Territory Manager PeopleReady, Inc.Territory ManagerCosta Mesa, CA$62,673–$75,207 / yearBacked by over 35 years of experience, PeopleReady's workforce solutions have been carefully crafted to service businesses and workers across a wide range of industries, including construction, manufacturing and logistics, retail, and hospitality. Associate Support: Promote a Safe Workplace by conducting on-site safety visits, performing associate check-ins, and ensure personal protective equipment (PPE) is accessible to associates.
Senior Complex Claims Specialist EMC Insurance Group Inc.Senior Complex Claims SpecialistCA$103,954–$149,372 / yearServes as the subject matter expert on highly complex coverage issues impacting assigned claims, seeks assistance when needed or appropriate, issues coverage correspondence, and takes coverage into account when setting reserves and driving claims towards resolution. Reviews and communicates comprehensive evaluations of assigned claims presenting serious injuries (such as fatality, amputation, loss of sight, burns, paraplegia, quadriplegia, sex abuse, etc.), intellectual property claims, and claims with exposures of $750,000 or greater.
CCSB Eligibility Specialist I Western GrowersCCSB Eligibility Specialist ICA$35,288.33–$45,874.31 / yearKnowledge of generally accepted health care eligibility and billing procedures as well as Health Insurance Portability and Accountability Act (HIPAA), Consolidated Omnibus Budget Reconciliation Act (COBRA), California Continuation Benefits Replacement Act (Cal-COBRA) and Employee Retirement Income Security Act (ERISA) legislation. Assist in reviewing and processing all manual and/or Electronic Data Interchange (EDI) enrollment transactions (adds, changes, terminations) in the system of record as received from the client or internal sources in accordance with Participation Agreements, Employer Policy Statement, Eligibility Guidelines and/or Summary Plan Descriptions.
Senior Claims Specialist, Construction Defect AXA SASenior Claims Specialist, Construction DefectLos Angeles, CA$117,000–$184,400 / yearBy combining a comprehensive and efficient capital platform, data-driven insights, leading technology, and the best talent in an agile and inclusive workspace, empowered to deliver top client service across all our lines of business property, casualty, professional, financial lines and specialty. Senior Claims Specialist - Construction Defect Los Angeles, CA | Hartford, CT | Exton, PA | New York, NY | Morristown, NJ | Atlanta, GA | USA At AXA XL, we deliver on our claims promise by having the best systems, the best people and the best partnerships in place.
Call Center Representative I (California Only) Western GrowersCall Center Representative I (California Only)Irvine, CARemote$38,625.60–$50,874.31 / yearAt Pinnacle Claims Management, we are an innovative third-party administrator (TPA) that provides a full-suite of comprehensive and customized health benefits administration services for self-funded companies, including health management and wellness solutions, and pharmacy benefit management. The Call Center Representative I will play a crucial role in assisting clients over the phone and electronically, making a real difference in their experience with the Health Benefits Exchange (HBEX).
Medical Claims Resolution Specialist Kinetic Personnel Group, Inc.Medical Claims Resolution SpecialistOrange, CA$25–$31 / hourA full time permanent position includes a pay raise, telecommute options, a CalPERS Pension and excellent government benefits including generous holiday, PTO and sick pay days off, year one! Job duties: Addresses provider inquiries, questions, and concerns in all areas including enrollment, claims submission and payment, benefit interpretation, and referrals/authorizations for medical care.
Claims Representative- Healthcare Billing Vista Del MarClaims Representative- Healthcare BillingLos Angeles, California$28–$30 / hourIf TIER data is complete, submits the call to update CWS; Monthly, runs Non-Final Saved Notes reports for programs assigned, reviews notes for action required., and disseminates to programs; Reviews Final Saved Charge reports before batching claims for electronic submission to DMH. Completes any updates or corrections required, and manually updates services charges and ‘final save’ so that claims can be batched; Daily, reviews Diagnosis and Financial Update Reports and Client Action Forms submitted for any client information that requires updating in CWS.
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.
Claims Specialist Diversity Caree HubClaims SpecialistOrange, CaliforniaManage medical malpractice claims, including the assignment, direction, and control of defense counsel, under supervision and in compliance with the Claims Technical Manual, the Defense Attorney Guidelines, and the MPT Agreement. Minimum five years of medical malpractice claims management experience and/or three years CAP claims experience.
Senior Major Loss Claims Manager Kemper CorpSenior Major Loss Claims ManagerCerritos, CA$99,000–$164,800 / yearWe believe a high-performing culture, valuable opportunities for personal development and professional challenge, and a healthy work-life balance can be highly motivating and productive. The Claims Manager will provide technical expertise, staff development and guidance on California claims handling practices/procedures and provide training as appropriate and necessary.
Senior Construction Defect Technical Claims Specialist Argo Group International Holdings IncSenior Construction Defect Technical Claims SpecialistLos Angeles, CARemote$137,496–$164,934 / yearBoston metro area, California outside of Los Angeles & San Francisco metro area, Connecticut, Chicago metro area, Denver metro area, New Jersey (outside of New York City metro area), New York State (outside of New York City metro area, including but limited to Albany county), Washington, D. C. Essential Responsibilities: Working under limited oversight under broad management direction, adjudicate construction defect claims at the highest authority limits on assignments reflecting the highest degree of technical complexity, potentially with major impact on departmental results.
Sr Claims Specialist Argo Group International Holdings Ltd.Sr Claims SpecialistLos Angeles, CA$75,200–$90,600 / yearThis includes assessing coverage, contacting the customers, investigating the facts surrounding the loss, arranging inspection, experts, and third parties; collecting information and evaluating complexity of loss of claims when needed; negotiating loss settlements either directly with our customers or through their assigned counsel and finalizing settlement. Core qualifications and requirements for this position include: A broad theoretical knowledge of general liability claims as well as an exceptional customer service focus typically obtained through: Bachelor's degree from an accredited university required.
Sr Claims Specialist Argo Group International Holdings IncSr Claims SpecialistLos Angeles, CA$75,200–$90,600 / yearThis includes assessing coverage, contacting the customers, investigating the facts surrounding the loss, arranging inspection, experts, and third parties; collecting information and evaluating complexity of loss of claims when needed; negotiating loss settlements either directly with our customers or through their assigned counsel and finalizing settlement. Core qualifications and requirements for this position include: A broad theoretical knowledge of general liability claims as well as an exceptional customer service focus typically obtained through: Bachelor's degree from an accredited university required.
Sr. Claims Specialist, Professional Liability | Medical Malpractice | California Sedgwick Claims Management Services, Inc.Sr. Claims Specialist, Professional Liability | Medical Malpractice | CaliforniaLong Beach, CA$100,000–$125,000 / yearIdeal candidates demonstrate strong analytical and negotiation skills, exercise sound judgment, and are committed to delivering timely, cost‑effective claim resolutions while maintaining a high level of customer service. ESSENTIAL RESPONSIBLITIES MAY INCLUDE: Analyzes and processes complex or technically difficult medical malpractice 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.
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.
Lead - Claims Examiner Astrana Health IncLead - Claims ExaminerMonterey Park, CAManager - Claims and enable us to continue to scale in the healthcare industry. We are currently seeking a highly motivated Lead - Claims Examiner.
Director, Real World Evidence Jazz Pharmaceuticals PlcDirector, Real World EvidenceCARemote$204,000–$306,000 / yearThe successful candidate may also be eligible for a discretionary annual cash bonus or incentive compensation (depending on the role), in accordance with the terms of the Company's Global Cash Bonus Plan or Incentive Compensation Plan, as well as discretionary equity grants in accordance with Jazz's Long Term Equity Incentive Plan. Assess real-world data assets and establish data curation plans, including provisioning data licenses and data platforms, in collaboration with Medical Affairs statistics, epidemiology and RWE leadership team.
Sr. Manager - Claims Astrana Health IncSr. Manager - ClaimsMonterey Park, CAThis role will report to the AVP - Claims Operations and enable us to continue to scale in the healthcare industry. About the Role: We are currently seeking a highly motivated Claims Manager.
EPIC Applications Analyst (1-4): Hospital Billing Admin and Hospital Billing Claims - IT Services - Full Time SolutionHealthEPIC Applications Analyst (1-4): Hospital Billing Admin and Hospital Billing Claims - IT Services - Full TimeCAEpic Application Analysts 2-4 require current Epic training status (certification, accreditation, and/or proficiency) in primary application required, with a combination of current Epic training statuses in additional area(s) in application maintenance and development required in upper levels. Ideal candidates will possess strong experience as analyst with expert knowledge and experience in leading system analysis with special emphasis on system methodologies, projects management and business process reengineering related to information systems required.
Senior Claims Auditor Astrana Health IncSenior Claims AuditorMonterey Park, CAThis role will report to the Director - Claims and enable us to continue to scale in the healthcare industry. About the Role: We are currently seeking a highly motivated Senior Claims Auditor.