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 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.
NewClaim Specialist - Property Field Inspection State Farm Mutual Automobile Insurance CompanyClaim Specialist - Property Field InspectionSanta Monica, CA$64,965.62–$111,595 / yearAdditional Details: Employees must successfully complete all required training, including applicable licensing exam(s), Motor Vehicle Record (MVR) checks, and background checks required of various state(s). With 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!
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.
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.
NewWorkers 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.
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.
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.
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.
Senior Claims Examiner W. R. Berkley CorpSenior Claims ExaminerIrvine, CA$110,000–$125,000 / yearThis role actively supports and participates in the company's culture of continuous learning and innovation, including engagement in innovation groups focused on identifying opportunities for process improvement, enhancement, and transformational change. Key functions include but are not limited to: Adjust all aspects of complex claims and loss notices, including coverage and compensability analysis, reserve setting, reinsurance reporting, and coverage litigation.
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.
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 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.
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.
NewWorkers 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 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.
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.
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.
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.
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.
Claims Recovery Representative II SchoolsFirst Federal Credit UnionClaims Recovery Representative IITustin, CA$24.56–$35.62 / hourAt SchoolsFirst FCU we are dedicated to building and growing a diverse, inclusive, and authentic Dream Team, so if you're excited about a position or wanting to make a career change but your past experience doesn't align perfectly with every qualification in the job description, we encourage you to apply anyway. Responsible for assisting and completing basic debit and credit card investigations, including fraud, and/or reviewing basic cardholder claim reports in order to take appropriate action to mitigate loss to the organization.
Claims Client Service Executive Sales The Hartford Insurance Group IncClaims Client Service Executive SalesBrea, 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 Specialist II Mercury Insurance Services, LLCClaims Specialist IICalifornia$44,466–$77,881 / yearBodily Injury Claims Management : Analyze medical records to evaluate, negotiate, and settle moderate bodily injury claims with legal counsel for represented claimants and unrepresented parties. If you’re passionate about helping people restore their lives when the unexpected happens, and providing high-quality customer experiences, then our Mercury Insurance Claims team could be the place for you!
Claims Examiner - Workers Compensation eTeam Inc.Claims Examiner - Workers CompensationLong Beach, CA$45–$50 / 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.
NewClaims Counsel: Real Estate & Litigation Leader First GroupClaims Counsel: Real Estate & Litigation LeaderSanta Ana, CAFirst American in Santa Ana is seeking an Associate Claims Counsel responsible for managing a claims load and overseeing outside litigation counsel. The ideal candidate should possess a Law Degree and have at least 2 years of experience in litigation or claims handling.
Senior Claims Specialist Your Next CareerSenior Claims SpecialistSanta Fe Springs, CaliforniaEnsure the timely logging of all new claims (delegate to Claims Assistant if necessary) and timely reporting to our Insurance Carrier, with guidance by the Dir of Risk Management. Recognized as the 2026 “Top Hispanic Supermarket in the U.S.” by Abasto, we are committed to serving our customers, supporting our communities, and creating growth opportunities for our team members.
Claims (Billing) Specialist / Patient Account Representative - Healthcare Guidehouse IncClaims (Billing) Specialist / Patient Account Representative - HealthcareEl Segundo, CA$38,000–$64,000 / yearRepresentatives are responsible for maintaining knowledge, skills, and abilities that contribute to various accounting/administrative tasks involved in preparing billing data for agencies Guidehouse works with. 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.
NewClaims Casualty Adjuster AAAClaims Casualty AdjusterLong Beach, CaliforniaThe Claims Casualty Adjuster handles low to moderate-complexity claims involving material damage, property, and/or liability lines of insurance written by the Interinsurance Exchange in compliance with all regulatory and statutory requirements. With 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.
NewClaims Service Representative - Total Salvage AAAClaims Service Representative - Total SalvageCarson, CaliforniaThis entry level position supports the Auto Claims Operation by providing service pursuant to the policy by handling claims of material damage, property and/or liability lines of insurance written by the Interinsurance Exchange in compliance with all regulatory and statutory requirements. With 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.
NewClaims Auto Adjuster AAAClaims Auto AdjusterCosta Mesa, CaliforniaThis entry-level position supports the Auto Claims Operation by providing service pursuant to the policy by handling claims of material damage, property damage, and/or liability lines of insurance written by the Interinsurance Exchange in compliance with all regulatory and statutory requirements. With 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.
Senior Claims Examiner BerkleySenior Claims ExaminerIrvine, California$110,000–$125,000 / yearThis role actively supports and participates in the company’s culture of continuous learning and innovation, including engagement in innovation groups focused on identifying opportunities for process improvement, enhancement, and transformational change. Key functions include but are not limited to: Adjust all aspects of complex claims and loss notices, including coverage and compensability analysis, reserve setting, reinsurance reporting, and coverage litigation.
Claims Director(WC & TPA Oversight) CNA Financial CorpClaims Director(WC & TPA Oversight)Brea, CA$97,000–$189,000 / yearJOB DESCRIPTION: Essential Duties & Responsibilities: Performs a combination of duties in accordance with departmental guidelines: Leads the work activities of claims professionals and/or claims managers and has full management responsibility for setting and communicating expectations, providing direction and coaching, facilitating ongoing training and development, managing employee performance and contributing to employee engagement. This director-level role operates under general direction with broad authority to lead the oversight of complex, high-exposure commercial Workers' Compensation claims managed by Third-Party Administrators (TPAs), while also managing and developing a team of claim professionals.
Risk and Claims Specialist SA Recycling LLCRisk and Claims SpecialistOrange, CA$30–$34 / hourThe essential and critical functions include answering calls, initial processing of new claims, maintaining accurate digital files, managing high-volume correspondence and acts as a primary point of contact for injured workers. The ideal candidate is detail-oriented, highly organized, maintains a professional and caring demeanor, listens well, provides excellent customer service and manages sensitive medical and financial data with strict confidentiality.
Field Claims Specialist, Remote - Southern CA Workers'''' Compensation Great American Insurance CompanyField Claims Specialist, Remote - Southern CA Workers'''' CompensationCARemote$115,000–$125,000 / yearWe take an extremely aggressive and pro-active approach in claims adjusting and are looking for the person who not only knows their territory's comp laws but also enjoys the role of putting that experience to good use. Based in Cincinnati, Ohio, the operations of Great American Insurance Group are engaged primarily in property and casualty insurance focusing on specialty commercial products for businesses.
Senior Claims Specialist - CA Workers'''' Compensation Great American Insurance CompanySenior Claims Specialist - CA Workers'''' CompensationCA$110,000–$120,000 / yearAlthough we typically require 10+ years of experience, we will consider exceptional candidates with 7+ years of proven success in California workers' compensation claims adjusting experience with higher exposure claims. We take an extremely aggressive and proactive approach to claims adjusting and are looking for the person who not only knows their territory's comp laws but also enjoys the role of putting that experience to good use.
Field Claims Specialist - CA Workers'''' Compensation Great American Insurance CompanyField Claims Specialist - CA Workers'''' CompensationCA$115,000–$125,000 / yearWe take an extremely aggressive and pro-active approach in claims adjusting and are looking for the person who not only knows their territorys comp laws but also enjoys the role of putting that experience to good use. Based in Cincinnati, Ohio, the operations of Great American Insurance Group are engaged primarily in property and casualty insurance focusing on specialty commercial products for businesses.
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.
Claims Examiner - Workers Compensation (Hourly) ICONMA, LLCClaims 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.
Sr. Manager, EPL Claims - Financial Lines Starr International Co IncSr. Manager, EPL Claims - Financial LinesCAThe successful candidate will be required to evaluate coverage, draft coverage correspondence, assess appropriate reserves, undertake claims investigations, manage defense counsel and legal spend, assess liability and financial exposure, and effectively negotiate cost effective, good faith claims resolution. 10+ years of experience in the insurance/legal profession dealing specifically with Financial and/or Professional Lines claims In-depth understanding of policy language/coverage Experience managing, evaluating, mediating and negotiating EPL claims.
NewComplex Claims Consulting Director - EPL, Private & NFP D&O CNA Financial CorpComplex Claims Consulting Director - EPL, Private & NFP D&OBrea, CA$97,000–$189,000 / yearJOB DESCRIPTION: Essential Duties & Responsibilities: Performs a combination of duties in accordance with departmental guidelines: Manages an inventory of the most complex EPL and Private and Not-For-Profit D&O, which are generally multi-year and have very significant loss exposure, by following company protocols to manage and oversee all aspects of the claim handling, including coverage determinations, investigations, and resolution strategies which may include extensive negotiations and complex litigation management. Drives the resolution of 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, negotiating complex settlements, partnering with counsel to manage complex litigation and authorizing settlements within scope of authority.