Claims Auditor Health Source MSOClaims AuditorAlhambra, CAFull timeResponsibilities include, but not limited to: Maintain up-to-date knowledge of procedures for all ICD-10, CPT, HCPC codes including:Contractual agreement rates. Job Description: Claims Auditor will be responsible for auditing claims processed by Claims Examiners.
Claims Adjuster Kinetic Personnel GroupClaims AdjusterMonrovia, CA$55,000–$75,000 / yearTemporaryThe ideal candidate has a strong understanding of coverage analysis, liability evaluation, and California insurance regulations, and is able to resolve claims efficiently and fairly. This role is responsible for providing high-quality customer service while managing a volume of property damage claims.
Claims Examiner - Workers Compensation (Hourly) IconmaClaims Examiner - Workers Compensation (Hourly)Brea, CA$43–$48 / hourResponsibilities: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.
NewClaims Examiner - Workers Compensation IconmaClaims Examiner - Workers CompensationRancho Cucamonga, CA$45–$50 / hourResponsibilities: 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.
NewAssociate Attorney WinCorp SolutionsAssociate AttorneyIrvine, CA$130,000–$150,000 / yearFull timeOur dynamic Insurance Services Practice Group is known for its comprehensive approach to complex insurance claims analysis and for representing insurance company clients in high-stakes coverage litigation cases across the country, including matters involving defective products, mass torts, environmental contamination, habitability, transportation, personal injury, professional liability, and intellectual property. WinCorp Solutions is looking to hire an Associate Attorney (Civil Litigation/Insurance Coverage) for a large award-winning law firm based in Irvine, CA.
NewRisk Manager MV TransportationRisk ManagerEl Monte, CA$97,000–$114,000This role is exclusively assigned to the potential contract and plays a crucial role in mitigating risk exposure, supporting safe operations, and driving continuous improvement in loss prevention efforts. The Risk Manager will serve as the primary point of contact for all Agency-related risk management matters and must be available and responsive at all times via mobile phone, email, or text message.
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.
Casualty Claims Quality Assurance Consultant EMC Insurance Group Inc.Casualty Claims Quality Assurance ConsultantCA$85,799–$118,545 / yearYou'll partner closely with Casualty, Complex, and Specialty teams to review claim files, evaluate performance against best practices and KPIs, and identify opportunities to improve outcomes. Through targeted audits and broader claims reviews, you'll uncover trends, provide actionable insights, and help drive accountability and continuous improvement.
Medical Biller - Healthcare Claims Guidehouse IncMedical Biller - Healthcare ClaimsEl Segundo, CA$38,000–$63,000 / 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. Demonstrates an ability to find solutions to problems and keeps management informed of patterns regarding billing edits, compliance issues, payments and or other issues with specific payers.
Workers 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.
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.
NewManager, Construction Claims The Vertex Companies, LLCManager, Construction ClaimsIrvine, CA$78,000–$186,000 / yearFull timeResponsible for supporting assigned Director in meeting or exceeding the defined annual budget for the entire practice area/practice division (including proactive management of assigned resources to meet or exceed defined utilization targets, oversight of execution of profitable engagement work streams, and communication with clients as assigned or requested). The Manager, Construction Claims will assist their assigned Director with leading and managing assigned resources in support of achieving the defined overall practice area/ practice division strategy, and in meeting or exceeding defined financial performance and revenue generation targets.
Claims Auditor Western GrowersClaims AuditorIrvine, CAThis position reports to the Supervisor of Payment Integrity and performs in-depth audits to ensure existing health (medical/dental) benefit plans of Western Growers Assurance Trust and Pinnacle Claims Management, Inc. clients are in compliance with the respective employers summary plan descriptions. At 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.
NewFreight Claims Specialist Oldcastle BuildingEnvelopeFreight Claims SpecialistLos Angeles, CaliforniaFrom apartments in New York to hospitals and stadiums in Dallas, libraries at prestigious universities to creating modern retail experiences, our teams contribute architectural glass and building products to projects that shape the way people live, work, heal, learn, and play. The Freight Claims Specialist is focused on managing and recovering freight claims related to lost or damaged shipments across parcel and LTL carriers and reports to the Logistics Manager .
Fractional Customer Service (Claims) Manager Silva-Lining HRFractional Customer Service (Claims) Managerlos Angeles, CARemoteSilva-Lining HR is seeking a Fractional Customer Service (Claims) Manager for a client to oversee and optimize the end-to-end claims process, ensuring timely resolution, operational efficiency, and exceptional customer experience. Lead project management efforts for claims resolution, including task delegation and coordination with internal team members, vendor partners, shipping providers, and repair services.
Personal Auto Property Damage (PD) Claims Adjuster Hankey Group ExternalPersonal Auto Property Damage (PD) Claims AdjusterLos Angeles, CaliforniaThe exact starting compensation to be offered will be determined at the time of selecting an applicant for hire and will be dependent on a wide range of factors, including but not limited to geographic location, skill set, experience, education, credentials, and licensure when applicable. Following successful completion of training and demonstrated performance, employees may be eligible for up to one work-from-home day per week, subject to business needs and manager approval.
Claims Administrator - US Domestic & GeneralClaims Administrator - USNorwalk, CaliforniaRemoteAs a Claims Administrator, you’ll be the key point of contact between our customers and our service partners, ensuring extended warranty claims are handled quickly, accurately, and with empathy. Provide occasional backup support to our Contact Center teams across general warranty inquiries, claims, credits, sales, and product registration.
Senior Commercial Auto Claims Adjuster Hankey Group ExternalSenior Commercial Auto Claims AdjusterLos Angeles, CaliforniaThe exact starting compensation to be offered will be determined at the time of selecting an applicant for hire and will be dependent on a wide range of factors, including but not limited to geographic location, skill set, experience, education, credentials, and licensure when applicable. The ideal candidate has strong analytical skills, sound judgment, and the ability to manage claims with efficiency, accuracy, and professionalism.
Associate Bond Claims Attorney HCC Service CompanyAssociate Bond Claims AttorneySanta Ana, CaliforniaAs an insurance company, however, we must comply with certain Federal and state laws such as the Violent Crime Control and Law Enforcement Act of 1994 (18 USC § 1033(e)), which limits our ability to employ individuals with certain types of criminal convictions. After making a conditional offer and running a background check, if the Company is concerned about a conviction that is directly related to the job, you will be given the chance to explain the circumstances surrounding the conviction or challenge the accuracy of the background report.
Claims Counsel, Financial Lines & Cyber MSIG HoldingsClaims Counsel, Financial Lines & CyberLos Angeles, CaliforniaThe Claims Attorney will be responsible for handling complex matters, including high severity claims and class actions, from inception through resolution for Financial Lines and Cyber products with an emphasis on Directors & Officers (D&O), Financial Institutions Professional Liability (E&O), Pension Trust (Fiduciary), Employment Practices Liability, and Fidelity policies. You will work closely with internal and external customers and stakeholders, deliver excellent customer service, analyze coverage, draft coverage letters, evaluate liability, make claim presentations, set judgmental reserves, and formulate and execute resolution strategies.
Sr. Claims Resolution Analyst SHPCA SCAN Health PlanSr. Claims Resolution AnalystLong Beach, CaliforniaHowever, employees who have access to the compensation information of other employees or applicants as a part of their essential job functions cannot disclose the pay of other employees or applicants to individuals who do not otherwise have access to compensation information, unless the disclosure is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, or (c) consistent with the contractor’s legal duty to furnish information. Our work spans Medicare Advantage, fully integrated care models, primary care, care for the most medically and socially complex populations, and next-generation care delivery models.
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.
Field Property Claims Adjuster: Los Angeles, CA (Gateway Cities / Central LA) Farmers Group, Inc.Field Property Claims Adjuster: Los Angeles, CA (Gateway Cities / Central LA)Los Angeles, CARemote$24.70–$41.88 / hourExposure to some or all of the following environments when in the field: Uncontrolled outside environmental conditions, Excessive noise levels, Chemicals Chemical/Biological conditions, Moving mechanical parts, Areas considered dangerous, Conditions which could affect the respiratory system or skin such as fumes, odors, dust, mists, gases, oils, smoke, soot, or poor ventilation. A Day in the Life of a Field Property Claims Adjuster: Conduct both virtual and on-site investigations by visiting policyholders' residences to assess propertydamage, determine liability, evaluate the extent of loss, and negotiate fair settlements.
NewSenior Manager, Claims Adjustments Mitchell MartinSenior Manager, Claims AdjustmentsLos Angeles, CA$117,509–$152,762 / yearBy applying for this job, you agree to receive AI-generated calls, text messages, and/or emails from Mitchell Martin Inc and its affiliates and contracted partners at various frequency through traditional and automated methods. • This role involves managing complex workflows, ensuring compliance, and leading a team to drive performance.
NewManager, Claims Compliance Mitchell MartinManager, Claims ComplianceLos Angeles, CA$117,509–$152,762 / yearBy applying for this job, you agree to receive AI-generated calls, text messages, and/or emails from Mitchell Martin Inc and its affiliates and contracted partners at various frequency through traditional and automated methods. • This role involves regulatory interpretation, compliance monitoring, and the development of operational training.
NewDirector, Claims Administration Mitchell MartinDirector, Claims AdministrationLos Angeles, CA$135,136–$175,676 / yearBy applying for this job, you agree to receive AI-generated calls, text messages, and/or emails from Mitchell Martin Inc and its affiliates and contracted partners at various frequency through traditional and automated methods. • The position involves leading a team, ensuring compliance with regulations, and utilizing general office software for reporting and data analysis.
Business Analyst Sr, Claims - Covered California CalOptimaBusiness Analyst Sr, Claims - Covered CaliforniaOrange, CA$77,863–$124,581 / yearWe are hoping you will join us as a Business Analyst Sr, Claims - Covered California and help shape the future of healthcare where you'll be an integral part of our Claims Administration team, helping to strive for excellence while we serve our member health with dignity, respecting the value and needs of each of our members through collaboration with our providers, community partners and local stakeholders. Provides analytical support and technical expertise to executives, directors and staff by delivering insights on Covered California performance, trends and compliance, while partnering with department leadership and internal teams to identify and implement process improvements that enhance efficiency and compliance in claims operations.
Sr. Claims Specialist - Commercial Auto BI Philadelphia Insurance CompaniesSr. Claims Specialist - Commercial Auto BIMission Viejo, CA$102,150–$120,177 / yearEvaluates each claim in light of facts; Affirm or deny coverage; investigate to establish proper reserves; and settles or denies claims in a fair and expeditious manner. Marketing Statement: Philadelphia Insurance Companies, a member of the Tokio Marine Group, designs, markets and underwrites commercial property/casualty and professional liability insurance products for select industries.
Claims Resolution Specialist CalOptimaClaims Resolution SpecialistOrange, CA$53,813–$80,720 / yearWe are hoping you will join us as a Claims Resolution Specialist and help shape the future of healthcare where you'll be an integral part of our Claims Administration team, helping to strive for excellence while we serve our member health with dignity, respecting the value and needs of each of our members through collaboration with our providers, community partners and local stakeholders. Responds to provider questions and researches issues regarding claims payments, denials, resolves claim issues, contractual and/or CalOptima Health agreements, established payment methodologies, division of financial responsibility, applicable regulatory legislation, claims processing guidelines and company policies and procedures.
Manager, Configuration - Claims Adjudication/Custom Solutions - Remote Molina Healthcare IncManager, Configuration - Claims Adjudication/Custom Solutions - RemoteCARemoteLeads and manages team responsible for configuration activities including accurate and timely implementation and maintenance of critical information on claims databases, validation of data stored on databases, and adherence to health plan business and system requirements as it pertains to contracting, benefits, prior authorizations, fee schedules and other business requirements. Represents as primary liaison with various functional areas/stakeholders (i.e. utilization management, claims, configuration, provider network, health plan leadership, etc.) to seek understanding of workflows and obtain required documentation for applicable audits.
Multi-Line Claims Adjuster - California / Los Angeles Area Property Claim ProfessionalsMulti-Line Claims Adjuster - California / Los Angeles AreaLos Angeles, CAWe excel in providing professional, knowledgeable claims professionals to handle large losses, catastrophe claims, business interruption and daily property claims, as well as handle complete liability investigations, task assignments including scene investigations and property damage appraisals, construction defect claims as well as first party automobile claims for personal and commercial insurance policyholders. Experience in industry specific areas a plus, but not necessary: fire departments, agricultural, lumber mills, high value or historic buildings or Construction Defects, Automobile Liability, Subrogation Recovery investigations.
Claims Specialist Elite SourcingClaims SpecialistCosta Mesa, CaliforniaYou will be responsible for investigating and evaluating property damage claims arising from automobile accidents, working closely with the demands team and clients to ensure fair compensation for damages. Investigate property damage claims involving auto accidents, including reviewing police reports, witness statements, and damage assessments.
GLOVIS: Analyst, Operations Administration Claims Temp Elevated ResourcesGLOVIS: Analyst, Operations Administration Claims TempIrvine, CaliforniaHandle and process insurance claims on behalf of customers on force majeure/act of god related incidents: • Collect incident report. To handle and resolve claims issues and disputes from dealers and transportation vendors.
Senior Claims Specialist, Workers Compensation Tokio Marine GroupSenior Claims Specialist, Workers CompensationPasadena, CaliforniaWe provide unique insurance and risk management tools from our experienced staff of account executives, underwriters and loss prevention engineers and fair and timely claim settlement from a skilled team of claim professionals. Tokio Marine has been conducting business in the U.S. market for over a century and we are licensed in all states, Puerto Rico and the District of Columbia, and write all major lines of Commercial Property and Casualty Insurance.
Senior Claims Assistant BP&CSenior Claims AssistantLos Angeles, CaliforniaUnder limited supervision, provide complex clerical support utilizing in-depth procedures on assignments of higher-level complexity to a nationwide team of claims adjusters and aide in facilitating timely and accurate management of claims by entering stop/cancel/release of checks, processing cash receipts, work check exceptions, and completion of complex state forms. This role is responsible for providing robust clerical support to our team of Claims Adjusters working across a wide variety of specialties and providing exceptional customer service to our brokers, claimants, and insureds.
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.
Claims Consultant - Physicians & Surgeons (West Region) The Medical Protective CompanyClaims Consultant - Physicians & Surgeons (West Region)CAService to insureds, assist where possible in sales and retention efforts of sales force. Confirm coverage and then manage claims and suits brought against policyholders in our Dental Division.
Analyst III, Epic Application Professional Billing and Claims Pacific Dental Services IncAnalyst III, Epic Application Professional Billing and ClaimsIrvine, CA$103,000–$133,000 / yearOwns highly complex projects, such as multi-module implementations or enterprise-wide systems upgrades; leads medium-scale projects, including scoping, design, implementation, testing and go-live support. This role ensures accurate and efficient billing workflows, claim generation, and revenue cycle operations by collaborating with finance, billing, and operational teams.
NewManager, Schedule Delay Claims The Vertex Companies, LLCManager, Schedule Delay ClaimsIrvine, CA$85,000–$202,000 / yearFull timeThe salary ranges for this role are as follows: $85,000 - $202,000 USD annually (Geographical Tier AA - Sample Locations: NY Metro, San Franscisco, San Jose, Seattle) $78,000 - $186,000 USD annually (Geographical Tier A - Sample Locations: Irvine CA, Middlesex NJ, Tacoma WA, Boston, Alexandria) $72,000 - $171,000 USD annually (Geographical Tier B - Sample Locations - Baltimore, Chicago, Anchorage, Portland) Time away matters—so we provide a generous paid time off program, including vacation, sick time, and paid holidays (with prorated options for eligible part-time employees). 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.
Claims Enablement Analyst EMC Insurance Group Inc.Claims Enablement AnalystCA$66,294–$91,570 / yearAs a Claims Enablement Analyst, you'll support Claims teams by resolving complex system and process issues, identifying root causes, and delivering timely solutions that improve daily operations. You'll collaborate with the Help Desk, IT, and business partners to enhance workflows, contribute to system improvements, and support testing and training efforts.
Associate Bond Claims Examiner HCC Service CompanyAssociate Bond Claims ExaminerLos Angeles, CaliforniaTokio Marine HCC – Surety Group, a member of the Tokio Marine Group of Companies, has an exciting opportunity for an Associate Claims Examiner position on-site at our office in Los Angeles, California. We are looking for motivated individuals to join our team of highly skilled claims examiners who are part of a successful division that specializes in surety bond business.
NewClaims Representative Mercury Insurance Services, LLCClaims RepresentativeCalifornia$32,363–$56,701 / yearThe Claims Representative will handle a high volume of calls and make regular contact with customers on multiple platforms, collaborating cohesively with other team members to achieve department goals. • Sets reserves for anticipated losses, arranges vehicle inspections and rental authorizations, and makes referrals to specialty teams as warranted.
Workers Compensation Claims Manager, West CNAWorkers Compensation Claims Manager, WestPlacentia, CaliforniaBuilds and maintains collaborative relationships with internal and external work partners by participating in round table discussions, working with claims operations and coverage resources, providing insights to underwriters, partnering with SIU and Recovery Services and interacting with external customers, brokers and vendors as appropriate. Performs a combination of duties in accordance with departmental guidelines: Oversees the work activities of a team of claims professionals and has full management responsibility by setting and communicating expectations, providing direction and coaching, facilitating training and development, managing employee performance, and contributing to employee engagement.
NewClaims Representative Mercury Insurance CompanyClaims RepresentativeCA$32,363–$56,701 / yearThe Claims Representative will handle a high volume of calls and make regular contact with customers on multiple platforms, collaborating cohesively with other team members to achieve department goals. Sets reserves for anticipated losses, arranges vehicle inspections and rental authorizations, and makes referrals to specialty teams as warranted.
NewClaims Field Senior Property Adjuster AAAClaims Field Senior Property AdjusterCarson, CaliforniaWith our national brand recognition, long-standing reputation since 1900, and constantly growing membership, we are seeking career-minded, service-driven professionals to join our team. Travel Requirements Claims field duties may involve company car usage and local travel to inspect accident scenes or first-party homeowner losses.
Senior Claims Counsel - Financial Institutions/Public D&O CNA Financial CorpSenior Claims Counsel - Financial Institutions/Public D&OBrea, CA$97,000–$189,000 / yearThe position requires the ability to independently evaluate liability and coverage; proactively formulate and execute claim resolution strategies; and, without the assistance of counsel, attend mediations, navigate complex settlement dynamics and drive and influence best possible claim outcomes. The individual in this position will primarily focus on high severity D&O and E&O claims under policies issued to Public Companies as well as Financial Institutions such as large depository institutions, insurance companies, asset managers, private equity and venture capital firms and REITs.
Workers Compensation Claims Manager, West CNA Financial CorpWorkers Compensation Claims Manager, WestBrea, CA$72,000–$141,000 / yearJOB DESCRIPTION: Essential Duties & Responsibilities: Performs a combination of duties in accordance with departmental guidelines: Oversees the work activities of a team of claims professionals and has full management responsibility by setting and communicating expectations, providing direction and coaching, facilitating training and development, managing employee performance, and contributing to employee engagement. Builds and maintains collaborative relationships with internal and external work partners by participating in round table discussions, working with claims operations and coverage resources, providing insights to underwriters, partnering with SIU and Recovery Services and interacting with external customers, brokers and vendors as appropriate.
NewVP, Claims Technical Lead, Workers Comp Sompo International Holdings LimitedVP, Claims Technical Lead, Workers CompIrvine, CA$170,000–$225,000 / yearThe successful candidate will supervise the internal Sompo TPA oversight claims team, manage TPAs who handle claims on Sompo's behalf, and work closely with internal and external business partners. 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 Client Service Executive Sales The Hartford Insurance Group IncClaims Client Service Executive SalesLos Angeles, CA$108,000–$162,000 / yearWe look to the Client Service Executive, Sales to support the end-to-end service mission while delivering engaging customer presentations that demonstrate professional diplomacy, articulated messaging and a friendly confidence that drives positive outcomes for our customers. Responsibilities: As the integral member of the Client Service Team, supports the overall service mission by delivering customer presentations that demonstrate professional diplomacy, articulated messaging and confidence that drives positive outcomes for our customers.
Claims Examiner - Workers Compensation eTeam Inc.Claims Examiner - Workers CompensationOntario, CARemote$45–$52 / 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.