NewComplex Claims Consulting Director - Mass Tort Unit CNA Financial CorpComplex Claims Consulting Director - Mass Tort UnitBrea, CA$97,000–$189,000 / yearManages an inventory of the most complex commercial claims, which generally involve multiple years of coverage, have 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 management of complex litigation. Drives the resolution of claims by collaborating with internal and external business partners to develop, own and execute a claim resolution strategy, that often includes negotiating complex settlements, partnering with counsel to manage complex litigation and authorizing payments within scope of authority.
Major Litigation Unit Complex Claims Consulting Director CNA Financial Corp.Major 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.
Complex Claims Consultant , Medical Malpractice and Dental CNA Financial CorpComplex Claims Consultant , Medical Malpractice and DentalIrvine, 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 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.
Complex Claims Consultant - Hospitals , Allied Facilities and Physicians CNA Financial CorpComplex Claims Consultant - Hospitals , Allied Facilities and PhysiciansIrvine, CA$72,000–$141,000 / yearPerforms a combination of duties in accordance with departmental guidelines: Manages an inventory of highly complex healthcare claims, with large 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.
General Liability Claims Specialist CNA Financial Corp.General Liability Claims SpecialistBrea, 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.
Complex Claims Consultant - Hospitals , Allied Facilities And Physicians CNA Financial Corp.Complex Claims Consultant - Hospitals , Allied Facilities And PhysiciansIrvine, CA$72,000–$141,000 / yearPerforms a combination of duties in accordance with departmental guidelines: Manages an inventory of highly complex healthcare claims, with large 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 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.
Claims & Litigation Associate (Remote) Stanford Health CareClaims & Litigation Associate (Remote)CARemote$100.03–$132.51 / hourInvestigates pre-suit claims, reviews medical records, interviews providers, retains consultants when necessary, communicates with patients and/or families, and directly negotiates settlements when warranted. Oversees legal defense strategy, retains outside counsel, coordinates support for investigation, reviews attorney invoices, and monitors counsel's compliance with litigation management guidelines.
CA Claims Specialist - Bilingual (Spanish) CorVel Enterprise Claims, Inc.CA Claims Specialist - Bilingual (Spanish)Rancho Cucamonga, CARemote$25.48–$41.09 / hourPart timeThe Workers’ Compensation Claims Specialist manages within company best practices lower-level, non-complex and non-problematic workers’ compensation claims within delegated limited authority to best possible outcome, under the direct supervision of a senior claims professional, supporting the goals of claims department and of CorVel. Pay rates are established taking into account the following factors: federal, state, and local minimum wage requirements, the geographic location differential, job-related skills, experience, qualifications, internal employee equity, and market conditions.
Workers Compensation Claims Specialist, West CNAWorkers Compensation Claims Specialist, WestPlacentia, CaliforniaPartners with attorneys, account representatives, agents, underwriters, doctors, nurse case managers and insureds to develop a focused strategy for timely and cost effective resolution of more complex claims. In District of Columbia,California, Colorado, Connecticut, Illinois , Maryland, Massachusetts , New York and Washington, the national base pay range for this job level is $54,000 to $103,000 annually.
Workers Compensation Claims Specialist, West CNA Financial Corp.Workers Compensation Claims Specialist, WestBrea, CA$54,000–$103,000 / yearPartners with attorneys, account representatives, agents, underwriters, doctors, nurse case managers and insureds to develop a focused strategy for timely and cost effective resolution of more complex claims. Performs a combination of duties in accordance with departmental guidelines: Interprets more complex or unusual policy coverages and determines if coverages apply to claims submitted, escalating issues as needed.
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.
Claims Specialist Next Insurance IncClaims SpecialistCARemote$100,000–$143,000 / yearLeverage a working knowledge of insurance contracts, Unfair Claims Settlement Practices, insurance codes, civil codes, vehicle codes, arbitration rules and regulations, tort law, claims best practices handling and management as part of your ongoing adjudication of claims. High degree of comfort with navigating sometimes ambiguous environments and a willingness to dive in and assist coworkers with workloads or contribute to organizational needs/projects when needed.
Claims Representative - Workers Compensation (On-Site - Rancho Cucamonga) Sedgwick Claims Management Services, Inc.Claims Representative - Workers Compensation (On-Site - Rancho Cucamonga)Rancho Cucamonga, CA$28–$30 / hourProcesses 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. Experience: Two (2) years of claims management experience or equivalent combination of education and experience or successful completion of Claims Representative training required.
Claims Examiner - Workers Compensation (On-Site Ontario, CA) Sedgwick Claims Management Services, Inc.Claims Examiner - Workers Compensation (On-Site Ontario, CA)Ontario, CA$85,000–$95,000 / 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 Team Lead (Supervisor) - Workers Compensation | Brea, CA Sedgwick Claims Management Services, Inc.Claims Team Lead (Supervisor) - Workers Compensation | Brea, CABrea, CA$105,000–$118,000 / 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. Sedgwick is building a diverse, equitable, and inclusive workplace and recognizes that each person possesses a unique combination of skills, knowledge, and experience.
Claims Examiner - Workers Compensation | Glendale, CA - Hybrid Sedgwick Claims Management Services, Inc.Claims Examiner - Workers Compensation | Glendale, CA - HybridGlendale, CA$72,914–$85,000 / yearPRIMARY 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. Sedgwick is building a diverse, equitable, and inclusive workplace and recognizes that each person possesses a unique combination of skills, knowledge, and experience.
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.
Claims Representative (IAP) - Workers Compensation Training Program (On-Site Orange, CA) Sedgwick Claims Management Services, Inc.Claims Representative (IAP) - Workers Compensation Training Program (On-Site Orange, CA)Orange, 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. Adjusting various levels of workers' compensation claims under close supervision, which includes: Processing and responding to incoming mail, emails and other claim related documents according to status of the claim.
NewClaims Team Lead = Workers Compensation (Pasadena, CA) Sedgwick Claims Management Services, Inc.Claims Team Lead = Workers Compensation (Pasadena, CA)Pasadena, CA$100,000–$105,000 / 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. Provides technical and jurisdictional guidance on claims adjudication, including quality reviews and reserve evaluations for high-cost or complex claims.