NewWorkers Compensation TPA Oversight Claims Consultant CNA Financial CorpWorkers Compensation TPA Oversight Claims ConsultantBrea, CA$72,000–$141,000 / yearThis individual contributor position works under general direction, and within broad authority limits, to provide technical oversight of complex, high-exposure commercial Workers' Compensation claims handled by Third-Party Administrators (TPAs). Success in this role requires the ability to lead through influence by setting expectations, partnering effectively with TPAs, clients, and internal stakeholders, and driving accountability for quality, compliance, and performance through consultative engagement and clear communication.
Claims Auditor MedPOINT ManagementClaims AuditorSherman Oaks, CARemoteFull timeMedPOINT Management is a leading Independent Practice Association (IPA) management company serving the greater Los Angeles area, dedicated to delivering high-quality, coordinated healthcare to patients across Southern California. Our team enjoys a collaborative work culture, opportunities for professional growth, and the satisfaction of making a meaningful impact in the healthcare industry.
Claims Examiner MedPOINT ManagementClaims ExaminerSherman Oaks, CARemoteFull timeMedPOINT Management is a leading Independent Physician Association (IPA) management company based in Sherman Oaks, CA, dedicated to delivering high-quality healthcare administrative services. We foster a collaborative and supportive work environment where employees are empowered to grow and make a meaningful impact in the healthcare industry.
NewWorkers'''' Compensation Claims Specialist - Republic Indemnity Great American Insurance CompanyWorkers'''' Compensation Claims Specialist - Republic IndemnityWoodland Hills, CA$91,080–$122,820 / yearScope of Job: Works within broad limits on highly complex assignments requiring specialized knowledge in breadth and/or depth within area of expertise. For over 50 years, Republic Indemnity has been a trusted partner for businesses across the western U.S., helping them effectively manage their workers' compensation costs.
Claims Delegations Oversight Specialist MedPOINT ManagementClaims Delegations Oversight SpecialistSherman Oaks, CARemoteFull timeMedPOINT Management is a leading Independent Practice Association (IPA) management company serving the greater Los Angeles area, with decades of experience supporting physician organizations and health plan partnerships. Our clients trust us for our deep expertise in managed care operations, and our employees value the collaborative, mission-driven culture we've built.
Workers Compensation Claims Handler IV Zurich Insurance Group LtdWorkers Compensation Claims Handler IVCARemoteTo handle Workers' Compensation claims of moderate to high exposure and complexity within specific authority limits, to ensure that claims are handled in the most efficient, effective way while delivering a customer-centric claims service. Ability to determine the scope and exposure for moderate to complex claimsAbility to leverage knowledge of industry trends and relationships to provide high-quality customer service.
Claims Assistant Iconma LLCClaims AssistantLos Angeles, CAProficient computer skills and extensive knowledge of the Microsoft suite of Office products, including Outlook (use templates that are provided), Word (utilizing templates), Excel (data entry), and PowerPoint (basic creation of slide deck); knowledge of state EDI systems and/or familiarity with CA Workers Compensation terminology are a plus. Responsibilities: This worker will be assisting Lost Time Examiners with benefit notices, settlement documents, requesting records, and indemnity payments.
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.
Commercial Claims Insurance Analyst - Remote CSAA Insurance GroupCommercial Claims Insurance Analyst - RemoteCARemote$99,855–$110,950 / yearAlabama - Home Teleworkers, Alabama - Home Teleworkers, Arizona - Home Teleworkers, Arkansas - Home Teleworkers, Colorado - Home Teleworkers, Connecticut - Home Teleworkers, Delaware - Home Teleworker, District of Columbia - Home Teleworkers, Florida - Home Teleworkers, Georgia - Home Teleworkers, Idaho - Home Teleworkers, Illinois - Home Teleworkers, Indiana - Home Teleworkers, Iowa - Home Teleworkers, Kansas - Home Teleworker, Kentucky - Home Teleworkers, Louisiana - Home Teleworkers, Maine Home Teleworkers, Maryland - Home Teleworkers, Massachusetts - Home Teleworkers, Michigan - Home Teleworkers, Minnesota - Home Teleworkers, Mississippi - Home Teleworker, Missouri - Home Teleworker, Montana - Home Teleworkers {+ 15 more}. Your Work: Performs complex data analysis for assigned client groups, evaluating findings in relation to broader business objectives Collaborates with cross-functional partners outside of IPM/IPO to gather insights, validate findings, and gain alignment on recommended actions.
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.
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.
Claims Clinical Specialist Genworth Financial IncClaims Clinical SpecialistCAYou will be responsible for communicating with medical personnel at Long Term Care Facilities, Home Care Agencies, and/or individuals by conducting telephonic assessments for claimants to develop the plan of care and provide tax qualified certifications as required by the policy. At least two years' experience working in a role that required an understanding of single and cumulative medical conditions (particularly those common in the aging process), including their effect on physical/cognitive function, as well as their prognosis and rehabilitative potential.
Sr. Claims Counsel Sompo InternationalSr. Claims CounselLos Angeles, CA$125,000–$175,000 / yearOur business, your impact, our opportunity: What you'll be doing: Direct handle primary & excess Casualty claims involving emerging risks, potential long-term exposure, or significant coverage issues. Below is a summary of our current comprehensive U.S. benefit programs: Two medical plans to choose from, including a Traditional PPO & a Consumer Driven Health Plan with a Health Savings account providing a competitive employer contribution.
Sr. Claims Counsel Sompo International Holdings LimitedSr. Claims CounselLos Angeles, CA$125,000–$175,000 / yearOur business, your impact, our opportunity: What you'll be doing: Direct handle primary & excess Casualty claims involving emerging risks, potential long-term exposure, or significant coverage issues. Below is a summary of our current comprehensive U.S. benefit programs: Two medical plans to choose from, including a Traditional PPO & a Consumer Driven Health Plan with a Health Savings account providing a competitive employer contribution.
Senior Claims Manager EPL - Remote Providence Health & ServicesSenior Claims Manager EPL - RemoteCalifornia, CARemoteRequsition ID: 455795 Company: Providence Jobs Job Category: Financial Transactions Job Function: Health Plans Services Job Schedule: Full time Job Shift: Day Career Track: Business Professional Department: 4008 SS RIS Address: CA Orange 1100 W Stewart Dr Work Location: St Joseph Hospital-Orange Workplace Type: Remote Pay Range: $See Posting - $See Posting The amounts listed are the base pay range; additional compensation may be available for this role, such as shift differentials, standby/on-call, overtime, premiums, extra shift incentives, or bonus opportunities. Providence Shared Services is a service line within Providence that provides a variety of functional and system support services for our family of organizations across Alaska, California, Montana, New Mexico, Oregon, Texas and Washington.
Senior Claims Manager EPL - Remote Providence St. Joseph HealthSenior Claims Manager EPL - RemoteLos Angeles, CARemoteTogether, our 120,000 caregivers (all employees) serve in over 50 hospitals, over 1,000 clinics and a full range of health and social services across Alaska, California, Montana, New Mexico, Oregon, Texas and Washington. Candidate must possess strong communication and litigation management skills to collaborate with business partners and defense counsel to direct litigation activities and claim outcomes while considering the overall impact to the company and individual stakeholders.
Claims Examiner CalOptimaClaims ExaminerOrange, CA$47,840–$64,584 / yearAnalyzes and validates Medi-Cal pricing; researches, adjusts and adjudicates claims; reviews services for accurate charges and utilizes current billing code sets, including International Classification Diseases (ICD10) codes, Current Procedural Terminology (CPT) codes and/or authorization guidelines as reference. We are hoping you will join us as a Claims Examiner 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.
Claims Counsel Capital Insurance GroupClaims CounselLos Angeles, CARemote$114,364–$190,607 / yearResponsible 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. Under general supervision, this position will be part of the Claims Legal team, which will provide settlement authority and general strategic support for claims/exposures that exceed the line unit’s authority.
ESIS Claims Associate Chubb LtdESIS Claims AssociateChatsworth, CA$47,500–$67,500 / yearThe company is distinguished by its extensive product and service offerings, broad distribution capabilities, exceptional financial strength, underwriting excellence, superior claims handling expertise and local operations globally. With operations in 54 countries, Chubb provides commercial and personal property and casualty insurance, personal accident and supplemental health insurance, reinsurance, and life insurance to a diverse group of clients.
Complex Claims Consultant - Private & NFP D&O CNA Financial CorpComplex Claims Consultant - Private & NFP D&OLos Angeles, CA$72,000–$141,000 / yearPerforms a combination of duties in accordance with departmental guidelines: Manages an inventory of highly complex Financial Lines claims, with large exposures that require a high degree of specialized technical expertise and coordination, by following company protocols to verify policy coverage, conduct investigations, develop and employ resolution strategies, and authorize disbursements within authority limits. Resolves 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, collaborating with coverage experts, negotiating complex settlements, partnering with counsel to manage complex litigation and authorizing payments within scope of authority.