Medical Claims Resolution Specialist Kinetic Personnel GroupMedical Claims Resolution SpecialistOrange, CA$25–$31 / hourTemporaryA full time permanent position includes a pay raise, telecommute options, a CalPERS Pension and excellent government benefits including generous holiday, PTO and sick pay days off, year one! Job duties: Addresses provider inquiries, questions, and concerns in all areas including enrollment, claims submission and payment, benefit interpretation, and referrals/authorizations for medical care.
NewClaims Examiner - Workers Compensation IconmaClaims Examiner - Workers CompensationRancho Cucamonga, CA$45–$50 / hourResponsibilities: 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. Analyzes and processes complex or technically difficult workers' compensation 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.
NewClaim Specialist - Property Field Inspection State Farm Mutual Automobile Insurance CompanyClaim Specialist - Property Field InspectionYorba Linda, CA$69,398.62–$104,056 / yearCompetitive candidates should reside within one of the listed zip codes and will service this same territory: 92602, 92606, 92614, 92701, 92705, 92706, 92707, 92780, 92782, 92807, 92808, 92861, 92862, 92865, 92866, 92867, 92868, 92869, 92886, 92887 . 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).
Senior Workers' Comp Claims Specialist - CA Claims Zenith Insurance CompanySenior Workers' Comp Claims Specialist - CA ClaimsOrange, California$94,502.68–$127,972.38 / yearFull timeIntroduction: Zenith is a team of Workers' Compensation Specialists committed to helping businesses succeed by protecting against the financial and human consequences of workplace injuries, providing for the needs of injured employees and making the workplace safer. Opens new Claims, completes three-point contact, and performs needed investigations to determine compensability as well as possible subrogation or apportionment, according to state and/or Zenith’s timeframes and guidelines.
RCIS Crop Claims Specialist or Claims Crop Field Adjuster CA Zurich Insurance Group LtdRCIS Crop Claims Specialist or Claims Crop Field Adjuster CACARemote$51,300–$89,100 / yearRCIS offers a wide range of private product coverages, including a diverse selection of named-peril options, supplemental and stand-alone insurance products as well as federal crop insurance plans through the United States Department of Agriculture's Risk Management Agency. RCIS Crop Adjuster Physical Requirements: walk in agricultural fields up to 3 miles, climb agricultural storage bins up to 25 feet, lift 25 lbs to 50 lbs, work outdoors in varying temperatures/weather conditions.
Senior Workers'' Comp Claims Specialist CA Claims Zenith Insurance CompanySenior Workers'' Comp Claims Specialist CA ClaimsOrange, CA$94,502.68–$127,972.38 / yearZenith is a team of Workers'' Compensation Specialists committed to helping businesses succeed by protecting against the financial and human consequences of workplace injuries, providing for the needs of injured employees and making the workplace safer. Opens new Claims, completes three-point contact, and performs needed investigations to determine compensability as well as possible subrogation or apportionment, according to state and/or Zenith's timeframes and guidelines.
Claims Specialist - Claims Processing Providence St. Joseph HealthClaims Specialist - Claims ProcessingAnaheim, CATogether, 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. Required Qualifications: HMO claims processing experience in a managed care environment, preferably PMG/IPA setting within the last 3 years or any combination of education and/or experience which produces an equivalency.
Claims Specialist - Claims Processing Providence Health & ServicesClaims Specialist - Claims ProcessingAnaheim, CA$24–$33.73 / hourRequsition ID: 429445 Company: Providence Jobs Job Category: Claims Job Function: Revenue Cycle Job Schedule: Full time Job Shift: Day Career Track: Admin Support Department: 7520 CLAIMS PROCESSING CA HERITAGE SERVICES Address: CA Anaheim 200 W Center St Promenade Work Location: St Joseph Home Health-Anaheim Workplace Type: On-site Pay Range: $24.00 - $33.73 Together, 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.
Program Manager - Workers Compensation Claims | CA Claims Exp. Preferred (Hybrid - California) Sedgwick Claims Management Services, Inc.Program Manager - Workers Compensation Claims | CA Claims Exp. Preferred (Hybrid - California)Pasadena, CA$95,000–$120,000 / 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. Sedgwick is building a diverse, equitable, and inclusive workplace and recognizes that each person possesses a unique combination of skills, knowledge, and experience.
Claims Team Lead - Workers Compensation | CA Claims Exp. Required Sedgwick Claims Management Services, Inc.Claims Team Lead - Workers Compensation | CA Claims Exp. RequiredOntario, CARemote$100,000–$118,000 / yearPRIMARY PURPOSE: To supervise the operation of a team of workers compensation claims examiners and technical staff for workers compensation claims for clients; to monitor colleagues' workloads, provide training, and monitor individual claim activities; to provide technical/jurisdictional direction to examiner reports on claims adjudication; and to maintain a diary on claims in the teams including frequent diaries on complex or high exposure claims. The ideal candidate brings strong technical knowledge of California workers' compensation claims, experience supervising claims examiners and support staff, and the ability to provide guidance on complex and high-exposure matters.
Retail Claims Investigator Rebel Convenience StoresRetail Claims InvestigatorUpland, CAWe’re looking for a detail-oriented Claims Investigator to support the fair, accurate, and timely resolution of general liability, property damage, and Injury claims across our convenience store and fuel station locations. If you have a background in investigations and enjoy uncovering facts, assessing risk, and supporting sound outcomes, then this may just be the role for you!
Medical Only Claims Specialist CorVel Enterprise Claims, Inc.Medical Only Claims SpecialistRancho Cucamonga, CARemote$16.74–$26.92 / hourPart timePay 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. Over 4,000 people working across the United States embrace our core values of Accountability, Commitment, Excellence, Integrity and Teamwork (ACE-IT!).
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.
Claims Examiner I HCC Service CompanyClaims Examiner IEncino, California$46,600–$69,800 / yearJob Title: Claims Examiner I Location: Encino, CA Reports to: Claims Manager Employment Type: Full time Job Req ID: 2026 Req Begin Date: 6/12/2026 About TMHCC Tokio 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. The Company will consider for employment all qualified applicants, including those with criminal histories, in a manner consistent with the requirements of applicable federal, state and local laws, such as the Violent Crime Control and Law Enforcement Act of 1994 (18 USC § 1033(e))(the “VCCLEA”), which restricts financial institutions and insurers such as TMHCC from employing individuals with certain types of criminal convictions.
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 Supervisor CorVel Enterprise Claims, Inc.Claims SupervisorRancho Cucamonga, CARemote$73,345–$113,247 / yearPart timePay 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. CorVel, a certified Great Place to Work® Company, is a national provider of industry-leading risk management solutions for the workers’ compensation, auto, health and disability management industries.
Sr. Adjuster-Workers Comp Claims CopperPoint Insurance CoSr. Adjuster-Workers Comp ClaimsIrvine, CARemote$68,000–$98,500 / yearBuild and maintain professional relationships with injured workers, policy holders, brokers and agents through proactive claim management and timely communications. The Workers' Compensation Claims Adjuster Senior, Indemnity is responsible for analyzing time loss workers' compensation claims to determine compensability.
Auto Claims Representative DK Law's Open RolesAuto Claims RepresentativeCosta Mesa, CaliforniaInvestigate property damage claims involving auto accidents, including reviewing police reports, witness statements, and damage assessments. As a key member of our Claims Department, you will be responsible for investigating and evaluating property damage claims arising from automobile accidents.
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.
Claims Advocate Next Insurance IncClaims AdvocateCARemote$60,000–$80,000 / yearCommunication and Negotiation Skills: Proven ability to communicate effectively and negotiate with a range of stakeholders, including third-party insurers and legal representatives. You can find additional information about this type of scam and report any fraudulent employment offers via the Federal Trade Commission''s website ( https://consumer.ftc.gov/articles/job-scams ), or you can contact your local law enforcement agency.