General Liability Claims Specialist CNA Financial Corp.General Liability Claims SpecialistLos Angeles, CA$54,000–$103,000 / yearJOB DESCRIPTION: Performs a combination of duties in accordance with departmental guidelines: Manages an inventory of moderate to high complexity and exposure commercial claims by following company protocols to verify policy coverage, conduct investigations, develop and employ resolution strategies, and authorize disbursements within authority limits. Conducts focused investigation to determine compensability, liability and covered damages by gathering pertinent information, such as contracts or other documents, taking recorded statements from customers, claimants, injured workers, witnesses, and working with experts, or other parties, as necessary to verify the facts of the claim.
Major Litigation Unit Complex Claims Consulting Director CNA Financial CorpMajor 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.
Workers Compensation Claims Specialist The Home Depot IncWorkers Compensation Claims SpecialistPomona, CA$25–$27.50 / hourThis role serves as the primary Temco point of contact for employees experiencing workplace injuries and works closely with Operations, Payroll, HR, Safety, and our third-party claims partners to support employees from injury through return-to-work. The position plays a key role in Temco's newly enhanced workers' compensation model, which will centralize claim coordination within the Claims Department to provide a more consistent employee experience, stronger documentation, and improved operational support.
Utilization Management Claims Review Nurse RN II L.A. Care Health PlanUtilization Management Claims Review Nurse RN IILos Angeles, CAPerform claims pre-payment review by supporting the Claims team in evaluating flagged claims prior to adjudication to ensure services are medically necessary, documentation supports billed services, coding is accurate and aligned with authorization when applicable, and unnecessary denials are reduced through accurate clinical validation. This position supports payment integrity initiatives through retrospective and pre-payment review processes, helps reduce unnecessary denials, and monitors for potential fraud, waste, and abuse (FWA).
Claims Examiner I Clever Care Health Plan IncClaims Examiner IHuntington Beach, CA$27–$32 / hourThis position requires considerable interaction with clients, claimants on the phone, with management, other Claims Examiners, and other staff in the office; therefore, consistently being at work in the office or home office location as applicable, in a timely manner, is inherently required of this position. At Clever Care, you'll have the opportunity to make a real difference, shape the future of healthcare, and be part of a fast-moving, game-changing organization that celebrates diversity and innovation.
Complex Claims Consultant - Lawyers Professional Liability (Large Law) CNA Financial Corp.Complex 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.
Claims Consultant - Dental The Medical Protective CompanyClaims Consultant - DentalCARemote$80,000–$150,000 / yearFrom our roots in our hometown of Fort Wayne, Indiana, we''ve worked diligently to become the nation''s premier healthcare liability coverage provider, currently insuring more than 300,000 customers. We are hundreds of professionals with varied backgrounds and experience levels who came together to achieve one goal: protecting those who have made it their mission to serve and care for others.
Claims Processor ArsenaultClaims ProcessorLos Angeles, CaliforniaThrough our dedicated associates, Arsenault delivers mission-critical services and solutions on behalf of Fortune 100 companies and over 500 governments creating exceptional outcomes for our clients and the millions of people who count on them. It is essential to have a good understanding of EOBs, FSAs, how to read receipts, doctor bills, and basic medical paperwork.
Workers Compensation Claims Specialist, Complex & Settlement Focus CNA Financial Corp.Workers Compensation Claims Specialist, Complex & Settlement FocusIrvine, CA$54,000–$103,000 / yearJOB DESCRIPTION: Essential Duties & Responsibilities: Performs a combination of duties in accordance with departmental guidelines: Manages an inventory of moderate to high complexity and exposure commercial claims by following company protocols to verify policy coverage, conduct investigations, develop and employ resolution strategies, and authorize disbursements within authority limits. Conducts focused investigation to determine compensability, liability and covered damages by gathering pertinent information, such as contracts or other documents, taking recorded statements from customers, claimants, injured workers, witnesses, and working with experts, or other parties, as necessary to verify the facts of the claim.
Claims Examiner - Workers Compensation Apidel TechnologiesClaims Examiner - Workers CompensationOrange, CARemoteContractorTo 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.
Private Client Claims Advocacy Leader Marsh & McLennan Companies IncPrivate Client Claims Advocacy LeaderLos Angeles, CA$125,000–$233,000 / yearFrequently communicate key client and Family Office matters/concerns, team updates, market developments and claims trends with PCS field leadership teams (Zone Leaders and Zone Client Advisor Leaders) as well as MMA regions. Directs and interfaces with PCS Operations and EPIC Transformation teams to design and implement contemporary claims technologies, including claims 'use cases' for Risk Services and Solutions data platform.
Cust Serv Rep I -Claims Alert Crawford & CoCust Serv Rep I -Claims AlertCARemoteAll resumes submitted by search firms to any employee at Crawford via-email, the Internet or in any form and/or method without a valid written Statement of Work in place for this position from Crawford HR/Recruitment will be deemed the sole property of Crawford. Provides excellent customer service to all internal team members and external customers.
Claims Consultant, Life Sciences CNA Financial CorpClaims Consultant, Life SciencesLos Angeles, CA$72,000–$141,000 / yearPerforms 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 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 complex manage litigation and authorizing payments within scope of authority.
Managing Director Strategic Claims Oversight - Healthcare Severity CNA Financial CorpManaging Director Strategic Claims Oversight - Healthcare SeverityLos Angeles, CA$97,000–$189,000 / yearDevelops and maintains collaborative working relationships with internal and external business partners including Operations, Underwriting, Actuary and Risk Control and regularly shares claims outcomes, trends, legal developments and other relevant business updates. Responsible for the ongoing management of staff by attracting talent, setting clear direction, providing appropriate guidance, managing performance, recognizing contributions, and developing capabilities.
Claims Sr Rep Commercial Specialist Farmers Group, Inc.Claims Sr Rep Commercial SpecialistCARemote$70,304–$110,000 / yearRequired job duties are normally performed in a climate- controlled office environment, but with exposure to some or all of the following environments when in the field: Uncontrolled outside environmental conditions Excessive Noise Levels Chemicals Chemical/Biological Conditions Moving Mechanical Parts Areas considered dangerous Conditions, which could affect the respiratory system or skin such as: fumes, odors, dust, mists, gases, oils, smoke, soot, or poor ventilation. Contacts are a major part of activity and include policyholders, claimants, agents, witnesses, contractors, police and fire departments, state and county fraud and arson personnel, special investigators, attorneys, expert witnesses, members of the medical profession and all other persons incident to the investigation and processing of claims.
Claims Representative- Workers Compensation (On-Site Ontario, California) Sedgwick Claims Management Services, Inc.Claims Representative- Workers Compensation (On-Site Ontario, California)Ontario, CA$26.55–$27 / hourMental: 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. Processes low level workers compensation claims determining compensability and benefits due on long term indemnity claims, monitors reserve accuracy, and files necessary documentation with state agency.
Claims Coordinator ServiceMaster Restore 9430 - RiversideClaims CoordinatorRiverside, CAFull timeAs the hub of all claims, the coordinator is responsible for speaking with the customer, ongoing customer follow up, handling service complaints, logistics of dispatching field personnel to jobs while ensures that the required Cycle Time and insurance Service Level Agreement tasks deadlines are met. Ensure that uploading photos, and other documents are appropriately described, titled and uploaded in real time, as well as follows up to get missing required data from homeowner and insurance/mortgage information not obtained on initial call.
Claims Coordinator Mission ViejoClaims CoordinatorRiverisde, California$20–$30 / hourAs the hub of all claims, the coordinator is responsible for speaking with the customer, ongoing customer follow up, handling service complaints, logistics of dispatching field personnel to jobs while ensures that the required Cycle Time and insurance Service Level Agreement tasks deadlines are met. Ensure that uploading photos, and other documents are appropriately described, titled and uploaded in real time, as well as follows up to get missing required data from homeowner and insurance/mortgage information not obtained on initial call.
Independent Insurance Claims Adjuster in Diamond Bar, California MileHigh Adjusters HoustonIndependent Insurance Claims Adjuster in Diamond Bar, CaliforniaDiamond Bar, CaliforniaHow We Can Help You Succeed: At MileHigh Adjusters Houston, we offer comprehensive training programs tailored to equip you with the essential skills and knowledge needed to excel in the field of claims adjusting. You can also find us on YouTube at: ( https://www.youtube.com/channel/UC9nTRXrwnbC2TuYphDUVhWg ) and Facebook at: ( https://www.facebook.com/milehighadjustershouston ) for additional resources and updates.
Independent Insurance Claims Adjuster in Chino, California MileHigh Adjusters HoustonIndependent Insurance Claims Adjuster in Chino, CaliforniaChino, CaliforniaHow We Can Help You Succeed: At MileHigh Adjusters Houston, we offer comprehensive training programs tailored to equip you with the essential skills and knowledge needed to excel in the field of claims adjusting. You can also find us on YouTube at: ( https://www.youtube.com/channel/UC9nTRXrwnbC2TuYphDUVhWg ) and Facebook at: ( https://www.facebook.com/milehighadjustershouston ) for additional resources and updates.