Workers Compensation Large Loss Claims Director CNA Financial Corp.Workers Compensation Large Loss Claims DirectorWalnut Creek, CA$97,000–$189,000 / yearWorking closely with claims leadership, disposition consultants, legal services, customers, brokers, and business partners, the Large Loss Director drives superior claim outcomes, technical excellence, operational effectiveness, and profitable growth while serving as a mentor and resource to claims professionals across the organization. This individual contributor role provides company-wide influence and leadership in the interpretation of complex policy coverages, litigation management, reserving, claim resolution strategies, regulatory compliance, and large loss methodologies.
Claims Specialist Lead The Progressive CorpClaims Specialist LeadConcord, CA$39.18–$51.92 / hourFor ideas about how you might be able to protect yourself from job scams, visit our scam-awareness page at https://careers.progressive.com/pages/how-we-hire-faq-job-scams/ . As a claims specialist on our team, you'll play a critical role in our ability to successfully and efficiently resolve large-loss injury claims valued over $60k.
Senior Claims Examiner Commercial GL VenbrookSenior Claims Examiner Commercial GLSan Jose, CaliforniaAIC, AIM, ARM, CPCU) and/or insurance related courses are a plus• Experience working in claims management systems and strong knowledge of Microsoft applications (Outlook, Word, Excel, and PowerPoint). REQUIREMENTS• 6+ years of handling litigated auto and/or general liability property damage• Field investigation experience preferred• Public entity experience is a plus• College degree is preferred and a designation (e.g.
Claims Appraiser - Auto Estimatics State FarmClaims Appraiser - Auto EstimaticsFremont, CA$78,862.06–$102,500 / yearWith the opportunity to initially earn up to 20 days annually plus parental leave, paid holidays, celebration day, life leave (40 hours/year), bereavement leave, and community service/education support days, there will be plenty of time for you! Additional Details: Employees must successfully complete all required training, including applicable proficiency, licensing exam(s), Motor Vehicle Record (MVR) checks, and background checks required of various state(s).
Claims Examiner II North East Medical ServiceClaims Examiner IIBurlingame, CAESSENTIAL JOB FUNCTIONS: Perform the daily examination, auditing and adjudication activities to submitted hospital and professional claims based on established utilization criteria, Medi-Cal and/or Medicare guidelines, member's Evidence of Benefit, and policies and procedures outlined in the MSO Claims Manual. Responsible to prepare files and documents for the annual health plan delegation oversight audits, assist Claims Supervisor with MSO management reports, and other special projects as needed.
Claims Examiner I MSO North East Medical ServiceClaims Examiner I MSOBurlingame, CAESSENTIAL JOB FUNCTIONS: Perform the daily examination, auditing and adjudication activities to submitted professional claims based on established utilization criteria, Medi-Cal and/or Medicare guidelines, member's Evidence of Benefit, and policies and procedures outlined in the MSO Claims Manual. Identify claims payment errors and/or system configuration flaws during day-to-day operation, report to department manager/supervisor and MSO System Configuration team to correct/resolve them.
NewSr. Claims Specialist, Professional Liability | Medical Malpractice | California Sedgwick Claims Management Services, Inc.Sr. Claims Specialist, Professional Liability | Medical Malpractice | CaliforniaConcord, CA$100,000–$125,000 / yearIdeal candidates demonstrate strong analytical and negotiation skills, exercise sound judgment, and are committed to delivering timely, cost‑effective claim resolutions while maintaining a high level of customer service. ESSENTIAL RESPONSIBLITIES MAY INCLUDE: Analyzes and processes complex or technically difficult medical malpractice 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 Specialist - Workers'''' Compensation (California) ICW GroupClaims Specialist - Workers'''' Compensation (California)Pleasanton, CA$78,678.61–$132,686.15 / yearHeadquartered in San Diego with regional offices located throughout the United States, ICW Group has been named for ten consecutive years as a Top 50 performing P&C organization offering the stability of a large, profitable and growing company combined with a focus on all things people. Bachelor's degree (or equivalent combination of education and experience) required along with a minimum of 8 - 10+ years' related claims handling experience involving complex litigation, reserving, settlement strategy, and high exposure claims.
Senior Software Engineer, Claims Submissions CommureSenior Software Engineer, Claims SubmissionsMountain View, CaliforniaThe claim generation pipeline: transforming structured claim payloads into valid electronic EDI claims across professional (CMS-1500), institutional (CMS-1450/UB), and dental (CDT) formats, plus paper-claim and PDF generation for payers that require mail or fax. Our platform spans the full care journey: Ambient AI and Dictation eliminating documentation burden at the point of care, intelligent Agents automating patient and revenue workflows, and autonomous RCM processing billions in claims, all on a single AI-native platform integrated with 60+ EHRs.
NewLiability Claims Examiner Sedgwick Claims Management Services, Inc.Liability Claims ExaminerConcord, 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: To address and handle high end General Liability cases with serious injuries, complex coverage scenarios and legal inquiries or disputes; to develop a strategy to bring a case to satisfactory resolution.
Manager, Claims Operations San Francisco Health PlanManager, Claims OperationsSan Francisco, CA$140,000–$150,000 / yearSFHP is chosen by eight out of every ten San Francisco Medi-Cal managed care enrollees and its 175,000+ members have access to a full spectrum of medical services including preventive care, specialty care, hospitalization, prescription drugs, and family planning services. ABOUT SFHP: Established in 1997, San Francisco Health Plan (SFHP) is an award-winning, managed care health plan whose mission is to provide affordable health care coverage to the underserved low and moderate-income residents in San Francisco County.
Property & Casualty Claims Advocate Hub International LtdProperty & Casualty Claims AdvocateSan Francisco, CA$68,000–$100,000 / yearMaintains accurate and organized claim files by appropriately documenting conversations with clients and carrier representatives; updates all HUB computer systems and automated agency management systems; ensures the accuracy of data. QUALIFICATIONS: High School Diploma / GED 2-3 years property & casualty claims adjustment experience (brokerage preferred) or equivalent combination of education & experience Property & Casualty License required or willingness to obtain within 3 months.
APeX Claims Analyst UCSF Medical CenterAPeX Claims AnalystSan Francisco, CAYesWorks on complex initiatives to analyze patient care workflow in various clinical departments, and to develop and define information technology solutions for improved system integration and functionality. Ability to work with senior staff and managers, serving as a technical resource and providing advice and counsel on issues of functionality, efficiency, cost-effectiveness, policy, and performance.
Senior Complex Claims Manager Airbnb IncSenior Complex Claims ManagerCARemote$125,000–$145,000 / yearIn partnership with key stakeholders in the organization, you'll support our Complex Claims Leader and contribute to Airbnb's multiple year strategy (vision, risk appetite, operating model, goals, KPIs), manage partners to influence prioritization, drive accountability, deliver improvements, and scale changes on claims which impact Airbnb. Philosophy will be to identify intelligence / risk gaps and work with other internal risk management teams (such as Trust team, and Safety team), third party adjusters, our partners, Platform Product Management, Global Crisis Management, Community support, Policy, Privacy Legal teams to strengthen Airbnb's platform.
Claims Processor 1 Zenith American SolutionsClaims Processor 1San Francisco, CaliforniaWe are currently looking for a dedicated, energetic employee with the necessary skills, initiative, and personality, along with the desire to get the most out of their working life, to help us be our best every day. Zenith American Solutions is the largest independent Third Party Administrator in the United States and currently operates over 44 offices nationwide.
Supervisor, Claims Zenith American SolutionsSupervisor, ClaimsSan Francisco, CaliforniaZenith American Solutions is the largest independent Third Party Administrator in the United States and currently operates over 44 offices nationwide. We are currently looking for a dedicated, energetic employee with the necessary skills, initiative, and personality, along with the desire to get the most out of their working life, to help us be our best every day.
Claims Processor 3 Zenith American SolutionsClaims Processor 3San Francisco, CaliforniaWe are currently looking for a dedicated, energetic employee with the necessary skills, initiative, and personality, along with the desire to get the most out of their working life, to help us be our best every day. High school diploma or general education degree (GED); two years related experience processing all types of group health and/or dental benefit claims.
Victim Claims Specialist I San Joaquin CountyVictim Claims Specialist ISan Jose, CAMobility-Frequent keyboard operation, sitting; occasional pushing, pulling, bending, squatting; Lifting-Frequent lifting up to 5 pounds; Vision-Constant reading and close-up work requiring good overall vision; frequent eye/hand coordination; occasional color/depth perception and peripheral vision; Dexterity-Frequent holding, gripping, writing and repetitive motion; occasional reaching; Hearing/Talking-Constant hearing normal speech, hearing/talking in person and on the telephone; occasional hearing faint sounds; Emotional/Special Conditions-Frequent public contact, decision making, and concentration; frequent exposure to trauma, grief and death; occasional working overtime. Learns to review and process a variety of claims submitted by victims including medical bills, mental health bills, funeral/burial bills, wage loss requests and other expenses; learns to research information as required to establish a link to the qualifying crime and to verify losses claimed by the victim; learns to calculate losses to victims and determine reimbursements considering all other sources of compensation available; learns to recommend approval or denial of reimbursement and level of services; notifies victims of claim determinations.
NewManaging Director - Disputes, Claims, & Investigations Group StoutManaging Director - Disputes, Claims, & Investigations GroupSan Francisco, CaliforniaBoth our client service and culture are second to none, stemming from our firmwide embrace of our core values: Positive and Team-Oriented, Accountable, Committed, Relationship-Focused, Super-Responsive, and being Great communicators. As a Managing Director in Commercial Litigation, you will lead complex dispute consulting engagements and serve as a senior advisor to clients, legal counsel, and expert witnesses.
Workers' Compensation Claim Specialist CCMSIWorkers' Compensation Claim SpecialistConcord, CaliforniaRemote$85,000–$98,000 / yearResponsibilities: When we hire Workers’ Compensation Adjusters at CCMSI, we look for detail‑driven problem‑solvers who balance empathy with sound judgment, navigate complex regulations with confidence, and deliver fair, timely outcomes that support injured workers and strengthen client trust. At CCMSI, we partner with global clients to solve their most complex risk management challenges, delivering measurable results through advanced technology, collaborative problem-solving, and an unwavering commitment to their success.