NewClaims Consultant - Cyber - E&O (Hybrid) Intact InsuranceClaims 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.
NewClaims Consultant - Cyber - E&O (Hybrid) Onebeacon Professional Insurance IncClaims 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.
Claims Specialist Pavement Recycling Systems, IncClaims SpecialistJurupa Valley, California$85,000–$115,000 / yearFull timeThe Claims Specialist is responsible for evaluating, processing, and managing liability, property, auto, general liability claims, and employment claims in compliance with state regulations; documenting activities; conveying information regarding claims and/or benefits; and providing testimony in benefit disputes while exercising discretion, independent judgment, critical thinking skills and demonstrate exemplary customer services skills. Serve as the face of the company in providing frequent, proactive verbal communication with our claimants, customers and/or their representatives demonstrating empathy and active listening while providing clear updates, direction and explanations regarding the claim process, benefits, and other pertinent policy provisions.
Claims Counsel Capital Insurance GroupClaims CounselOrange County, CARemote$114,364–$190,607 / yearThis is a remote position, ideally with someone based in Orange County (Irvine, Costa Mesa, Newport Beach, Santa Ana, Anaheim, Orange, Huntington Beach, and Fullerton). Responsible 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.
Claims Specialist Lead The Progressive CorpClaims Specialist LeadIrvine, 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.
Claims Examiner - Workers Compensation (Hourly) eTeam Inc.Claims Examiner - Workers Compensation (Hourly)Brea, CARemote$45–$48.57 / 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. Analyzing and processing claims through well-developed action plans to an appropriate and timely resolution by investigating and gathering information to determine the exposure on the claim.
Senior Complex Claims Specialist EMC Insurance Group Inc.Senior Complex Claims SpecialistCA$103,954–$149,372 / yearServes as the subject matter expert on highly complex coverage issues impacting assigned claims, seeks assistance when needed or appropriate, issues coverage correspondence, and takes coverage into account when setting reserves and driving claims towards resolution. Reviews and communicates comprehensive evaluations of assigned claims presenting serious injuries (such as fatality, amputation, loss of sight, burns, paraplegia, quadriplegia, sex abuse, etc.), intellectual property claims, and claims with exposures of $750,000 or greater.
Claims Specialist, Workers Compensation - West Region Liberty Mutual Holding Company IncClaims Specialist, Workers Compensation - West RegionGlendale, CARemoteResponsibilities: Plans and conducts investigations of claims (including such activities as interviewing insureds, witnesses and claimants, collecting and evaluating appropriate documentation and securing evidence and protecting the chain-of-custody) to analyze and confirm coverage and to determine liability, compensability and damages. As a Workers Compensation Claims Specialist, you will work within a Claims Team, using the latest technology to review, analyze, and process claims that are routinely characterized as moderately complex to complex within assigned authority limits.
Claims Resolution Specialist - Covered California CalOptimaClaims Resolution Specialist - Covered CaliforniaOrange, CA$53,813–$80,720 / yearWe are hoping you will join us as a Claims Resolution Specialist - Covered California and help shape the future of healthcare where you'll be an integral part of our CLA - Claims Production 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.
NewSenior Claims Specialist I, Workers Compensation - West Region Liberty Mutual Holding Company IncSenior Claims Specialist I, Workers Compensation - West RegionGlendale, CARemoteResponsibilities: Plans and conducts investigations of claims (including such activities as interviewing insureds, witnesses and claimants, collecting and evaluating appropriate documentation and securing evidence and protecting the chain-of-custody) to analyze and confirm coverage and to determine liability, compensability and damages. Demonstrates an advanced knowledge of claims case handling practices, legal liability, general insurance policy coverage, and the state s tort laws as normally acquired through a bachelor s degree (or equivalent training) plus 3 to 5 years directly related work experience.
Claims Associate - Workers Compensation Apidel TechnologiesClaims Associate - Workers CompensationBrea, CARemoteContractorSkills & Knowledge Excellent oral and written communication skills PC literate, including Microsoft Office products Analytical and interpretive skills Strong organizational skills Good interpersonal skills Ability to work in a team environment Ability to meet or exceed Performance Competencies. 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.
Senior Claims Auditor - Managed Care Cedars-Sinai Medical CenterSenior Claims Auditor - Managed CareCalifornia, CAThe incumbent leads cross departmental audit initiatives, performs specialized system testing, and supports internal and external regulatory audits. Produces written and verbal reports summarizing audit findings for leadership, highlighting compliance risks and recommending mitigation strategies.
Lead - Claims Examiner Astrana Health IncLead - Claims ExaminerMonterey Park, CAManager - Claims and enable us to continue to scale in the healthcare industry. We are currently seeking a highly motivated Lead - Claims Examiner.
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.
EPIC Applications Analyst (1-4): Hospital Billing Admin and Hospital Billing Claims - IT Services - Full Time SolutionHealthEPIC Applications Analyst (1-4): Hospital Billing Admin and Hospital Billing Claims - IT Services - Full TimeCAEpic Application Analysts 2-4 require current Epic training status (certification, accreditation, and/or proficiency) in primary application required, with a combination of current Epic training statuses in additional area(s) in application maintenance and development required in upper levels. Ideal candidates will possess strong experience as analyst with expert knowledge and experience in leading system analysis with special emphasis on system methodologies, projects management and business process reengineering related to information systems required.
GLOVIS: Temp Analyst, Claims Revenue and Cost Integration Elevated ResourcesGLOVIS: Temp Analyst, Claims Revenue and Cost IntegrationIrvine, CaliforniaThis role will focus on collecting, organizing, validating, and analyzing claims-related data to help develop an AI solution that can review claim photos, inspection reports, repair estimates, and other documentation to identify damages, estimate severity, and assist with determining liability. Collect, organize, and maintain claim photos, inspection reports, repair estimates, invoices, incident reports, and supporting documentation.
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.
Quality Claims Administrator Assistant Bentley Mills IncQuality Claims Administrator AssistantCABentley Mills reserves the right to pay outside of the given range based on a variety of factors including but not limited to: candidate skills and experience, complexity of the job, budgetary factors, and local/geography. Skills: The Quality Claims Administrator Assistant uses strong organizational skills daily to manage multiple claims efficiently and ensure accurate documentation.
Claims Examiner Sr, Covered California CalOptimaClaims Examiner Sr, Covered CaliforniaOrange, CA$51,744–$72,441 / yearWe are hoping you will join us as a Claims Examiner Sr, 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. If you make it through the steps above and are selected for this exciting role, you will be required to undergo a reference and a background check (to include a conviction record) and if applicable also pass a drug screening and/or a post-offer pre-employment medical examination (for specific positions) If you are an Internal CalOptima Health applicant, please apply through the internal portal on InfoNet.