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 - Claims Astrana Health, Inc.Sr. Manager - ClaimsMonterey Park, CaliforniaRemote$125,000–$140,000 / yearYou’ll partner closely with internal teams, resolve escalations, and coach a team of claims professionals to deliver compliant, efficient, and accurate outcomes in a fast‑paced environment. Minimum of a Bachelor's degree (B.A.) from a four-year college or university; or at least four (4) years current Management or equivalent experience with an MSO or IPA Management.
NewSupervising Veterans Claims Representative County of OrangeSupervising Veterans Claims RepresentativeOrange County, CA$70,220.80–$94,660.80 / yearThe ideal candidate will possess a minimum of two (2) years of work experience assisting the public in determining their eligibility and completing and submitting claim requests for public benefits programs (e.g., veterans' benefits, medical insurance benefits, unemployment benefits, disability benefits, and/or Social Security benefits, AND two (2) years of experience training, mentoring, leading or supervising staff. Assisting the Veterans Service Officer in the implementation and coordination of newly approved programs, participating in the planning and development of new veterans assistance programs and special projects in order to improve services to veterans.
Sr. Manager - Claims Delegation Audit Astrana Health, Inc.Sr. Manager - Claims Delegation AuditMonterey Park, California$125,000–$140,000 / yearThe 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. External Audit planning, execution & support Own the end‑to‑end strategy and execution of all external audits (e.g., CMS, DMHC, health plan audits), ensuring readiness, successful delivery, and continuous score improvement.
Claims Examiner 2-Managed Care Loma Linda University Medical CenterClaims Examiner 2-Managed CareRedlands, CAAble to think critically; manage multiple assignments effectively; organize and prioritize workload; work well under pressure; problem solve; recall information with accuracy; pay close attention to detail; work independently with minimal supervision. Able to distinguish colors as necessary; hear sufficiently for general conversation in person and on the telephone, and identify and distinguish various sounds associated with the workplace; see adequately to read computer screens, and written documents necessary to the position.
Pharmacy Claims Technician - Pharmacy Admin - FT Day Shift University of California, IrvinePharmacy Claims Technician - Pharmacy Admin - FT Day ShiftOrange, CaliforniaFull timeAs Orange County’s only academic health systems, UCI Health is home to the only National Cancer Institute-designated comprehensive cancer center based in the county, the region’s only American College of Surgeons-verified Level I adult and Level II pediatric trauma center , American College of Emergency Physicians Gold Level 1 Geriatric Emergency Department and a nationally recognized regional burn center verified by the American Burn Association. *Misconduct Disclosure Requirement: As a condition of employment, the final candidate who accepts a conditional offer of employment will be required to disclose if they have been subject to any final administrative or judicial decisions within the last seven years determining that they committed any misconduct; received notice of any allegations or are currently the subject of any administrative or disciplinary proceedings involving misconduct; have left a position after receiving notice of allegations or while under investigation in an administrative or disciplinary proceeding involving misconduct; or have filed an appeal of a finding of misconduct with a previous employer.
Senior Claim Examiner I AmTrust Financial Services, Inc.Senior Claim Examiner IIrvine, California$49–$54 / hourFull timeSalaries are based upon a wide range of factors considered in making the compensation decision, including, but not limited to, candidate skills, experience, education and training, the scope and responsibilities of the role, as well as market and business considerations . Your ability to effectively interact with insureds, claimants, and their legal representatives will be essential in driving timely settlements while adhering to AmTrust’s mission, vision, and values.
Senior Claims Auditor (External Audit) Astrana Health, Inc.Senior Claims Auditor (External Audit)Monterey Park, CaliforniaRemote$70,308–$80,000 / yearKnowledge of medical terminology combined with detail knowledge and experience with CPT, HCPCS, DRG, REV, OPS, ASC, ICD10, CRVS, RBRVS, CMS, ICE for Health Plan, DMHC and DHS fee schedules and CMS Medicare regulatory agencies, COB and Third-Party Liability recovery. Detail knowledge and understanding of Industry pricing methodologies, such as Resources-Based Relative Value Scale (RBRVS), Medicare/Medi-Cal fee schedule, All Patient Refined Diagnosis Related Groups (AP-DRG), Ambulatory Payment Classifications (APC), etc.
NewSr Claim Examiner- WC Paladin Consulting, Inc.Sr Claim Examiner- WCBrea, CARemote$37.27 / hourEstablish reserves, using independent judgment and expertise and authorizes payments within scope of authority, settling claims in the most cost effective manner and ensuring timely issuance of disbursements. Duties: Interprets and makes decisions using independent judgment on more complex and unusual policy coverages and determines if coverages apply to claims submitted.
Claim Assistant - Workers Compensation (On-Site Ontario, CA) Sedgwick Claims Management Services, Inc.Claim Assistant - Workers Compensation (On-Site Ontario, CA)Ontario, CA$18–$20 / hourMental: Clear and conceptual thinking ability; excellent judgment 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.
Auto Liability Claim Rep TravelersAuto Liability Claim RepDiamond Bar, CaliforniaOne-year bodily injury liability claim handling experience or comparable liability claim handling experience, or successful completion of Travelers Claim Representative training program is required. In this detail-oriented and customer focused role, you will work closely with insureds to ensure claims are resolved efficiently while maintaining a high level of professionalism, empathy, and service throughout the claims handling process What Will You Do? .
Sr Claim Examiner-WC (CA) Crawford & CoSr Claim Examiner-WC (CA)Brea, CARemoteTo 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. Work within established authority on moderate-to-difficult claims, reviewing coverages, determining liability/compensability, collecting statements and essential information, and settling claims using best practices.
Property Outside Claim Representative TravelersProperty Outside Claim RepresentativeDiamond Bar, CaliforniaDetermines appropriate settlement amount based on independent judgment, computer assisted building and/or contents estimate, estimation of actual cash value and replacement value, contractor estimate validation, appraisals, application of applicable limits and deductibles and work product of Independent Adjusters. Investigates and evaluates all relevant facts to determine coverage, damages and liability of first-party property damage claims (including but not limited to analyzing leases, contracts, by-laws and other relevant documents which may have an impact), damages, business interruption calculations and liability of first-party property claims under a variety of policies.
Senior Workers Compensation Claim Representative TravelersSenior Workers Compensation Claim RepresentativeDiamond Bar, CaliforniaEducation/Course of Study: Work Experience: Analytical Thinking: Identifies current or future problems or opportunities; analyzes, synthesizes and compares information to understand issues; identifies cause/effect relationships; and explores alternative solutions that support sound decision-making. Independently handles assigned claims of low to moderate complexity where Wage loss and the expectation is a return to work to modified or full duty or obtain MMI with no RTW.
General Liability Inside Claim Representative TravelersGeneral Liability Inside Claim RepresentativeDiamond Bar, CaliforniaInvestigates each claim through prompt contact with appropriate parties such as policyholders, accounts, claimants, law enforcement agencies, witnesses, agents, medical providers and technical experts to determine the extent of liability, damages, and contribution potential. The actual salary for this position will be determined by a number of factors, including the scope, complexity and location of the role; the skills, education, training, credentials and experience of the candidate; and other conditions of employment.
NewPersonal Insurance Associate General Adjuster / General Adjuster - CA/AZ The HartfordPersonal Insurance Associate General Adjuster / General Adjuster - CA/AZBrea, ArizonaThe successful Associate General Adjuster candidate will plan, recommend, reserve and execute the investigation, valuation, disposition and settlement of large personal insurance property claims in a manner consistent with corporate claim settlement policies and procedures and statutory, regulatory and ethics requirements throughout the United States as appropriate. The successful General Adjuster candidate will plan, recommend, reserve and execute the investigation, valuation, disposition and settlement of large Personal Insurance property claims in a manner consistent with corporate claim settlement policies and procedures and statutory, regulatory and ethics requirements throughout the United States as appropriate.
Chief Trial Attorney Zurich Insurance Group LtdChief Trial AttorneyIrvine, CADesigned with our employees needs in mind, the ZNA Claims hybrid work model emphasizes flexibility, allowing claims employees to conduct individual work in their preferred location including the ability to work from a home office, while facilitating in-person connections and collaborative activities when meaningful and valuable. With minimal direction, The Chief Trial General Liability Attorney will represent the Companys insureds in all phases of litigation for matters of the highest technical complexity and engage in the practice of and the representation of Zurich insureds in litigation to protect their interests.
NewMedical Biller - Multi Specialty Provider Little Scholars ServicesMedical Biller - Multi Specialty ProviderMission Viejo, CAPart timeAs a Medical Biller, you will be working closely with clients to answer questions related to billing, processing all forms needed for insurance billing purposes, and collecting necessary documentation from clients. You will also assist other Medical Billers with follow-up inquiries to clients, communicate with physicians' offices and hospitals to obtain records, and accurately record patient information.
Medical Biller- Full - Time - On -Site Raincross Medical Group, Inc.Medical Biller- Full - Time - On -SiteRiverside, CAPrepare, review, and submit clean and accurate medical claims to commercial insurance companies, Medicare, Medicaid/Medi-Cal, and other payers. If you have strong medical billing experience, understand insurance follow-up and denials, and enjoy being part of a collaborative healthcare team, we would love to hear from you.
Experienced Auto Body Shop Estimator Smart Prep Automotive Reconditioning, IncExperienced Auto Body Shop EstimatorRiverside, CAFull timeCommunicate with body shop personnel to ensure that estimates are understood and that all repairs are known and carried out by all team members. Inspect vehicle after repairs are completed to ensure that all repairs have been done, that vehicle is safety compliant, and that no further supplements are needed.