals to join our team of highly skilled claims examiners who are part of a successful division that specializes in surety bond business.
Associate Bond Claims Examiner HCC Service CompanyAssociate Bond Claims ExaminerLos Angeles, California$29.44–$40.46 / hourTokio Marine HCC – Surety Group, a member of the Tokio Marine Group of Companies, has an exciting opportunity for an Associate Claims Examiner position on-site at our office in Los Angeles, California. We are looking for motivated individuals to join our team of highly skilled claims examiners who are part of a successful division that specializes in surety bond business.
Property Claims Examiner II Wind/Hail Mercury Insurance CompanyProperty Claims Examiner II Wind/HailCA$98,568–$120,473 / yearBe able to seamlessly transition between various methods of inspection, including video, or photo, to write a damage estimate: Possess strong organizational, time management, and prioritization skills to handle varying workloads due to seasonal volume changes and catastrophes. Knowledge and Skills: As a Property Claims Examiner 2, you will: Possess the ability to work independently with limited or no supervision over daily activities required to successfully investigate, evaluate, write damage estimates, negotiate, and resolve property claims.
NewProperty Claims Examiner II Mercury Insurance CompanyProperty Claims Examiner IICA$98,568–$120,473 / yearKnowledge and Skills: As a Property Claims Examiner 2, you will: Possess the ability to work independently with limited or no supervision over daily activities required to successfully investigate, evaluate, write damage estimates, negotiate, and resolve property claims. Upon completion of the training program, ideal candidates will transition into a property claims Examiner adjusting position, collaborating with vendors, and/or virtually inspecting and estimating losses damaged by fire, water, weather, or other unexpected events.
Western Growers Family Of Companies Careers - Claims Examiner I Western Growers AssociationWestern Growers Family Of Companies Careers - Claims Examiner IFresno, CA$40,580.28–$52,756.02 / yearAdjudicate all claims types including Dental, Vision and Medical claims for inpatient and outpatient facilities, Blue Card, physician claims, In and Out of Network claims, Medicaid reclamation (HIPD), outpatient lab and radiology, accident and Third-Party Liability (TPL) claims, by calculating benefit due to approve or deny, based on SPD and within accepted corporate cycle timeframe. Claims Examiner I is responsible for reviewing and processing medical, dental, vision, and electronic claims per state, federal, and health plan regulatory requirements and department guidelines, as well as meeting established quality and production performance benchmarks, including research and review of applicable documentation.
Claims Examiner/Senior Claims Examiner W. R. Berkley CorpClaims Examiner/Senior Claims ExaminerWalnut Creek, CA$65,000–$115,000 / yearIn these roles, you will be responsible for the analysis and management of moderate to complex workers' compensation claims, including reviewing, investigating, and making determinations around coverage, compensability, and claim appropriateness. Success in this role requires strong judgment, consistent performance, and a high level of competency in negotiating settlements, managing subrogation, and delivering sound, compliant outcomes.
Claims Examiner I Western GrowersClaims Examiner IFresno, CA$40,580.28–$52,756.02 / yearAdjudicate all claims types including Dental, Vision and Medical claims for inpatient and outpatient facilities, Blue Card, physician claims, In and Out of Network claims, Medicaid reclamation (HIPD), outpatient lab and radiology, accident and Third-Party Liability (TPL) claims, by calculating benefit due to approve or deny, based on SPD and within accepted corporate cycle timeframe. Claims Examiner I is responsible for reviewing and processing medical, dental, vision, and electronic claims per state, federal, and health plan regulatory requirements and department guidelines, as well as meeting established quality and production performance benchmarks, including research and review of applicable documentation.
Associate Bond Claims Examiner HCC Life Insurance CompanyAssociate Bond Claims ExaminerLos Angeles, CA$29.44–$40.46 / hourTokio Marine HCC - Surety Group, a member of the Tokio Marine Group of Companies, has an exciting opportunity for an Associate Claims Examiner position on-site at our office in Los Angeles, California. We are looking for motivated individuals to join our team of highly skilled claims examiners who are part of a successful division that specializes in surety bond business.
Associate Bond Claims Examiner Tokio Marine HCCAssociate Bond Claims ExaminerLos Angeles, CaliforniaTokio Marine HCC – Surety Group, a member of the Tokio Marine Group of Companies, has an exciting opportunity for an Associate Claims Examiner position on-site at our office in Los Angeles, California. We are looking for motivated individuals to join our team of highly skilled claims examiners who are part of a successful division that specializes in surety bond business.
Workers Compensation Claims Examiner (California Jurisdiction) EliteWorkers Compensation Claims Examiner (California Jurisdiction)Los Angeles, CaliforniaThe Senior Claims Examiner will adjust workers’ compensation claims from inception through settlement and closure, ensuring timely processing of claims and payment of benefits, managing, and directing medical treatment, setting reserves, and negotiating settlements. Must possess a current Experienced Indemnity Claims Adjuster Designation, provided by an insurer, as defined in California Code of Regulations, Title 10, Chapter 5, Subchapter 3, Section 2592.01(f).
Claims Examiner/Senior Claims Examiner BerkleyClaims Examiner/Senior Claims ExaminerWalnut Creek, California$65,000–$115,000 / yearIn these roles, you will be responsible for the analysis and management of moderate to complex workers’ compensation claims, including reviewing, investigating, and making determinations around coverage, compensability, and claim appropriateness. Success in this role requires strong judgment, consistent performance, and a high level of competency in negotiating settlements, managing subrogation, and delivering sound, compliant outcomes.
CLAIMS EXAMINER I MSO North East Medical ServiceCLAIMS EXAMINER I MSOBurlingame, CAESSENTIAL JOB FUNCTIONS: Perform the daily examination, auditing and adjudication activities to submitted professional claims based on established utilization criteria, Medi-Cal and/or Medicare guidelines, member's Evidence of Benefit, and policies and procedures outlined in the MSO Claims Manual. Working knowledge of managed care and/or healthcare claim reimbursement or medical billing in Medi-Cal and Medicare Advantage program preferred.
Executive Claims Examiner Markel Group IncExecutive Claims ExaminerWoodland Hills, CA$97,520–$134,090 / yearThis includes race; color; sex; religion; creed; national origin or place of birth; ancestry; age; disability; affectional or sexual orientation; gender expression or identity; genetic information, sickle cell trait, or atypical hereditary cellular or blood trait; refusal to submit to genetic tests or make genetic test results available; medical condition; citizenship status; pregnancy, childbirth, or related medical conditions; marital status, civil union status, domestic partnership status, familial status, or family responsibilities; military or veteran status, including unfavorable discharge from military service; personal appearance, height, or weight; matriculation or political affiliation; expunged juvenile records; arrest and court records where prohibited by applicable law; status as a victim of domestic or sexual violence; public assistance status; order of protection status; status as a smoker or nonsmoker; membership or activity in local commissions; the use or nonuse of lawful products off employer premises during non-work hours; declining to attend meetings or participate in communications about religious or political matters; or any other classification protected by applicable law. Manage litigation filed nationwide against insureds; appoint, direct and manage defense counsel; proactively work toward expeditious and economical resolution of claims; assist Company claims vendor management, disbursement and legal collections teams with defense counsel, bill payment and collection issues.
NewClaims Examiner - Workers'''' Compensation (California) ICW GroupClaims Examiner - Workers'''' Compensation (California)San Diego, CA$61,979.26–$97,736.56 / yearHeadquartered in San Diego with regional offices located throughout the United States, ICW Group has been named for ten consecutive years as a Top 50 performing P&C organization offering the stability of a large, profitable and growing company combined with a focus on all things people. If hired at ICW Group, your final base salary compensation will be determined by factors unique to each candidate, including experience, education and the location of the role and considers employees performing substantially similar work.
Senior Claims Examiner - Workers'''' Compensation (California) ICW GroupSenior Claims Examiner - Workers'''' Compensation (California)San Diego, CA$68,481.25–$115,489.01 / yearHeadquartered in San Diego with regional offices located throughout the United States, ICW Group has been named for ten consecutive years as a Top 50 performing P&C organization offering the stability of a large, profitable and growing company combined with a focus on all things people. If hired at ICW Group, your final base salary compensation will be determined by factors unique to each candidate, including experience, education and the location of the role and considers employees performing substantially similar work.
Senior Claims Examiner W. R. Berkley CorpSenior Claims ExaminerIrvine, CA$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.
Claims Examiner I MSO North East Medical ServiceClaims Examiner I MSOBurlingame, CAESSENTIAL JOB FUNCTIONS: Perform the daily examination, auditing and adjudication activities to submitted professional claims based on established utilization criteria, Medi-Cal and/or Medicare guidelines, member's Evidence of Benefit, and policies and procedures outlined in the MSO Claims Manual. Identify claims payment errors and/or system configuration flaws during day-to-day operation, report to department manager/supervisor and MSO System Configuration team to correct/resolve them.
Indemnity Claims Examiner- Workers' Compensation (Sacramento, CA) (Open) KERN COUNTY SUPERINTENDENT OF SCHOOLSIndemnity Claims Examiner- Workers' Compensation (Sacramento, CA) (Open)Bakersfield, CA$7,173–$8,683Experience: Three (3) years of Workers' Compensation claims adjusting experience, preferably in a self-insurance operation, to include processing claims from inception of injury through litigation to closure. Education: Equivalent to the completion of the twelfth grade, supplemented by coursework and training in business office practices, workers compensation insurance matters, or closely related fields.
Indemnity Claims Examiner- Workers' Compensation (Open) KERN COUNTY SUPERINTENDENT OF SCHOOLSIndemnity Claims Examiner- Workers' Compensation (Open)Bakersfield, CA$7,173–$8,683Experience: Three (3) years of Workers' Compensation claims adjusting experience, preferably in a self-insurance operation, to include processing claims from inception of injury through litigation to closure. Education: Equivalent to the completion of the twelfth grade, supplemented by coursework and training in business office practices, workers compensation insurance matters, or closely related fields.
Indemnity Claims Examiner- Workers' Compensation (Fresno/Clovis, CA) (Open) KERN COUNTY SUPERINTENDENT OF SCHOOLSIndemnity Claims Examiner- Workers' Compensation (Fresno/Clovis, CA) (Open)Bakersfield, CA$7,173–$8,683Experience: Three (3) years of Workers' Compensation claims adjusting experience, preferably in a self-insurance operation, to include processing claims from inception of injury through litigation to closure. Education: Equivalent to the completion of the twelfth grade, supplemented by coursework and training in business office practices, workers compensation insurance matters, or closely related fields.
Health Claims Examiner Ultimate Staffing ServicesHealth Claims ExaminerPasadena, California$24–$28 / hourCommunicate professionally with members and providers to resolve inquiries, follow up on pended claims, and complete corrections or adjustments. This position is ideal for someone who enjoys problem‑solving, working with complex benefit plans, and collaborating with both internal teams and external partners.
Senior Workers' Compensation Claims Examiner (FULL Remote - Perm) - CA Johnson Service GroupSenior Workers' Compensation Claims Examiner (FULL Remote - Perm) - CAConcord, CARemote$98,000–$109,000 / yearThe Senior Claims Examiner will adjust workers compensation claims from inception through settlement and closure, ensuring timely processing of claims and payment of benefits, managing, and directing medical treatment, setting reserves, and negotiating settlements. Must possess a current Experienced Indemnity Claims Adjuster Designation, provided by an insurer, as defined in California Code of Regulations, Title 10, Chapter 5, Subchapter 3, Section 2592.01(f).
Senior Workers' Compensation Claims Examiner (FULL Remote - Contract) - CA Johnson Service GroupSenior Workers' Compensation Claims Examiner (FULL Remote - Contract) - CAConcord, CARemote$50.25–$55.89 / hourThe Senior Claims Examiner will adjust workers compensation claims from inception through settlement and closure, ensuring timely processing of claims and payment of benefits, managing, and directing medical treatment, setting reserves, and negotiating settlements. Must possess a current Experienced Indemnity Claims Adjuster Designation, provided by an insurer, as defined in California Code of Regulations, Title 10, Chapter 5, Subchapter 3, Section 2592.01(f) .
Claims Examiner I HCC Service CompanyClaims Examiner IEncino, California$46,600–$69,800 / yearJob Title: Claims Examiner I Location: Encino, CA Reports to: Claims Manager Employment Type: Full time Job Req ID: 2026 Req Begin Date: 6/12/2026 About TMHCC Tokio Marine HCC (TMHCC) brings 50 years of service to the specialty insurance industry, today offering over 100 products to commercial customers in 180 countries around the world. The Company will consider for employment all qualified applicants, including those with criminal histories, in a manner consistent with the requirements of applicable federal, state and local laws, such as the Violent Crime Control and Law Enforcement Act of 1994 (18 USC § 1033(e))(the “VCCLEA”), which restricts financial institutions and insurers such as TMHCC from employing individuals with certain types of criminal convictions.
Claims Examiner - Workers Compensation Iconma LLCClaims Examiner - Workers CompensationCAResponsibilities: 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 Examiner I HCC Life Insurance CompanyClaims Examiner IEncino, CA$46,600–$69,800 / yearThe Company will consider for employment all qualified applicants, including those with criminal histories, in a manner consistent with the requirements of applicable federal, state and local laws, such as the Violent Crime Control and Law Enforcement Act of 1994 (18 USC § 1033(e))(the "VCCLEA"), which restricts financial institutions and insurers such as TMHCC from employing individuals with certain types of criminal convictions. As an insurance company, we comply with certain federal, state and local laws such as the Violent Crime Control and Law Enforcement Act of 1994 (18 USC § 1033(e)), which restricts our ability to employ individuals with certain types of criminal convictions.
Claims Examiner - Workers Compensation (Hourly) Iconma LLCClaims Examiner - Workers Compensation (Hourly)Brea, 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.
NewWorkers Compensation Claims Examiner TEEMA GroupWorkers Compensation Claims ExaminerChino, CA$93,000–$104,000This role requires strong technical expertise, sound judgment, and the ability to handle highly complex indemnity claims within established authority limits. This is a highly interactive role requiring regular communication with clients, claimants, attorneys, medical providers, and internal stakeholders.
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.
Hospital Claims Examiner MedPOINT ManagementHospital Claims ExaminerSherman Oaks, CARemoteFull timeJoin MedPOINT Management as a Hospital Claims Examiner in Sherman Oaks, CA, where you'll play a crucial role in ensuring accurate and timely processing of hospital claims. Our commitment to quality and innovation has earned us a reputation for excellence, making us a preferred partner in the healthcare industry.
Claims Examiner I Tokio Marine HCCClaims Examiner IEncino, CaliforniaThe Company will consider for employment all qualified applicants, including those with criminal histories, in a manner consistent with the requirements of applicable federal, state and local laws, such as the Violent Crime Control and Law Enforcement Act of 1994 (18 USC § 1033(e))(the “VCCLEA”), which restricts financial institutions and insurers such as TMHCC from employing individuals with certain types of criminal convictions. As an insurance company, we comply with certain federal, state and local laws such as the Violent Crime Control and Law Enforcement Act of 1994 (18 USC § 1033(e)), which restricts our ability to employ individuals with certain types of criminal convictions.
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.
Senior Claims Examiner - 4850 Athens AdministratorsSenior Claims Examiner - 4850Orange, CaliforniaATHENS POSITION DETAILS Position Title: Senior Claims Examiner Department: Workers’ Compensation California Reports To: Claims Supervisor FLSA Status: Non-Exempt Job Grade: 12 Career Ladder: Next step in progression could include Lead Senior Claims Examiner or Claims Supervisor ATHENS ADMINISTRATORS Explore the Athens Administrators difference: We have been dynamic, innovative leaders in claims administration since our founding in 1976. The Senior Claims Examiner will adjust police and fire 4850 workers’ compensation claims from inception through settlement and closure, ensuring timely processing of claims and payment of benefits, managing, and directing medical treatment, setting reserves, and negotiating settlements.
NewSenior Claims Examiner Athens AdministratorsSenior Claims ExaminerOrange, CaliforniaATHENS POSITION DETAILS Position Title: Senior Claims Examiner Department: Workers’ Compensation California Reports To: Claims Supervisor FLSA Status: Non-Exempt Job Grade: 12 Career Ladder: Next step in progression could include Lead Senior Claims Examiner or Claims Supervisor ATHENS ADMINISTRATORS Explore the Athens Administrators difference: We have been dynamic, innovative leaders in claims administration since our founding in 1976. The Senior Claims Examiner will adjust police and fire 4850 workers’ compensation claims from inception through settlement and closure, ensuring timely processing of claims and payment of benefits, managing, and directing medical treatment, setting reserves, and negotiating settlements.
NewSenior Claims Examiner - Remote or Hybrid Athens AdministratorsSenior Claims Examiner - Remote or HybridFresno, CaliforniaRemoteATHENS POSITION DETAILS Position Title: Senior Claims Examiner Department: Workers’ Compensation California Reports To: Claims Supervisor FLSA Status: Non-Exempt Job Grade: 12 Career Ladder: Next step in progression could include Lead Senior Claims Examiner or Claims Supervisor ATHENS ADMINISTRATORS Explore the Athens Administrators difference: We have been dynamic, innovative leaders in claims administration since our founding in 1976. POSITION SUMMARY Athens Administrators has an immediate need for a full-time Senior Claims Examiner to support our workers compensation offices and can be located anywhere in the state of California, however, employees who live less than 26 miles from the Concord, CA or Orange, CA offices are required to work once a week in the office on a day determined by their supervisor between Tuesday – Thursday.
NewSenior Claims Examiner - School District Athens AdministratorsSenior Claims Examiner - School DistrictCaliforniaATHENS POSITION DETAILS Position Title: Senior Claims Examiner Department: Workers’ Compensation California Reports To: Claims Supervisor FLSA Status: Non-Exempt Job Grade: 12 Career Ladder: Next step in progression could include Lead Senior Claims Examiner or Claims Supervisor ATHENS ADMINISTRATORS Explore the Athens Administrators difference: We have been dynamic, innovative leaders in claims administration since our founding in 1976. POSITION SUMMARY Athens Administrators has an immediate need for a full-time Senior Claims Examiner to support our workers compensation offices and can be located anywhere in the state of California, however, employees who live less than 26 miles from the Concord, CA or Orange, CA offices are required to work once a week in the office on a day determined by their supervisor between Tuesday – Thursday.
Claims Examiner II North East Medical ServiceClaims Examiner IIBurlingame, CAESSENTIAL JOB FUNCTIONS: Perform the daily examination, auditing and adjudication activities to submitted hospital and professional claims based on established utilization criteria, Medi-Cal and/or Medicare guidelines, member's Evidence of Benefit, and policies and procedures outlined in the MSO Claims Manual. Responsible to prepare files and documents for the annual health plan delegation oversight audits, assist Claims Supervisor with MSO management reports, and other special projects as needed.
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.
Claims Examiner - Workers Compensation eTeam Inc.Claims Examiner - Workers CompensationPasadena, CARemote$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. 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.
Executive Claims Examiner, Miscellaneous Professional E&O Markel CorporationExecutive Claims Examiner, Miscellaneous Professional E&OWoodland, CA$97,520–$134,090 / yearThis includes race; color; sex; religion; creed; national origin or place of birth; ancestry; age; disability; affectional or sexual orientation; gender expression or identity; genetic information, sickle cell trait, or atypical hereditary cellular or blood trait; refusal to submit to genetic tests or make genetic test results available; medical condition; citizenship status; pregnancy, childbirth, or related medical conditions; marital status, civil union status, domestic partnership status, familial status, or family responsibilities; military or veteran status, including unfavorable discharge from military service; personal appearance, height, or weight; matriculation or political affiliation; expunged juvenile records; arrest and court records where prohibited by applicable law; status as a victim of domestic or sexual violence; public assistance status; order of protection status; status as a smoker or nonsmoker; membership or activity in local commissions; the use or nonuse of lawful products off employer premises during non-work hours; declining to attend meetings or participate in communications about religious or political matters; or any other classification protected by applicable law. Manage litigation filed nationwide against insureds; appoint, direct and manage defense counsel; proactively work toward expeditious and economical resolution of claims; assist Company claims vendor management, disbursement and legal collections teams with defense counsel, bill payment and collection issues.
NewClaims Examiner GallagherClaims ExaminerOakland, 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. As part of Gallagher, a global leader in insurance, risk management, and consulting, you’ll be joining a team that’s passionate about helping individuals and organizations thrive.
Senior Claims Examiner, Complex General Liability GallagherSenior Claims Examiner, Complex General LiabilityOakland, 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. The Senior Claims Examiner will be responsible for managing complex liability claims, employment & civil rights claims to their conclusion in the most cost-effective way possible for the client.