Claims Examiner Workers Compensation I CA experienced required I Remote Sedgwick Claims Management Services, Inc.Claims Examiner Workers Compensation I CA experienced required I RemoteCARemote$63,404–$95,000 / yearTo analyze California 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. PRIMARY PURPOSE OF THE ROLE: We are looking for driven individuals that embody our caring counts model and core values that include empathy, accountability, collaboration, growth, and inclusion.
Claims Representative (IAP) - Workers Compensation Training Program Sedgwick Claims Management Services, Inc.Claims Representative (IAP) - Workers Compensation Training ProgramCAMental: 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.
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 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, Auto | Bodily Injury Sedgwick Claims Management Services, Inc.Claims Examiner, Auto | Bodily InjuryMSEducation & Licensing: Five (5) years of claims management experience or equivalent combination of education and experience required to include in-depth knowledge of personal and commercial line auto policies, coverages, principles, and laws. Processes complex auto commercial and personal line claims, including bodily injury and ensures claim files are properly documented and coded correctly.
Claims Examiner - Workers Compensation (Hybrid- West Hills, Ca/3 Days Remote) Sedgwick Claims Management Services, Inc.Claims Examiner - Workers Compensation (Hybrid- West Hills, Ca/3 Days Remote)West Hills, CARemote$80,000–$90,000 / 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 Representative (IAP) -Workers Compensation Training Program Sedgwick Claims Management Services, Inc.Claims Representative (IAP) -Workers Compensation Training ProgramCAMental: 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.
Claims Examiner, Bodily Injury | Commercial Trucking | Remote Sedgwick Claims Management Services, Inc.Claims Examiner, Bodily Injury | Commercial Trucking | RemoteCARemote$80,000–$85,000 / yearTo analyze complex auto bodily injury and commercial trucking claims on behalf of our valued clients by evaluating coverage, investigating liability, and managing damages, while ensuring timely resolution within service expectations, industry best practices, and specific client requirements. Education & Licensing: Five (5) years of claims management experience or equivalent combination of education and experience required to include in-depth knowledge of personal and commercial line auto policies, coverage's, principles, and laws.
Senior Technical Claims Specialist Argo Group International Holdings IncSenior Technical Claims SpecialistLos Angeles, CA$173,706–$208,386 / yearEssential Responsibilities: Working with limited oversight under broad management direction, adjudicate highly complex claims and insurance coverage disputes mostly for our professional liability line of business, at the highest authority limits on assignments reflecting the highest degree of technical complexity and coordination in liability and litigated claims, potentially with major impact on departmental results. Qualifications / Experience Required: A deep knowledge of claims adjudication and focus on customer service typically achieved through: At least seven years' experience handling insurance coverage issues and disputes, with exposure of $100,000 or more, for Professional Liability claims.
Business Technology Strategy Lead - Claims, Finance, HR, Legal & Compliance L.A. Care Health PlanBusiness Technology Strategy Lead - Claims, Finance, HR, Legal & ComplianceLos Angeles, CAThe TPM II applies functional healthcare systems knowledge to ensure solutions meet business intent and regulatory requirements, leverages data to measure outcomes and validate hypotheses, and promotes disciplined product management practices within the domain. Collaborates with IT and business partners to ensure solutions within the domain comply with Health Insurance Portability and Accountability Act (HIPAA), Centers for Medicare and Medicaid Services (CMS), Department of Health Care Services (DHCS), and other relevant regulatory requirements.
Data Analyst Claims Mercury Insurance CompanyData Analyst ClaimsCA$76,829–$142,213 / yearCoordinates and executes reporting; directs and supports underwriting users/leaders in identifying data needed for reporting using Guidewire Database, NextGen Database, and Enterprise Data Warehouse. Position Summary: The primary job function, under general supervision, is interpreting complex data sets related to various operations of the Claims Department and provide data-driven analysis.
NewClaims Solutions Partner ClaimSorted IncClaims Solutions PartnerCAYoull partner with sales to diagnose prospects operational gaps, answer the hard technical questions, provide the expertise behind our RFP and RFI responses, run deep analyses of partner portfolios to surface where we add value, and then ensure a clean technical handoff to account management as new partners onboard. Were looking for a Claims Solutions Partner - the claims-operations expert who sits inside our sales cycle and makes technically complex deals winnable.
NewFinancial Lines Claims Counsel Mitsui Sumitomo Insurance Company Of AmericaFinancial Lines Claims CounselLos Angeles, CA$150,000–$200,000 / yearThe role focuses primarily on Directors & Officers (D&O), Financial Institutions Professional Liability (E&O), Employment Practices Liability (EPL), Fiduciary, and Fidelity claims, including complex litigation, class actions, securities matters, and high-severity financial loss exposures. Analyze coverage, liability, damages, and exposure issues, establish appropriate reserves, and provide accurate claim assessments involving D&O, Financial Institutions E&O, EPL, Fiduciary, and Fidelity policies.
Claims Examiner HCC Life Insurance CompanyClaims ExaminerLos Angeles, CA$29.44–$40.46 / hourTokio 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.
Claims Examiner - Workers Compensation IconmaClaims Examiner - Workers CompensationLong Beach, CA$45–$50 / hourSubject 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. 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 Consultant - Cyber - E&O (Hybrid) Onebeacon Professional Insurance IncClaims Consultant - Cyber - E&O (Hybrid)Anaheim, CA$143,000–$167,000 / yearWe currently have an opportunity for a Claim Consultant to join our Cyber - E&O team based in our New York City, NY; Chicago, IL; Plymouth, MN; Boston, MA; Canton, MA; Anaheim, CA; Irvine, CA; Denver, CO offices on a hybrid schedule. In return, we promise you support, opportunities and performance-led financial rewards in a flexible work environment where you can: Shape the future: Help us lead an insurance transformation to better protect people, businesses and society.
Claims Consultant - Cyber - E&O (Hybrid) Intact InsuranceClaims Consultant - Cyber - E&O (Hybrid)Irvine, CA$143,000–$167,000 / yearWe currently have an opportunity for a Claim Consultant to join our Cyber- E&O team based in our New York City, NY; Chicago, IL; Plymouth, MN; Boston, MA; Canton, MA; Anaheim, CA; Irvine, CA; Denver, CO offices on a hybrid schedule. In return, we promise you support, opportunities and performance-led financial rewards in a flexible work environment where you can: Shape the future: Help us lead an insurance transformation to better protect people, businesses and society.
Patient Account Representative - Physician Claims Guidehouse IncPatient Account Representative - Physician ClaimsEl Segundo, CA$34,000–$56,000 / yearThe Patient Account Representative has an extensive knowledge of billing, accounts receivable follow-up, timely filing guidelines and the ability to effectively review remittance advices and electronic billing reports from payer to determine the action required. 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.
Sr Claims Clerk Crawford & CoSr Claims ClerkCATo determine the actual offer, Crawford considers a wide range of factors including the candidate's previous experience and education, market rates, minimum pay requirements for the applicable jurisdiction, business segment, supply/demand, and scheduled hours. All resumes submitted by search firms to any employee at Crawford via-email, the Internet or in any form and/or method without a valid written Statement of Work in place for this position from Crawford HR/Recruitment will be deemed the sole property of Crawford.
Insurance Collections Specialist Your Behavioral HealthInsurance Collections SpecialistTorrance, CA$21–$24At YBH, we pride ourselves on being a centralized hub teeming with resources designed to aid clients and their families in pinpointing the optimal support tailored to their distinct needs and aspirations for well-being. Answering questions from patients, clerical staff and insurance companies, Compiling and tracking outstanding balances owed to our providers.