Patient Account Representative - Medicare, Medicaid, Commercial Claims GuidehousePatient Account Representative - Medicare, Medicaid, Commercial ClaimsEl Segundo, CA$34,000–$56,000 / yearCompensation decisions depend on a wide range of factors, including but not limited to skill sets, experience and training, security clearances, licensure and certifications, and other business and organizational needs. All communication regarding recruitment for a Guidehouse position will be sent from Guidehouse email domains including @guidehouse.com or guidehouse@myworkday.com.
Claim Representative - Accident And Health (Hybrid) Intact InsuranceClaim Representative - Accident And Health (Hybrid)Anaheim, CA$79,000–$91,000 / yearWe currently have an opportunity for a Claim Representative to join our Claims Accident and Health based in our Plymouth, MN; Canton, MA; New York City, NY; Chicago, IL; Naperville, IL; Barrington, IL; Alpharetta, GA; Anaheim, CA; Irvine, CA; Southfield, MI; Mt Juliet, TN on a hybrid schedule. Some of the Claim Representative responsibilities include but are not limited to: Makes timely and appropriate contacts, determines and completes appropriate level of investigation to make determination of coverage, assess liability and determine damages.
Lead - Claims Operations Astrana Health, Inc.Lead - Claims OperationsMonterey Park, CA$27–$32 / hourWork closely with other Company departments and specifically, the Claims QA and Training Specialist to communicate findings of recovery audits and to facilitate accurate adjudication of claims. Ensures that all legal, regulatory and policy requirements are met by keeping informed of changes and by implementing necessary controls and/or programs to meet requirements.
Technical Claim Manager-Design Professionals/Construction RLI Corp.Technical Claim Manager-Design Professionals/ConstructionLos Angeles, CA$115,778–$168,746 / yearThis approach rises from and is supported by our talented, ethical and smart team of employee owners united around a single purpose: to work alongside our customers and partners when they need us, in unexpected ways, with exceptional results. Our goal is to attract, develop, and retain the best employee talent from diverse backgrounds while promoting an environment where all viewpoints are valued and individuals feel respected, are treated fairly, and have an opportunity to excel in their chosen careers.
Life Insurance Position - State Farm Agent Team Member Derek Tsu - State Farm AgentLife Insurance Position - State Farm Agent Team MemberSan Marino, CAFull timeDerek Tsu - State Farm Agent is seeking a qualified and empathetic professional for the role of Life Insurance Position - State Farm Agent Team Member. As a customer-oriented expert, you will market Life/Health insurance services and products to benefit customers and their families.
Senior Claims Auditor (External Audit) Astrana Health, Inc.Senior Claims Auditor (External Audit)Monterey Park, CaliforniaRemote$70,308–$80,000 / yearKnowledge of medical terminology combined with detail knowledge and experience with CPT, HCPCS, DRG, REV, OPS, ASC, ICD10, CRVS, RBRVS, CMS, ICE for Health Plan, DMHC and DHS fee schedules and CMS Medicare regulatory agencies, COB and Third-Party Liability recovery. Detail knowledge and understanding of Industry pricing methodologies, such as Resources-Based Relative Value Scale (RBRVS), Medicare/Medi-Cal fee schedule, All Patient Refined Diagnosis Related Groups (AP-DRG), Ambulatory Payment Classifications (APC), etc.
Customer Service Representative - State Farm Agent Team Member Derek Tsu - State Farm AgentCustomer Service Representative - State Farm Agent Team MemberSan Marino, CAFull timeAs a Customer Service Representative - State Farm Agent Team Member with Derek Tsu - State Farm Agent, you will generate the kind of exceptional customer experiences that reinforce the growth of a successful insurance agency. You will enhance your career while resolving customer inquiries, coordinating with other agency team members, and anticipating the needs of the community members you support.
Account Associate - State Farm Agent Team Member Jose Gutierrez - State Farm AgentAccount Associate - State Farm Agent Team MemberAnaheim, CAPart timeROLE DESCRIPTION: As Account Associate for the sale of Auto, Home, Life, and Health insurance you are vital to our daily business operations and customers’ success. You help grow our office through meaningful customer relations and acting as a liaison between customer needs and agency departments.
Claims Adjuster - Attorney Represented Injury The Progressive CorpClaims Adjuster - Attorney Represented InjuryPasadena, CA$30.29–$39.23 / hourAn ideal candidate will have experience managing an inventory independently, experience assessing and evaluating liability, coverage, and damages, as well as working independently and directly with attorneys to negotiate and settle claims. For 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/ .
General Liability Claims Consultant CNA Financial Corp.General Liability Claims ConsultantBrea, CA$72,000–$141,000 / yearThis individual contributor role operates under broad authority to manage commercial claims of high complexity and exposure within the Commercial Auto/General Liability/ Construction Auto and General Liability line(s) of business. Performs a combination of duties in accordance with departmental guidelines: Manages highly complex investigations of claims, including coverage issues, liability, compensability and damages.
Risks & Claims Manager (Workers' Compensation & General Liability) sweetgreenRisks & Claims Manager (Workers' Compensation & General Liability)Los Angeles, CA$84,000–$119,000 / yearSitting on the Operations Services team and reporting to the Senior Director of Risk + Safety, you will direct the claims adjusting service provided by our workers' compensation carrier, oversee our general liability carrier, and serve as the internal point of contact connecting our restaurants, carriers, brokers, and defense counsel. Build and partner with the People Team and Restaurant Operations on the return-to-work and modified duty program to reduce lost-time exposure, and serve as a clear, consistent point of contact for injured team members.
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.
Patient Account Collector - Fertility Claims 26-00237 Alura Workforce SolutionsPatient Account Collector - Fertility Claims 26-00237Pasadena, CA$22–$25 / hourWith multiple locations across Los Angeles, Orange County, and the Inland Empire, their board-certified physicians and clinical teams have helped thousands of individuals and couples build families through personalized treatment and advanced technology. Committed to innovation, inclusivity, and patient-centered care, our client remains a trusted leader in reproductive medicine and family-building care.
NewSr. Claims Counsel Sompo International Holdings LimitedSr. Claims CounselLos Angeles, CA$125,000–$175,000 / yearOur business, your impact, our opportunity: What you'll be doing: Direct handle primary & excess Casualty claims involving emerging risks, potential long-term exposure, or significant coverage issues. 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.
NewSr. Claims Counsel Sompo InternationalSr. Claims CounselLos Angeles, CA$125,000–$175,000 / yearOur business, your impact, our opportunity: What you'll be doing: Direct handle primary & excess Casualty claims involving emerging risks, potential long-term exposure, or significant coverage issues. 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.
Workers Compensation Large Loss Claims Director CNA Financial Corp.Workers Compensation Large Loss Claims DirectorBrea, 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.
Claims Representative- Healthcare Billing Vista Del MarClaims Representative- Healthcare BillingLos Angeles, CaliforniaIf TIER data is complete, submits the call to update CWS; Monthly, runs Non-Final Saved Notes reports for programs assigned, reviews notes for action required., and disseminates to programs; Reviews Final Saved Charge reports before batching claims for electronic submission to DMH. Completes any updates or corrections required, and manually updates services charges and ‘final save’ so that claims can be batched; Daily, reviews Diagnosis and Financial Update Reports and Client Action Forms submitted for any client information that requires updating in CWS.
Claims Examiner - Workers Compensation ObjectWin TechnologyClaims Examiner - Workers CompensationLong Beach, CA, CARemoteTo 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.
Junior Claims Processor Southern California Pipe Trades Administrative CorporationJunior Claims ProcessorLos Angeles, CAFull timeJOB RESPONSIBILITIES:Specific:Review and resolve participant repayment accounts, including determining amounts owed and issuing repayment notices through the WEX online benefits platform. Review and resolve vision auto-adjudication claims, including approving claims and requesting additional information through the WEX online benefits platform.
Claims Associate - Workers Compensation Apidel TechnologiesClaims Associate - Workers CompensationBrea, CARemoteContractorSkills & Knowledge Excellent oral and written communication skills PC literate, including Microsoft Office products Analytical and interpretive skills Strong organizational skills Good interpersonal skills Ability to work in a team environment Ability to meet or exceed Performance Competencies. 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.