Claims Auditor Health Source MSOClaims AuditorAlhambra, CAFull timeResponsibilities include, but not limited to: Maintain up-to-date knowledge of procedures for all ICD-10, CPT, HCPC codes including:Contractual agreement rates. Job Description: Claims Auditor will be responsible for auditing claims processed by Claims Examiners.
NewClaim Specialist - Property Field Inspection State Farm Mutual Automobile Insurance CompanyClaim Specialist - Property Field InspectionSanta Monica, CA$64,965.62–$111,595 / yearAdditional Details: Employees must successfully complete all required training, including applicable licensing exam(s), Motor Vehicle Record (MVR) checks, and background checks required of various state(s). With 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!
NewRisk Manager MV TransportationRisk ManagerEl Monte, CA$97,000–$114,000This role is exclusively assigned to the potential contract and plays a crucial role in mitigating risk exposure, supporting safe operations, and driving continuous improvement in loss prevention efforts. The Risk Manager will serve as the primary point of contact for all Agency-related risk management matters and must be available and responsive at all times via mobile phone, email, or text message.
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.
Casualty Claims Quality Assurance Consultant EMC Insurance Group Inc.Casualty Claims Quality Assurance ConsultantCA$85,799–$118,545 / yearYou'll partner closely with Casualty, Complex, and Specialty teams to review claim files, evaluate performance against best practices and KPIs, and identify opportunities to improve outcomes. Through targeted audits and broader claims reviews, you'll uncover trends, provide actionable insights, and help drive accountability and continuous improvement.
Claims Examiner I HCC Service CompanyClaims Examiner IEncino, CaliforniaTokio Marine HCC (TMHCC) brings 50 years of service to the specialty insurance industry, today offering over 100 products to commercial customers in 180 countries around the world. Our Good Company values, including integrity, empowerment, and commitment to customer service, and a culture of innovation, communication, and collaboration make TMHCC a great place to work.
Claims Counsel, Financial Lines & Cyber MSIG HoldingsClaims Counsel, Financial Lines & CyberLos Angeles, CaliforniaThe Claims Attorney will be responsible for handling complex matters, including high severity claims and class actions, from inception through resolution for Financial Lines and Cyber products with an emphasis on Directors & Officers (D&O), Financial Institutions Professional Liability (E&O), Pension Trust (Fiduciary), Employment Practices Liability, and Fidelity policies. You will work closely with internal and external customers and stakeholders, deliver excellent customer service, analyze coverage, draft coverage letters, evaluate liability, make claim presentations, set judgmental reserves, and formulate and execute resolution strategies.
NewSenior Manager, Claims Adjustments Mitchell MartinSenior Manager, Claims AdjustmentsLos Angeles, CA$117,509–$152,762 / yearBy applying for this job, you agree to receive AI-generated calls, text messages, and/or emails from Mitchell Martin Inc and its affiliates and contracted partners at various frequency through traditional and automated methods. • This role involves managing complex workflows, ensuring compliance, and leading a team to drive performance.
NewClaims Representative Mercury Insurance CompanyClaims RepresentativeCA$32,363–$56,701 / yearThe Claims Representative will handle a high volume of calls and make regular contact with customers on multiple platforms, collaborating cohesively with other team members to achieve department goals. Sets reserves for anticipated losses, arranges vehicle inspections and rental authorizations, and makes referrals to specialty teams as warranted.
NewClaims Representative Mercury Insurance Services, LLCClaims RepresentativeCalifornia$32,363–$56,701 / yearThe Claims Representative will handle a high volume of calls and make regular contact with customers on multiple platforms, collaborating cohesively with other team members to achieve department goals. • Sets reserves for anticipated losses, arranges vehicle inspections and rental authorizations, and makes referrals to specialty teams as warranted.
Fractional Customer Service (Claims) Manager Silva-Lining HRFractional Customer Service (Claims) Managerlos Angeles, CARemoteSilva-Lining HR is seeking a Fractional Customer Service (Claims) Manager for a client to oversee and optimize the end-to-end claims process, ensuring timely resolution, operational efficiency, and exceptional customer experience. Lead project management efforts for claims resolution, including task delegation and coordination with internal team members, vendor partners, shipping providers, and repair services.
Auditor, Delegate Claims Alignment Healthcare IncAuditor, Delegate ClaimsCA$70,823–$106,234 / yearThe Auditor also helps maintain productive working relationships with delegated provider organizations by facilitating clear communication during the audit process, supporting the development of Corrective Action Plans, and verifying that corrective actions are completed in accordance with audit outcomes and regulatory requirements. Prior Medicare Managed Care claims experience related to delegation oversight and auditing.1-2 years minimum experience conducting oversight audits of delegated entities and/or ancillary providersDemonstrable detailed knowledge/experience with CMS claims compliance reporting - Part C, ODAG, Monthly Timeliness, etc.
Personal Auto Property Damage (PD) Claims Adjuster Hankey Group ExternalPersonal Auto Property Damage (PD) Claims AdjusterLos Angeles, CaliforniaThe exact starting compensation to be offered will be determined at the time of selecting an applicant for hire and will be dependent on a wide range of factors, including but not limited to geographic location, skill set, experience, education, credentials, and licensure when applicable. Following successful completion of training and demonstrated performance, employees may be eligible for up to one work-from-home day per week, subject to business needs and manager approval.
Senior Commercial Auto Claims Adjuster Hankey Group ExternalSenior Commercial Auto Claims AdjusterLos Angeles, CaliforniaThe exact starting compensation to be offered will be determined at the time of selecting an applicant for hire and will be dependent on a wide range of factors, including but not limited to geographic location, skill set, experience, education, credentials, and licensure when applicable. The ideal candidate has strong analytical skills, sound judgment, and the ability to manage claims with efficiency, accuracy, and professionalism.
Construction Claims Consultant Aon CorporationConstruction Claims ConsultantLos Angeles, California$120,000–$190,000 / yearVarious other types of leaves of absence; paid sick leave as provided under state and local paid sick leave laws, short-term disability and optional long-term disability, health savings account, health care and dependent care reimbursement accounts, employee and dependent life insurance and supplemental life and AD&D insurance; optional personal insurance policies, adoption assistance, tuition assistance, commuter benefits, and an employee assistance program that includes free counseling sessions. You’ll spend significant time interacting with clients—addressing questions, providing updates, offering strategic guidance, and collaborating with your workers compensation advocate counterpart to get a full view of each client’s claims profile.
NewFreight Claims Specialist Oldcastle BuildingEnvelopeFreight Claims SpecialistLos Angeles, CaliforniaFrom apartments in New York to hospitals and stadiums in Dallas, libraries at prestigious universities to creating modern retail experiences, our teams contribute architectural glass and building products to projects that shape the way people live, work, heal, learn, and play. The Freight Claims Specialist is focused on managing and recovering freight claims related to lost or damaged shipments across parcel and LTL carriers and reports to the Logistics Manager .
Field Property Claims Adjuster: Los Angeles, CA (Gateway Cities / Central LA) Farmers Group, Inc.Field Property Claims Adjuster: Los Angeles, CA (Gateway Cities / Central LA)Los Angeles, CARemote$24.70–$41.88 / hourExposure to some or all of the following environments when in the field: Uncontrolled outside environmental conditions, Excessive noise levels, Chemicals Chemical/Biological conditions, Moving mechanical parts, Areas considered dangerous, Conditions which could affect the respiratory system or skin such as fumes, odors, dust, mists, gases, oils, smoke, soot, or poor ventilation. A Day in the Life of a Field Property Claims Adjuster: Conduct both virtual and on-site investigations by visiting policyholders' residences to assess propertydamage, determine liability, evaluate the extent of loss, and negotiate fair settlements.
NewManager, Claims Compliance Mitchell MartinManager, Claims ComplianceLos Angeles, CA$117,509–$152,762 / yearBy applying for this job, you agree to receive AI-generated calls, text messages, and/or emails from Mitchell Martin Inc and its affiliates and contracted partners at various frequency through traditional and automated methods. • This role involves regulatory interpretation, compliance monitoring, and the development of operational training.
NewDirector, Claims Administration Mitchell MartinDirector, Claims AdministrationLos Angeles, CA$135,136–$175,676 / yearBy applying for this job, you agree to receive AI-generated calls, text messages, and/or emails from Mitchell Martin Inc and its affiliates and contracted partners at various frequency through traditional and automated methods. • The position involves leading a team, ensuring compliance with regulations, and utilizing general office software for reporting and data analysis.
Manager, Configuration - Claims Adjudication/Custom Solutions - Remote Molina Healthcare IncManager, Configuration - Claims Adjudication/Custom Solutions - RemoteCARemoteLeads and manages team responsible for configuration activities including accurate and timely implementation and maintenance of critical information on claims databases, validation of data stored on databases, and adherence to health plan business and system requirements as it pertains to contracting, benefits, prior authorizations, fee schedules and other business requirements. Represents as primary liaison with various functional areas/stakeholders (i.e. utilization management, claims, configuration, provider network, health plan leadership, etc.) to seek understanding of workflows and obtain required documentation for applicable audits.
Multi-Line Claims Adjuster - California / Los Angeles Area Property Claim ProfessionalsMulti-Line Claims Adjuster - California / Los Angeles AreaLos Angeles, CAWe excel in providing professional, knowledgeable claims professionals to handle large losses, catastrophe claims, business interruption and daily property claims, as well as handle complete liability investigations, task assignments including scene investigations and property damage appraisals, construction defect claims as well as first party automobile claims for personal and commercial insurance policyholders. Experience in industry specific areas a plus, but not necessary: fire departments, agricultural, lumber mills, high value or historic buildings or Construction Defects, Automobile Liability, Subrogation Recovery investigations.
Senior Claims Specialist, Workers Compensation Tokio Marine GroupSenior Claims Specialist, Workers CompensationPasadena, CaliforniaWe provide unique insurance and risk management tools from our experienced staff of account executives, underwriters and loss prevention engineers and fair and timely claim settlement from a skilled team of claim professionals. Tokio Marine has been conducting business in the U.S. market for over a century and we are licensed in all states, Puerto Rico and the District of Columbia, and write all major lines of Commercial Property and Casualty Insurance.
Senior Claims Assistant BP&CSenior Claims AssistantLos Angeles, CaliforniaUnder limited supervision, provide complex clerical support utilizing in-depth procedures on assignments of higher-level complexity to a nationwide team of claims adjusters and aide in facilitating timely and accurate management of claims by entering stop/cancel/release of checks, processing cash receipts, work check exceptions, and completion of complex state forms. This role is responsible for providing robust clerical support to our team of Claims Adjusters working across a wide variety of specialties and providing exceptional customer service to our brokers, claimants, and insureds.
Claims Associate - Workers Comp. AvenicaClaims Associate - Workers Comp.Chatsworth, CAResponsibilities are consistent across both the Workers’ Compensation and Auto & General Liability claims desks and include: Receive claim assignments and review claim and policy information to provide background for investigation; determine extent of policy obligation as applicable. Our customer is a financially stable, nationally recognized employer of choice with offices in major U.S. cities and a strong track record of growing early-career talent into successful claims professionals.
Claims Specialist II Mercury Insurance CompanyClaims Specialist IILos Angeles, CA$44,466–$77,881 / yearBodily Injury Claims Management: Analyze medical records to evaluate, negotiate, and settle moderate bodily injury claims with legal counsel for represented claimants and unrepresented parties. If you're passionate about helping people restore their lives when the unexpected happens, and providing high-quality customer experiences, then our Mercury Insurance Claims team could be the place for you!
Sr. Complex Claims Adjuster Kin Insurance Technology Hub LLCSr. Complex Claims AdjusterCAYou demonstrate command of multi-state regulatory requirements and policy interpretation, producing well-documented files with sound coverage decisions, clear reservation of rights and denial letters where applicable, and effective negotiation outcomes with attorneys and public adjusters. Our disciplined growth, strong customer satisfaction, and focus on long-term sustainability fosters outstanding growth, attracts marquee investors, and earns recognition and accolades, including: Built In Chicagos Best Places to Work, Midsize Companies (2021-2026).
Director, Claims Administration L.A. Care Health PlanDirector, Claims AdministrationLos Angeles, CAEstablishes and leads the Service Validation Unit (SVU) to function in a strategic, proactive and preventative manner by independently validate that billed services were authorized, medically supported, accurately represented, and provided/received prior to payment. This position is responsible for leading the end-to-end claims ecosystem, including claims adjudication, claims adjustments (escalations, disputes, general adjustments, and litigation-related requests), and strong focus on preventative controls through the Service Validation Unit (SVU).
Property Claims Examiner II Wind/Hail Mercury Insurance CompanyProperty Claims Examiner II Wind/HailCA$98,568–$120,473 / yearBe able to seamlessly transition between various methods of inspection, including video, or photo, to write a damage estimate: Possess strong organizational, time management, and prioritization skills to handle varying workloads due to seasonal volume changes and catastrophes. Knowledge and Skills: As a Property Claims Examiner 2, you will: Possess the ability to work independently with limited or no supervision over daily activities required to successfully investigate, evaluate, write damage estimates, negotiate, and resolve property claims.
Senior Manager, Claims Administration L.A. Care Health PlanSenior Manager, Claims AdministrationLos Angeles, CARequired: Strong knowledge of Current Procedural Terminology (CPT), Healthcare Common Procedure Coding System (HCPCS), International Classification of Diseases (ICD)-10, DRG/ Ambulatory Payment Classification (APC), and pricing methodologies. Responsible for translating enterprise expectations into consistent frontline execution, maintaining a strong control environment, identifying emerging risks quickly, and building upstream partnerships that drive long-term operational maturity.
Claims Specialist Mechanical Protection Mercury Insurance CompanyClaims Specialist Mechanical ProtectionCA$55,056.15–$76,466.88 / yearPertinent state adjuster licenses are required• A minimum of one Automotive Service Excellence (ASE) certificate must be maintainedExperience:• At least 6 months experience as a Claims Specialist Trainee through the in-house training program.• Or equivalent combination of education and/or experience• Experience to handle mechanical protection claims normally is acquired through auto technician experience and/or service department service writer experience.
Manager, Claims Compliance L.A. Care Health PlanManager, Claims ComplianceLos Angeles, CAStrengthens operational integrity, improves adherence to state/federal requirements, and equips staff with the knowledge and tools needed to process claims accurately and consistently through cross-functional collaboration, transparent communication, and structured oversight. • Leads operational readiness planning for regulatory or contractual changes affecting claims payment, provider reimbursement, data requirements, notices, timelines, and related administrative rules.
Claims Supervisor - Worker Compensation StratAcuity Staffing Partners IncClaims Supervisor - Worker CompensationCARemote$95,000–$110,000 / yearIn terms of professional development, Everforth Apex hosts an on-demand training program, provides access to certification prep and a library of technical and leadership courses/books/seminars once you have 6+ months of tenure, and certification discounts and other perks to associations that include CompTIA and IIBA. Everforth Apex also offers a HSA (Health Savings Account on the HDHP plan), a SupportLinc Employee Assistance Program (EAP) with up to 8 free counseling sessions, a corporate discount savings program and other discounts.
Claims Specialist II Mercury Insurance Services, LLCClaims Specialist IICalifornia$44,466–$77,881 / yearBodily Injury Claims Management : Analyze medical records to evaluate, negotiate, and settle moderate bodily injury claims with legal counsel for represented claimants and unrepresented parties. If you’re passionate about helping people restore their lives when the unexpected happens, and providing high-quality customer experiences, then our Mercury Insurance Claims team could be the place for you!
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.
Claims Consultant - Physicians & Surgeons (West Region) The Medical Protective CompanyClaims Consultant - Physicians & Surgeons (West Region)CAService to insureds, assist where possible in sales and retention efforts of sales force. Confirm coverage and then manage claims and suits brought against policyholders in our Dental Division.
Claims Enablement Analyst EMC Insurance Group Inc.Claims Enablement AnalystCA$66,294–$91,570 / yearAs a Claims Enablement Analyst, you'll support Claims teams by resolving complex system and process issues, identifying root causes, and delivering timely solutions that improve daily operations. You'll collaborate with the Help Desk, IT, and business partners to enhance workflows, contribute to system improvements, and support testing and training efforts.
Associate Bond Claims Examiner HCC Service CompanyAssociate 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.
Senior Manager, Claims Adjustments L.A. Care Health PlanSenior Manager, Claims AdjustmentsLos Angeles, CAThe Senior Manager, Claims Adjustments manages all adjustment-related operational workflows, including provider disputes, escalated claim reviews, complex adjustments, and litigation-related claim support. Ensures all provider adjustments meet Department of Managed Health Care (DMHC), Department of Health Care Services (DHCS), Centers for Medicare and Medicaid Services (CMS), and contractual (TAT) requirements.
Claims Client Service Executive Sales The Hartford Insurance Group IncClaims Client Service Executive SalesLos Angeles, CA$108,000–$162,000 / yearWe look to the Client Service Executive, Sales to support the end-to-end service mission while delivering engaging customer presentations that demonstrate professional diplomacy, articulated messaging and a friendly confidence that drives positive outcomes for our customers. Responsibilities: As the integral member of the Client Service Team, supports the overall service mission by delivering customer presentations that demonstrate professional diplomacy, articulated messaging and confidence that drives positive outcomes for our customers.
EDI Claims Specialist MedPOINT ManagementEDI Claims SpecialistSherman Oaks, CARemoteJoin MedPOINT Management as an EDI Claims Specialist and play a crucial role in ensuring accurate and timely processing of electronic claims. MedPOINT Management has been a leader in healthcare management solutions for over a decade, committed to improving the efficiency and effectiveness of our partners.
Claims Examiner MedPOINT ManagementClaims ExaminerSherman Oaks, CARemoteAdhere to MedPOINT Management’s core value: Accountability, Community, Celebration, Integrity, Innovation & Collaboration. Researches, reviews and contacts provider services for problem claims and issues, as needed.
Hospital Claims Auditor MedPOINT ManagementHospital Claims AuditorSherman Oaks, CARemoteSummary: A Hospital Claims Auditor is responsible for the overall quality of claims processes as well as compliance, in accordance with outside regulations and the contractual obligations of the Health Plans and/or Hospital Clients. Knowledge, Skills and Abilities Required: · Strong organizational, analytical and oral/ written communication (English) skills required.
Hospital Claims Examiner MedPOINT ManagementHospital Claims ExaminerSherman Oaks, CARemoteAdhere to MedPOINT Management’s core values: Accountability, Community, Celebration, Integrity, Innovation & Collaboration. Researches, reviews and contacts provider services for problem claims and issues, as needed.
Senior Claims Specialist, Cyber Markel Group IncSenior Claims Specialist, CyberCAThis includes race; color; sex; religion; creed; national origin or place of birth; ancestry; age; disability; affectional or sexual orientation; gender expression or identity; genetic information, sickle cell trait, or atypical hereditary cellular or blood trait; refusal to submit to genetic tests or make genetic test results available; medical condition; citizenship status; pregnancy, childbirth, or related medical conditions; marital status, civil union status, domestic partnership status, familial status, or family responsibilities; military or veteran status, including unfavorable discharge from military service; personal appearance, height, or weight; matriculation or political affiliation; expunged juvenile records; arrest and court records where prohibited by applicable law; status as a victim of domestic or sexual violence; public assistance status; order of protection status; status as a smoker or nonsmoker; membership or activity in local commissions; the use or nonuse of lawful products off employer premises during non-work hours; declining to attend meetings or participate in communications about religious or political matters; or any other classification protected by applicable law. • Manage litigation filed nationwide against insureds; appoint, direct and manage defense counsel; proactively work toward expeditious and economical resolution of claims; assist Company claims vendor management, disbursement and legal collections teams with defense counsel, bill payment and collection issues.
Casualty Claims Associate HDI Global Insurance CompanyCasualty Claims AssociateGlendale, CA$70,000–$75,000 / yearKey Responsibilities: Overseeing the day-to-day administrative operations of an office, ensuring smooth functionality by managing tasks like scheduling meetings, managing office supplies, greeting visitors, handling correspondence, and maintaining office systems, all while prioritizing efficiency and organization within the workplace. This direction helps HDI Global lead the profitable growth game as a globally connected business, raise the bar every day through stronger underwriting, claims, and investment performance, and win tomorrow by starting today with a lean, fast, resilient, and future-ready organisation.
Claims Field Property Adjuster AAAClaims Field Property AdjusterLos Angeles, CaliforniaThis Claims Property Field Adjuster supports the Property Claims Operation by providing service pursuant to the Property policy by handling claims of property damage lines of insurance written by the Interinsurance Exchange in compliance with all regulatory and statutory requirements. 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.
Claims Auto Adjuster AAAClaims Auto AdjusterValencia, CaliforniaThis entry-level position supports the Auto Claims Operation by providing service pursuant to the policy by handling claims of material damage, property damage, and/or liability lines of insurance written by the Interinsurance Exchange in compliance with all regulatory and statutory requirements. 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.
Specialist, Claims & Export Documentation Sunkist Growers IncSpecialist, Claims & Export DocumentationValencia, CAVerify and maintain accurate pricing, including: validating invoice pricing against the weekly Export Sales scale, coordinating with Sales Operations (SOS) to ensure correct FOB and CNF values in Prophet, and requesting corrections when discrepancies are identified. At Sunkist, we believe that our strength and longevity is a result of the hard work and dedication from our employee's contribution Behind our history of innovation and commitment to market leadership is a company devoted to providing continued education, excellent benefits and good working conditions.
AVP, US Healthcare Claims Sompo International Holdings LimitedAVP, US Healthcare ClaimsLos Angeles, CA$145,000–$195,000 / yearThe successful candidate will be able to provide insight and analysis on US Healthcare claims across various product lines, including primary medical liability, excess and surplus lines, and allied healthcare. 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.
Executive Claims Examiner Markel Group IncExecutive Claims ExaminerWoodland Hills, CA$97,520–$134,090 / yearThis includes race; color; sex; religion; creed; national origin or place of birth; ancestry; age; disability; affectional or sexual orientation; gender expression or identity; genetic information, sickle cell trait, or atypical hereditary cellular or blood trait; refusal to submit to genetic tests or make genetic test results available; medical condition; citizenship status; pregnancy, childbirth, or related medical conditions; marital status, civil union status, domestic partnership status, familial status, or family responsibilities; military or veteran status, including unfavorable discharge from military service; personal appearance, height, or weight; matriculation or political affiliation; expunged juvenile records; arrest and court records where prohibited by applicable law; status as a victim of domestic or sexual violence; public assistance status; order of protection status; status as a smoker or nonsmoker; membership or activity in local commissions; the use or nonuse of lawful products off employer premises during non-work hours; declining to attend meetings or participate in communications about religious or political matters; or any other classification protected by applicable law. Manage litigation filed nationwide against insureds; appoint, direct and manage defense counsel; proactively work toward expeditious and economical resolution of claims; assist Company claims vendor management, disbursement and legal collections teams with defense counsel, bill payment and collection issues.