Claims Examiner - Workers Compensation ObjectWin TechnologyClaims Examiner - Workers CompensationLong Beach, CA, CARemoteTo 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.
Program Manager - Workers Compensation Claims | CA Claims Exp. Preferred (Hybrid - California) Sedgwick Claims Management Services, Inc.Program Manager - Workers Compensation Claims | CA Claims Exp. Preferred (Hybrid - California)Brea, CA$95,000–$120,000 / 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 Coordinator, PSA Collaborative SolutionsClaims Coordinator, PSASanta Ana, CaliforniaOur services span collectible trading cards, autographs, comic books, coins, video games, event tickets, and memorabilia. We grade, authenticate, vault, and sell millions of record-setting collectibles, all while modernizing and digitalizing the process to further our mission of helping collectors pursue their passions.
Chief Claims Officer, Argo Group Argo Group International Holdings Ltd.Chief Claims Officer, Argo GroupLos Angeles, CAPossesses an extensive knowledge and experience with adjudicating and management claims for a portfolio of commercial products/program lines including surety, auto, general liability, workers' compensation, property, asbestos/environmental, reinsurance and the relevant claims handling practices supporting such products/programs. The Chief Claims Officer, Argo Group provides claim leadership and direction to the Senior Management of all the Argo Group claims operations with a focus on supporting the consistent execution of claims functions and maintenance of operational excellence.
NewSenior Claims Specialist Macpower Digital Assets Edge Private LimitedSenior Claims SpecialistOrange, CA$110,000–$130,000 / yearJob Summary: Seeking a Senior Claims Specialist to manage a complex caseload of medical malpractice claims, supervise junior claims specialists, and contribute to ongoing training efforts. Key Responsibilities: Manage medical malpractice claims , including assigning and directing defense counsel, following Claims Technical Manual, Defense Attorney Guidelines, and MPT Agreement.
Assistant Director, Claims Operations Impresiv HealthAssistant Director, Claims OperationsHuntington Beach, CA$95,000–$120,000 / yearThe Assistant Director will provide operational, analytical, administrative, and project support across claims processing, 837 file oversight, payment integrity, issue resolution, provider and IPA coordination, reporting, audit readiness, system initiatives, and process improvement. Track, document, escalate, and help resolve complex claims issues involving providers, IPAs, delegated entities, vendors, and internal departments.
Claims Examiner - Workers Compensation (Hourly) Apidel TechnologiesClaims Examiner - Workers Compensation (Hourly)Brea, CAContractorTo 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.
Claims Examiner VenbrookClaims ExaminerLos Angeles, CaliforniaVenbrook works across the claims lifecycle with services that include Third Party Administration (TPA), Complex Claims Management, Catastrophe, Independent Adjusting, subrogation recovery, litigation management, investigative, and special investigations unit (SIU) services. Venbrook's team of experts and industry specialists partners with their clients to manage their risks, create security, promote growth, and add value by delivering best-in-class commercial property & casualty, employee benefits, and personal risk insurance products and programs.
Senior Litigation Construction Liability Claims Representative TravelersSenior Litigation Construction Liability Claims RepresentativeDiamond Bar, California$94,400–$155,800 / yearDirectly investigates each claim through prompt and strategically-appropriate contact with appropriate parties such as policyholders, accounts, claimants, law enforcement agencies, witnesses, agents, medical providers and technical experts to determine the extent of liability, damages, and contribution potential. Actively engages in the identification, selection and direction of appropriate internal and/or external resources for specific activities required to effectively evaluate claims, such as Subrogation, Risk Control, nurse consultants, and fire or fraud investigators, and other experts.
Patient Account Representative - Commercial Claims GuidehousePatient Account Representative - Commercial ClaimsEl Segundo, CA$38,000–$64,000 / yearCompensation decisions depend on a wide range of factors, including but not limited to skill sets, experience and training, security clearances, licensure and certifications, and other business and organizational needs. All communication regarding recruitment for a Guidehouse position will be sent from Guidehouse email domains including @guidehouse.com or guidehouse@myworkday.com.
Health Claims Examiner Ultimate Staffing ServicesHealth Claims ExaminerLos Angeles, California$23–$28 / hourInteract professionally with members and providers to resolve inquiries, follow up on pended claims, and complete corrections and adjustments. * Review claims for fraud, waste, abuse, hospital acquired conditions, Workers' Compensation, and Third Party Liability, referring cases as appropriate.
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.
Healthcare Claims Analyst Ultimate Staffing ServicesHealthcare Claims AnalystPasadena, California$56,000–$62,000This role handles claims processing, inbound customer inquiries, eligibility and benefits research, issue resolution, process improvement, and staff training while delivering exceptional customer service. Seeking an experienced customer service and claims professional to support participants, providers, and healthcare partners.
NewClaims & Risk Data Analyst FuntonetworkClaims & Risk Data AnalystLos Angeles, CaliforniaAt FuntoNetwork, we connect experienced consultants with Upcoming project opportunities through a mobile-first platform built for discovery, review, application submission, payment tracking, and consultant support. Once you complete AI vetting and are approved, you will log in to the FuntoNetwork mobile app to track relevant opportunities, application status, contracts, earnings, payments, withdrawals, and related records.
Claims (Billing) Specialist / Patient Account Representative - Healthcare GuidehouseClaims (Billing) Specialist / Patient Account Representative - HealthcareEl Segundo, CA$34,000–$56,000 / yearRepresentatives are responsible for maintaining knowledge, skills, and abilities that contribute to various accounting/administrative tasks involved in preparing billing data for agencies Guidehouse works with. Compensation decisions depend on a wide range of factors, including but not limited to skill sets, experience and training, security clearances, licensure and certifications, and other business and organizational needs.
Litigation Case Manager L.A. Injury AttorneysLitigation Case ManagerBurbank, CaliforniaCommunicate with providers and creditors to confirm lien amounts and negotiate liens · Maintain accurate and detailed records of all negotiations, agreements, and communications pertaining to lien resolution · Draft reduction letters to resolve and negotiate medical liens · Negotiate all medical liens, Medpay reimbursement claims, waivers, and attorney liens in settled personal injury cases. Injury Attorneys is one of the top rated personal injury law firms in California and belongs to the Million Dollar Advocates Forum and the Multi- Million Dollar Advocates forum which is exclusive to those law firms that have excelled in their profession and secured multi-million dollar settlements and verdicts for their clients.
Collections Representative Axelon Services CorporationCollections RepresentativeLos Angeles, CA$28–$32 / hourDocument billing activity, claim details, expected reimbursement, payments, and account actions clearly and accurately. Submit required supporting documentation, including authorizations, medical records, consent forms, and payer-specific forms.
Senior Mechanical Project Engineer Thornton TomasettiSenior Mechanical Project EngineerLos Angeles, CaliforniaIndividuals seeking employment at Thornton Tomasetti are considered without regards to age, ancestry, color, gender (including pregnancy, childbirth, or related medical conditions), gender identity or expression, genetic information, marital status, medical condition, mental or physical disability, national origin, protected family care or medical leave status, race, religion (including beliefs and practices or the absence thereof), sexual orientation, military or veteran status, or any other characteristic protected by federal, state, or local laws. An independent organization of creative thinkers and innovative doers collaborating from offices worldwide, our mission is to bring our clients' ideas to life and, in the process, lay the groundwork for a better, more resilient future.
Claims Examiner - Workers Compensation (Hourly) MindlanceClaims Examiner - Workers Compensation (Hourly)Brea, CARemote$47–$48 / hourDuties: PRIMARY 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.
Operations Analyst - National Claims (Hybrid in CA) First AmericanOperations Analyst - National Claims (Hybrid in CA)Santa Ana, CaliforniaFirst American reasonably believes that a criminal history may have a direct, adverse and negative relationship with the following material job duties for this position potentially resulting in the withdrawal of the conditional offer of employment: handling of confidential, proprietary or trade secret information belonging to First American or its customers, administrating or facilitating financial transactions, and the ability to meet customer-imposed criminal history requirements. This position supports title claims and claims-adjacent intake operations across multiple locations and serves as a key partner to senior leadership by providing operational support, audit coordination, advanced reporting, and systems optimization.