Inside Sales - Claims (Mandarin Required) ASUSTeK ComputerInside Sales - Claims (Mandarin Required)Fremont, CA$70,304–$71,400 / yearIn this role, you will partner closely with Sales, Product Management, Finance, and external customers to verify promotional documentation, resolve pricing and invoice discrepancies, coordinate claim resolution, and support the successful execution of channel programs. Essential Duties and Responsibilities: Serve as the primary liaison between ASUS Asia headquarters and North American Sales, Product Management, Finance, Accounts Receivable, and customers, ensuring timely communication and resolution of operational issues.
Vice President- P&C Claims Edgewood Partners Insurance CenterVice President- P&C ClaimsSan Francisco, CA$175,000–$200,000 / yearFueled and driven by capable, committed people who share common beliefs and values and "bring it" every day, EPIC is always looking for people who have "the right stuff" - people who know what they want and aren't afraid to make it happen. Managed PTO for salaried/exempt employees (personal time off without accruals or caps); 22 PTO days starting out for hourly/non-exempt employees; 12 company-observed paid holidays; 4 early-close days.
Pharmacy Technician – Prescription Routing & Claims Support PHILPharmacy Technician – Prescription Routing & Claims SupportSan Francisco, CaliforniaRemoteUtilize reroute best practices for orders falling outside normal workflow, including orders with state changes, insurance exceptions, pharmacy rejections, or failed transfers. Company Overview: Founded in 2015, Phil is a San Francisco-based, Series D health-tech startup that is revolutionizing prescription access by streamlining how doctors, pharmacies, and patients interact.
Claims Supervisor, Complex General Liability GallagherClaims Supervisor, Complex General LiabilityOakland, CaliforniaRemoteFull timeAbility 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. As part of Gallagher, a global leader in insurance, risk management, and consulting, you’ll be joining a team that’s passionate about helping individuals and organizations thrive.
Senior Claims Examiner, Workers' Compensation GallagherSenior Claims Examiner, Workers' CompensationPleasanton, CaliforniaRemote$75,000–$105,000 / yearFull timeThe actual compensation will be influenced by a wide range of factors including, but not limited to previous experience, education, pay market/geography, complexity or scope, specialized skill set, lines of business/practice area, supply/demand, and scheduled hours. Behaviors: Ability to think critically, solve problems, plan and organize activities, serve clients, negotiate, effectively communicate verbally and in writing and embrace new challenges.
Senior Claims Examiner GallagherSenior Claims ExaminerPleasanton, 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 Examiner GallagherClaims ExaminerOakland, 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. As part of Gallagher, a global leader in insurance, risk management, and consulting, you’ll be joining a team that’s passionate about helping individuals and organizations thrive.
Electronic Data Interchange (EDI) Claims Assistant UCSF Medical CenterElectronic Data Interchange (EDI) Claims AssistantEmeryville, CAThe Electronic Data Interchange (EDI) Claims Assistant will work in the EDI unit and will be responsible for all aspects of EDI production for UCSF Health Patient Financial Services (PFS), Medical Group Business Services (MGBS), UCSF Benioff Children's Hospital Oakland (BCH Oakland), By the Bay Health, UCSF Physicians Group, Community Connect clinic, and Community Hospitals. The EDI production supports all electronic claim production to various payers and clearinghouses, including Medicare, Medi-Cal, Medi-Cal MC, Anthem Blue Cross, Blue Shield, Availity, Optum IEDI, Optum Exchange, Jopari, PNT, and Office Ally.
Claims Resolution Coordinator Partnership HealthPlan of CaliforniaClaims Resolution CoordinatorFairfield, California$37.22–$46.53 / hourFull timeThe job duties, elements, responsibilities, skills, functions, experience, educational factors and the requirements and conditions listed in this job description are representative only and not exhaustive or definitive of the tasks that an employee may be required to perform. Acts as a resource and provides support to customer service staff, as well as Provider Relations staff for complex Provider questions regarding claims and payments.
Claims Specialist Lead The Progressive CorpClaims Specialist LeadConcord, 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.
Complex Claims Consultant - Epl, Private & NFP D&O CNA Financial Corp.Complex Claims Consultant - Epl, Private & NFP D&OWalnut Creek, 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.
Complex Claims Consultant - Private & NFP D&O CNA Financial CorpComplex Claims Consultant - Private & NFP D&OWalnut Creek, 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.
Workers Compensation Large Loss Claims Director CNA Financial Corp.Workers Compensation Large Loss Claims DirectorWalnut Creek, CA$97,000–$189,000 / yearWorking closely with claims leadership, disposition consultants, legal services, customers, brokers, and business partners, the Large Loss Director drives superior claim outcomes, technical excellence, operational effectiveness, and profitable growth while serving as a mentor and resource to claims professionals across the organization. This individual contributor role provides company-wide influence and leadership in the interpretation of complex policy coverages, litigation management, reserving, claim resolution strategies, regulatory compliance, and large loss methodologies.
Group Product Manager, Core TPA Claims Collective HealthGroup Product Manager, Core TPA ClaimsSan Francisco, CA | LehiSan Francisco, CA Pay Range $172,500 — $215,625 USD Lehi, UT Pay Range $138,000 — $172,500 USD Plano, TX Pay Range $151,800 — $189,750 USD Why Join Us?. Cross-Functional Influence: Enable deep connections between engineering, UX, sales, marketing, operations, and client success to ensure buy-in for complex initiatives and to surface critical market insights.
Claims Appraiser - Auto Estimatics State FarmClaims Appraiser - Auto EstimaticsSan Mateo, California$78,862.06–$102,500 / yearFull timeWith 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! Additional Details: Employees must successfully complete all required training, including applicable proficiency, licensing exam(s), Motor Vehicle Record (MVR) checks, and background checks required of various state(s).
Claims Process Specialist LancesoftClaims Process SpecialistOakland, CARemote$18Job duties include: Examine garnishments, levies, liens and information subpoenas to ensure accuracy, completeness and legal sufficiency. Claims include garnishments, levies, liens and information subpoenas received from creditors and taxing authorities.
Claims Examiner II North East Medical ServiceClaims Examiner IIBurlingame, CAESSENTIAL JOB FUNCTIONS: Perform the daily examination, auditing and adjudication activities to submitted hospital and professional claims based on established utilization criteria, Medi-Cal and/or Medicare guidelines, member's Evidence of Benefit, and policies and procedures outlined in the MSO Claims Manual. Responsible to prepare files and documents for the annual health plan delegation oversight audits, assist Claims Supervisor with MSO management reports, and other special projects as needed.
Claims Examiner I MSO North East Medical ServiceClaims Examiner I MSOBurlingame, CAESSENTIAL JOB FUNCTIONS: Perform the daily examination, auditing and adjudication activities to submitted professional claims based on established utilization criteria, Medi-Cal and/or Medicare guidelines, member's Evidence of Benefit, and policies and procedures outlined in the MSO Claims Manual. Identify claims payment errors and/or system configuration flaws during day-to-day operation, report to department manager/supervisor and MSO System Configuration team to correct/resolve them.
Sr. Claims Specialist, Professional Liability | Medical Malpractice | California Sedgwick Claims Management Services, Inc.Sr. Claims Specialist, Professional Liability | Medical Malpractice | CaliforniaConcord, CA$100,000–$125,000 / yearIdeal candidates demonstrate strong analytical and negotiation skills, exercise sound judgment, and are committed to delivering timely, cost‑effective claim resolutions while maintaining a high level of customer service. ESSENTIAL RESPONSIBLITIES MAY INCLUDE: Analyzes and processes complex or technically difficult medical malpractice 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.
Liability Claims Examiner Sedgwick Claims Management Services, Inc.Liability Claims ExaminerCA$85,000–$105,000 / 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: To address and handle high end General Liability cases with serious injuries, complex coverage scenarios and legal inquiries or disputes; to develop a strategy to bring a case to satisfactory resolution.