Senior Claims Manager EPL - Remote Providence St. Joseph HealthSenior Claims Manager EPL - RemoteLos Angeles, CARemoteTogether, our 120,000 caregivers (all employees) serve in over 50 hospitals, over 1,000 clinics and a full range of health and social services across Alaska, California, Montana, New Mexico, Oregon, Texas and Washington. Candidate must possess strong communication and litigation management skills to collaborate with business partners and defense counsel to direct litigation activities and claim outcomes while considering the overall impact to the company and individual stakeholders.
Claims Examiner - Workers Compensation Iconma LLCClaims Examiner - Workers CompensationLong Beach, CASubject 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. Responsibilities: 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.
Senior Claims Manager EPL - Remote Providence Health & ServicesSenior Claims Manager EPL - RemoteCalifornia, CARemoteRequsition ID: 455795 Company: Providence Jobs Job Category: Financial Transactions Job Function: Health Plans Services Job Schedule: Full time Job Shift: Day Career Track: Business Professional Department: 4008 SS RIS Address: CA Orange 1100 W Stewart Dr Work Location: St Joseph Hospital-Orange Workplace Type: Remote Pay Range: $See Posting - $See Posting The amounts listed are the base pay range; additional compensation may be available for this role, such as shift differentials, standby/on-call, overtime, premiums, extra shift incentives, or bonus opportunities. Providence Shared Services is a service line within Providence that provides a variety of functional and system support services for our family of organizations across Alaska, California, Montana, New Mexico, Oregon, Texas and Washington.
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?.
Workers Compensation Claims Examiner | Long Beach or Roseville, CA Sedgwick Claims Management Services, Inc.Workers Compensation Claims Examiner | Long Beach or Roseville, CALong Beach, CA$85,000–$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. 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 Supervisor, Complex General Liability GallagherClaims Supervisor, Complex General LiabilityTorrance, CaliforniaRemoteFull timeAbility to actively review work of others via file reviews; identify coaching opportunities, act on needed coaching opportunities and position subordinates for successful development leading to advancement within the organization. As part of Gallagher, a global leader in insurance, risk management, and consulting, you’ll be joining a team that’s passionate about helping individuals and organizations thrive.
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 Clinical Specialist Genworth Financial IncClaims Clinical SpecialistCAYou will be responsible for communicating with medical personnel at Long Term Care Facilities, Home Care Agencies, and/or individuals by conducting telephonic assessments for claimants to develop the plan of care and provide tax qualified certifications as required by the policy. At least two years' experience working in a role that required an understanding of single and cumulative medical conditions (particularly those common in the aging process), including their effect on physical/cognitive function, as well as their prognosis and rehabilitative potential.
Sr. Claims Counsel Sompo InternationalSr. Claims CounselLos Angeles, CA$125,000–$175,000 / yearOur business, your impact, our opportunity: What you'll be doing: Direct handle primary & excess Casualty claims involving emerging risks, potential long-term exposure, or significant coverage issues. Below is a summary of our current comprehensive U.S. benefit programs: Two medical plans to choose from, including a Traditional PPO & a Consumer Driven Health Plan with a Health Savings account providing a competitive employer contribution.
Sr. Claims Counsel Sompo International Holdings LimitedSr. Claims CounselLos Angeles, CA$125,000–$175,000 / yearOur business, your impact, our opportunity: What you'll be doing: Direct handle primary & excess Casualty claims involving emerging risks, potential long-term exposure, or significant coverage issues. Below is a summary of our current comprehensive U.S. benefit programs: Two medical plans to choose from, including a Traditional PPO & a Consumer Driven Health Plan with a Health Savings account providing a competitive employer contribution.
Claims Counsel Capital Insurance GroupClaims CounselLos Angeles, CARemote$114,364–$190,607 / yearResponsible for consultation with claims staff in a variety of claims issues, including but not limited to, coverage, indemnification, policy limit demand reviews, indemnity agreement review, release language review. Under general supervision, this position will be part of the Claims Legal team, which will provide settlement authority and general strategic support for claims/exposures that exceed the line unit’s authority.
ESIS Claims Associate Chubb LtdESIS Claims AssociateChatsworth, CA$47,500–$67,500 / yearThe company is distinguished by its extensive product and service offerings, broad distribution capabilities, exceptional financial strength, underwriting excellence, superior claims handling expertise and local operations globally. With operations in 54 countries, Chubb provides commercial and personal property and casualty insurance, personal accident and supplemental health insurance, reinsurance, and life insurance to a diverse group of clients.
NewSenior Claims Examiner, Complex Liability GallagherSenior Claims Examiner, Complex LiabilityTorrance, CaliforniaFull timeBehaviors: Ability to think critically, solve problems, plan and organize activities, serve clients, negotiate, effectively communicate verbally and in writing and embrace new challenges. Introduction : At Gallagher, we help clients face risk with confidence because we believe that when businesses are protected, they’re free to grow, lead, and innovate.
Complex Claims Consultant - Private & NFP D&O CNA Financial CorpComplex Claims Consultant - Private & NFP D&OLos Angeles, CA$72,000–$141,000 / yearPerforms a combination of duties in accordance with departmental guidelines: Manages an inventory of highly complex Financial Lines 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.
NewClaims Examiner - Workers Compensation Apidel TechnologiesClaims Examiner - Workers CompensationLong Beach, 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. 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.
NewProduct Owner - Claims Inovalon Holdings IncProduct Owner - ClaimsCAPerform validation and testing of solutions through managing and executing user acceptance plans, collaborating with the engineering team during user testing and complex validation sessions, and responding to technical and functional product questions raised by stakeholders, and reformulate solutions as necessary to ensure that the recommended solution is responsive to the data requirements; Analyze the impact of a proposed solution on connected processes, systems, and/or applications to determine the best course of action to achieve the desired outcome; Assist in the development of roadmaps and business strategy for assigned product or department; Demonstrate robust knowledge of the healthcare industry, product management, and software development to translate problems, needs, and opportunities into user stories. Develop detailed business requirements that meet the needs of internal and external stakeholders and support corporate objectives; Analyze the current system or application, conceptualize and define operational problems, model and present recommended enhancements and modifications, and walk each new enhancement or modification through the development process, from planning and preparation to testing and implementation; Oversee the design, prioritization, and delivery of products through the software development lifecycle, from concept to testing, deployment, adoption and value realization.
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.
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.
BusinessOperations - Claims Examiner (Operations) 1 - 700092 MindlanceBusinessOperations - Claims Examiner (Operations) 1 - 700092Woodland Hills, CA$23 / hourImpact and Purpose Candidate Requirements Education/Certification Required: High school diploma or higher education Preferred: High school diploma or higher education Licensure Required: No License Required Preferred: CA Pharmacy Technician License Years of experience required. Projected HM Candidate Review Date: 1-2 days post shortlisting Number and Type of Interviews: 1 Interview (Panel of 3) Extra Interview Prep for Candidate: No Required Testing or Assessment (by Vendor): Manager Communication Preferences & Next Steps