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.
Associate Bond Claims Examiner Tokio Marine HCCAssociate Bond Claims ExaminerLos Angeles, CaliforniaTokio Marine HCC – Surety Group, a member of the Tokio Marine Group of Companies, has an exciting opportunity for an Associate Claims Examiner position on-site at our office in Los Angeles, California. We are looking for motivated individuals to join our team of highly skilled claims examiners who are part of a successful division that specializes in surety bond business.
Claims Representative (Iap) - Workers Compensation Training Program (On-Site Orange, CA) Sedgwick Claims Management Services, Inc.Claims Representative (Iap) - Workers Compensation Training Program (On-Site Orange, CA)Orange, CAMental: 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. Adjusting various levels of workers' compensation claims under close supervision, which includes: Processing and responding to incoming mail, emails and other claim related documents according to status of the claim.
Claims Loss Reporting Specialist AAAClaims Loss Reporting SpecialistCosta Mesa, CaliforniaThe position receives and documents first notice of loss, takes overflow calls, and answers low complexity claims related questions for the Claims department while delivering a totally satisfying member experience through exceptional customer service. 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 Quality Control Coordinator (Hybrid in CA) First AmericanClaims Quality Control Coordinator (Hybrid in CA)Santa Ana, CaliforniaFirst American reasonably believes that a criminal history may have a direct, adverse and negative relationship with the following material job duties for this position potentially resulting in the withdrawal of the conditional offer of employment: handling of confidential, proprietary or trade secret information belonging to First American or its customers, administrating or facilitating financial transactions, and the ability to meet customer-imposed criminal history requirements. Responsible for receiving, reviewing, and processing potential claims documentation while serving as a key point of contact for customers contacting the National Intake Center (NIC).
Healthcare Claims Examiner Ultimate Staffing ServicesHealthcare Claims ExaminerEl Monte, California$25–$28 / hourResearch and resolve claim discrepancies, including making payment corrections, recovering overpayments, and reprocessing claims as needed. Evaluate claims for potential fraud, waste, abuse, Workers' Compensation, hospital-acquired conditions, and third-party liability; escalate issues appropriately.
Medical Malpractice Claims Specialist KI Executive GroupMedical Malpractice Claims SpecialistOrange, CaliforniaThe Medical Malpractice Claims Specialist is responsible for managing assigned medical malpractice claim files, including complex and high exposure matters. This role oversees claim investigation, litigation coordination, reporting, and documentation while working closely with defense counsel and internal stakeholders.
Marine Claims Analyst MCD Tokio Marine GroupMarine Claims Analyst MCDLos Angeles, CaliforniaTM Claims Service (TMCS) is an independent global claims management firm established in 1987 to provide clients with a broad range of claims related services in the areas of transportation, product liability and overseas travel accident insurance. In order to remain competitive we must attract, develop, motivate, and retain the most qualified employees regardless of age, color, race, religion, gender, disability, national or ethnic origin, family circumstances, life experiences, marital status, military status, sexual orientation and/or any other status protected by law.
Supervisor, Medicare Claims Clever Care Health PlanSupervisor, Medicare ClaimsHuntington Beach, CA5% - Facilitates and creates a team environment within the unit and with other departments; runs regular unit meetings, attends monthly claims review meetings and/or Clever Care meetings, as appropriate, in order to ensure effective communication between team members and disciplines. Participates in interviewing and hiring of new staff and facilitates or conducts effective onboarding and orientation for new employees; coordinates with the Manager for development of formal training programs; assigns staff to special projects and oversees workflow and workload of staff.
Senior Construction Defect Technical Claims Specialist BP&CSenior Construction Defect Technical Claims SpecialistLos Angeles, CaliforniaRemote$151,062–$181,254 / yearBoston metro area, California outside of Los Angeles & San Francisco metro area, Connecticut, Chicago metro area, Denver metro area, New Jersey (outside of New York City metro area), New York State (outside of New York City metro area, including but limited to Albany county), Washington, D. C. Working under limited oversight under broad management direction, adjudicate construction defect claims at the highest authority limits on assignments reflecting the highest degree of technical complexity, potentially with major impact on departmental results.
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.
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 Examiner - Workers Compensation -| Brea, CA Sedgwick Claims Management Services, Inc.Claims Examiner - Workers Compensation -| Brea, CABrea, CA$80,000–$100,000 / yearPRIMARY PURPOSE OF THE ROLE To analyze complex or technically difficult California 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. 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 Specialist Crum & ForsterSenior Claims SpecialistORANGE, CaliforniaRemoteWith our employee-first focus, the Company is consistently recognized as a great place to work, earning multiple workplace and wellness awards, including the Great Place to Work® Award, Fortune 100 Best Companies to Work For, Fortune Best Workplaces for Parents, Fortune Best Workplaces for Millennials, and many others. Salary ranges are available for all positions at this location, taking into account roles with a comparable level of responsibility and impact in the relevant labor market and these salary ranges are regularly reviewed and adjusted in accordance with prevailing market conditions.
NewSenior Claims Examiner (50714) Western Growers AssociationSenior Claims Examiner (50714)Irvine, CAAssist leadership team improve turnaround times, processes, or staff training identifying errors through data analysis and auditing, and working with various teams to ensure those errors are corrected in both the short and long term. Examine claim files for accuracy and make necessary adjustments and corrections: verifications (i.e. eligibility, medical authorization, etc.); reach out to Health Care Providers to obtain necessary claims documentation, perform complete file reviews when appropriate.
Senior Claims Examiner, Workers' Compensation GallagherSenior Claims Examiner, Workers' CompensationAnaheim, CaliforniaRemoteFull timeBehaviors: Ability to think critically, solve problems, plan and organize activities, serve clients, negotiate, effectively communicate verbally and in writing and embrace new challenges. Introduction : At Gallagher, we help clients face risk with confidence because we believe that when businesses are protected, they’re free to grow, lead, and innovate.
Claims Supervisor, Workers' Compensation GallagherClaims Supervisor, Workers' CompensationCorona, CaliforniaRemoteFull timeEnsures flawless and consistent execution of client service instructions and performance guarantees Ability to actively review work of others via file reviews; identify coaching opportunities, act on needed coaching opportunities and position subordinates for successful development leading to advancement within the organization. We are seeking an experienced Claims Supervisor to provide leadership, technical oversight, and operational guidance within our Workers’ Compensation claims department.
Workers Compensation - Claims Examiner | Hybrid | Riverside, CA Sedgwick Claims Management Services, Inc.Workers Compensation - Claims Examiner | Hybrid | Riverside, CARiverside, CA$80,000–$100,000 / 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 OF THE ROLE: To analyze workers' compensation claims on behalf of our valued clients to determine benefits due, while ensuring ongoing adjudication of claims within service expectations, industry best practices, and specific client service requirements.
Workers Compensation Claims Examiner | Brea, CA | Sign-On Bonus Eligible Sedgwick Claims Management Services, Inc.Workers Compensation Claims Examiner | Brea, CA | Sign-On Bonus EligibleBrea, CARemote$85,000–$105,000 / yearPRIMARY 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. 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.
Workers Compensation Claims Team Lead | Hybrid |Brea, CA Sedgwick Claims Management Services, Inc.Workers Compensation Claims Team Lead | Hybrid |Brea, CABrea, CAMental: 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. Sedgwick is building a diverse, equitable, and inclusive workplace and recognizes that each person possesses a unique combination of skills, knowledge, and experience.