Sr. Claims Specialist, Professional Liability | E&O, D&O, EPL | Remote Sedgwick Claims Management Services, Inc.Sr. Claims Specialist, Professional Liability | E&O, D&O, EPL | RemoteCARemote$100,000–$125,000 / 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 professional 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.
Liability Claims Representative | CA, OH, IN, KY Jurisdictional Knowledge | Licensing Required | Dedicated Client Sedgwick Claims Management Services, Inc.Liability Claims Representative | CA, OH, IN, KY Jurisdictional Knowledge | Licensing Required | Dedicated ClientLake Forest, CA$45,000–$63,000 / yearPRIMARY PURPOSE OF THE ROLE: We are looking for driven individuals that embody our caring counts model and core values that include empathy, accountability, collaboration, growth, and inclusion. To analyze Liability 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.
Workers Compensation Claims Examiner | HYBRID | Orange, CA Sedgwick Claims Management Services, Inc.Workers Compensation Claims Examiner | HYBRID | Orange, CAOrange, CA$80,000–$100,000 / 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.
Workers Compensation Claims Team Lead | Roseville, CA or Long Beach, CA, Sedgwick Claims Management Services, Inc.Workers Compensation Claims Team Lead | Roseville, CA or Long Beach, CA,Long 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. Workers Compensation Claims Team Lead | Roseville, CA or Long Beach, CA, Are you looking for an opportunity to join a global industry leader where you can bring your big ideas to help solve problems for some of the world's best brands?.
Claims Administrator MachinifyClaims AdministratorCAThis role involves performing incoming claim reviews, organizing data, assigning statuses, and routing completed files to auditors while maintaining document hygiene and adhering to internal procedures. Additionally, this role includes analyzing data trends, monitoring file-sharing processes, verifying data transfer accuracy, and ensuring appropriate volume levels are maintained.
Claims Business Systems Analyst Pie Insurance Holdings IncClaims Business Systems AnalystCARemote$90,000–$110,000 / yearWorking under the functional direction of the Staff Technical Program Manager, this role executes internal configuration and builds tickets from the Claims technology JIRA backlog, builds dashboards and templates, develops and runs test scripts, troubleshoots system issues, and maintains the technical integrity of the claims technology environment. The Claims Business Systems Analyst partners with Enterprise Technology, external vendors, and the Claims L&D Specialist to ensure that delivered solutions are technically sound, well-documented, and ready for end-user adoption.
Sr. Manager - Claims Delegation Audit Astrana Health IncSr. Manager - Claims Delegation AuditMonterey Park, CAThis role will be responsible for the development and execution of department strategies, overall Audit program, Audit process optimization, and management, identifying and leveraging technology and data to improve the quality and minimizing process cost of Claims. The position alongside the leadership team will contribute to driving strategic planning, operational excellence, and accuracy of the claims process and ensure compliance with regulations and contract requirements for Medicare, Commercial Exchange, and Medicaid service lines.
Facility Inpatient Surgical and Claims Edit Auditor Cedars-Sinai Medical CenterFacility Inpatient Surgical and Claims Edit AuditorLos Angeles, CARemoteMaintains appropriate open communication with internal and external partners and peer departments such as Coding Operations, Clinical Documentation Integrity (CDI), Payor Revenue Management (PRM), and Compliance Revenue Integrity (CRI). Auditors evaluate compliance with all coding guidelines including but not limited to: Internal Coding policies/procedures/handbook, American Hospital Association (AHA) and American Medical Association (AMA) coding references, local, State, and Federal Coding Guidelines.
Claims Examiner - Workers Compensation MindlanceClaims Examiner - Workers CompensationOrange, CARemote$49–$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.
Claims Examiner - Workers Compensation (Hourly) eTeam Inc.Claims Examiner - Workers Compensation (Hourly)Brea, CARemote$45–$48.57 / 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. Analyzing and processing claims through well-developed action plans to an appropriate and timely resolution by investigating and gathering information to determine the exposure on the claim.
Workers' Compensation Claims Supervisor - Orange, CA (PERM - HYBRID) Johnson Service GroupWorkers' Compensation Claims Supervisor - Orange, CA (PERM - HYBRID)Orange, CA$100,000–$110,000 / yearManaging People - Includes staff in planning, decision-making, facilitating and process improvement; Takes responsibility for subordinates' activities; Makes self available to staff; Provides regular performance feedback; Develops subordinates' skills and encourages growth; Solicits and applies customer feedback (internal and external); Fosters quality focus in others; Improves processes, products and services; Continually works to improve supervisory skills. Leadership - Exhibits confidence in self and others; Inspires and motivates others to perform well; Effectively influences actions and opinions of others; Inspires respect and trust; Accepts feedback from others; Provides vision and inspiration to peers and subordinates; Gives appropriate recognition to others; Displays passion and optimism; Mobilizes others to fulfill the vision.
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.
Accounts Receivable Representative II AltaMedAccounts Receivable Representative IICommerce, CA$25–$29.32 / houris concerned about a conviction directly related to the job, you will be given a chance to explain the circumstances surrounding the conviction, provide mitigating evidence, or challenge the accuracy of the background report. Actual salary offers are considered by various factors, including budget, experience, skills, education, licensure and certifications, and other business considerations.
Structural Forensic EngineerNEW The Vertex Co IncStructural Forensic EngineerNEWCosta Mesa, CA$146,000–$348,000 / yearStructural Forensic Engineers are involved in a wide variety of tasks, including forensic investigations of residential, commercial, and/or mixed-use buildings, code research and construction document review, failure analysis, the scope of repair preparation, and report writing. 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.
Workers Compensation Risk Consultant Edgewood Partners Insurance CenterWorkers Compensation Risk ConsultantOntario, CARemote$100,000–$120,000 / yearFueled and driven by capable, committed people who share common beliefs and values and "bring it" every day, EPIC is always looking for people who have "the right stuff" - people who know what they want and aren't afraid to make it happen. This position provides clients with day-to-day strategic claim oversight, guidance through complex risk management issues, and best practice process implementation to control costs and improve long-term WC program performance.
Independent Insurance Claims Adjuster in Stanton, California MileHigh Adjusters HoustonIndependent Insurance Claims Adjuster in Stanton, CaliforniaStanton, 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.
Senior Field Quality & Reliability Engineer Rivian Automotive IncSenior Field Quality & Reliability EngineerTustin, CA$135,100–$168,900 / yearDrive timely root cause analysis and resolution by engaging and holding cross-functional teams accountable with data driven approach to ensure root cause is identified and resolved Problem solving by using techniques like 8D, 3-Way 5-Whys Creating detailed documentation for review with customers Support business cases and present information to leadership for customer satisfaction campaigns and Field Service Actions (FSA) decisions. Rivian may use your Candidate Personal Data for the purposes of (i) tracking interactions with our recruiting system; (ii) carrying out, analyzing and improving our application and recruitment process, including assessing you and your application and conducting employment, background and reference checks; (iii) establishing an employment relationship or entering into an employment contract with you; (iv) complying with our legal, regulatory and corporate governance obligations; (v) recordkeeping; (vi) ensuring network and information security and preventing fraud; and (vii) as otherwise required or permitted by applicable law.
Independent Insurance Claims Adjuster in Hacienda Heights, California MileHigh Adjusters HoustonIndependent Insurance Claims Adjuster in Hacienda Heights, CaliforniaHacienda Heights, 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.
Account Manager I Universal AIT Worldwide Logistics, Inc.Account Manager I UniversalTorrance, CA$68,640–$88,250 / yearFor more than 40 years, the Chicago-based supply chain solutions leader has relied on a consultative approach to build a global network and trusted partnerships in nearly every industry, including aerospace, automotive, consumer retail, energy, food, government, high-tech, industrial, life sciences and marine. The Account Manager I will work as an individual SME on their portfolio with the primary focus of maintaining / expanding relationships with strategic accounts while executing within the following functional areas of account profitability for a customer portfolio, communication, customer service, problem resolution and load execution.
Claims Account Manager II (Northern California) ICW GroupClaims Account Manager II (Northern California)CARemote$90,559.93–$152,723.07 / 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. Identifies service levels of each account and balances Claims Account Manager staffing/ratio, in conjunction with the Customer Relations Manager, to ensure claim service meets our brand level.