Claims Auditor (50476) Western GrowersClaims Auditor (50476)Irvine, 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. Knowledge of the Patient Protection and Affordable Care Act (PPACA), Health Insurance Portability and Accountability Act (HIPAA), Consolidated Omnibus Budget Reconciliation Act (COBRA), California-COBRA, and Employee Retirement Income Security Act (ERISA) regulations.
CA Claims Specialist - Bilingual (Spanish) CorVel Enterprise Claims, Inc.CA Claims Specialist - Bilingual (Spanish)Rancho Cucamonga, CARemote$25.48–$41.09 / hourPart timeThe Workers’ Compensation Claims Specialist manages within company best practices lower-level, non-complex and non-problematic workers’ compensation claims within delegated limited authority to best possible outcome, under the direct supervision of a senior claims professional, supporting the goals of claims department and of CorVel. Pay rates are established taking into account the following factors: federal, state, and local minimum wage requirements, the geographic location differential, job-related skills, experience, qualifications, internal employee equity, and market conditions.
Claims Counsel, Cml, Private Companies Sompo InternationalClaims Counsel, Cml, Private CompaniesLos Angeles, CA$125,000–$175,000 / yearStrong cross-functional collaboration (underwriting/actuarial), communication/marketing, and analytical/writing/organizational skills; strong MS Office and claims systems experience (Guidewire/Genius/ImageRight a plus). Salary Range: $125,000-$175,000 Actual compensation for this role will depend on several factors including the cost of living associated with your work location, your qualifications, skills, competencies, and relevant experience.
Claims Receivables and Recovery Specialist (50627) Western GrowersClaims Receivables and Recovery Specialist (50627)Irvine, CAThe Claims Receivables and Recovery Specialist reports to the Supervisor, Payment Integrity, and works with various departments within the company to ensure all open claim receivables, which are results of claim overpayments and/or adjustments, are pursued and collected appropriately. Collect receivables for the Western Growers Assurance Trust (WGAT) and clients of the Third-Party Administrator (TPA) that may be a result of overpayments or claims adjustments by researching, writing letters, and actively making phone calls.
Claims Consultant -Life Sciences or Cyber/Technology E&O (Hybrid) Onebeacon Professional Insurance IncClaims Consultant -Life Sciences or Cyber/Technology E&O (Hybrid)Anaheim, CA$143,000–$167,000 / yearSpecial consideration will be given to candidates who have personally litigated life sciences matters as attorneys and possess firsthand experience developing litigation strategy, managing scientific and expert evidence, conducting depositions, participating in trial preparation, and evaluating product liability and professional liability exposures from both the litigation and insurance claims perspectives. The ideal candidate will possess substantial Technology Errors & Omissions claims experience and a deep understanding of E&O coverage, including the ability to analyze complex professional liability exposures, contractual liability issues, performance disputes, and technology-related loss scenarios.
Claims Consultant - Physicians & Surgeons (West Region) The Medical Protective CompanyClaims Consultant - Physicians & Surgeons (West Region)CARemote$90,000–$155,000 / yearFrom our roots in our hometown of Fort Wayne, Indiana, we''ve worked diligently to become the nation''s premier healthcare liability coverage provider, currently insuring more than 300,000 customers. We are hundreds of professionals with varied backgrounds and experience levels who came together to achieve one goal: protecting those who have made it their mission to serve and care for others.
Managing Director Strategic Claims Oversight - Healthcare Severity CNA Financial Corp.Managing Director Strategic Claims Oversight - Healthcare SeverityIrvine, CA$97,000–$189,000 / yearDevelops and maintains collaborative working relationships with internal and external business partners including Operations, Underwriting, Actuary and Risk Control and regularly shares claims outcomes, trends, legal developments and other relevant business updates. Responsible for the ongoing management of staff by attracting talent, setting clear direction, providing appropriate guidance, managing performance, recognizing contributions, and developing capabilities.
Manager, 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.
Workers 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.
National Complex Claims Leader Marsh & McLennan Companies IncNational Complex Claims LeaderIrvine, CARemote$93,700–$174,800 / yearReporting to the SVP, National Claims Director, you will serve as a senior resource and technical authority on complex and high-exposure claims, bringing deep expertise, strategic judgment, and a national perspective to drive resolution on complex, high-stakes commercial P&C claim situations across the organization. In this capacity, you will build and maintain strong relationships with national and regional leadership, industry vertical leaders, and Marsh Risk, ensuring MMA clients receive best-in-class advocacy at every level.
NewConsulting Director, Claims Strategy and Execution CNA Financial CorpConsulting Director, Claims Strategy and ExecutionIrvine, CA$97,000–$189,000 / yearThis individual contributor role will work across Professional Services and Healthcare segments: Architects & Engineers, Accounting, Program & Large Law, and Real Estate Professionals as well as Allied Healthcare Facilities, Aging Services, and Allied Health Providers. Knowledge of Microsoft Office Suite, and other business-related software especially in working with exporting data from various databases and compiling reports in MS Excel and other software tools.
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.
Lead - Claims Examiner Astrana Health IncLead - Claims ExaminerMonterey Park, CAManager - Claims and enable us to continue to scale in the healthcare industry. We are currently seeking a highly motivated Lead - Claims Examiner.
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.
Complex Claims Consulting Director - Mass Tort Unit CNA Financial Corp.Complex Claims Consulting Director - Mass Tort UnitLos Angeles, CA$97,000–$189,000 / yearManages an inventory of the most complex commercial claims, which generally involve multiple years of coverage, have 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 pursuit of risk transfer, extensive negotiations and management of complex litigation. Drives the resolution of claims by collaborating with internal and external business partners to develop, own and execute a claim resolution strategy, that often includes negotiating complex settlements, partnering with counsel to manage complex litigation and authorizing payments within scope of authority.
Senior Claims Auditor Astrana Health IncSenior Claims AuditorMonterey Park, CAThis role will report to the Director - Claims and enable us to continue to scale in the healthcare industry. About the Role: We are currently seeking a highly motivated Senior Claims Auditor.
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.
NewSenior Claims Counsel – Title Insurance (Hybrid) First AmericanSenior Claims Counsel – Title Insurance (Hybrid)Santa Ana, CaliforniaThe Senior Claims Counsel position with First American Title Insurance Company provides an excellent opportunity for counsel to engage in complex legal analysis, craft creative solutions to difficult problems, manage their own caseload, oversee outside litigation counsel, and engage in high-level problem solving, negotiation and legal analysis in a stimulating and collegial environment with an opportunity for long-term growth and advancement. First 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.
Major Litigation Unit Complex Claims Consulting Director CNA Financial Corp.Major Litigation Unit Complex Claims Consulting DirectorLos Angeles, 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 commercial claims, 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 pursuit of risk transfer, 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, collaborating with coverage experts, negotiating complex settlements, partnering with counsel to manage complex litigation and authorizing payments within scope of authority.
Workers' Compensation Claim Consultant CCMSIWorkers' Compensation Claim ConsultantIrvine, CaliforniaRemote$80,000–$95,000 / yearResponsibilities: When we hire Workers’ Compensation Adjusters at CCMSI, we look for detail‑driven problem‑solvers who balance empathy with sound judgment, navigate complex regulations with confidence, and deliver fair, timely outcomes that support injured workers and strengthen client trust. At CCMSI, we partner with global clients to solve their most complex risk management challenges, delivering measurable results through advanced technology, collaborative problem-solving, and an unwavering commitment to their success.