1,679 Results for

Claims Jobs in Venice, CA

Jobs

Reinsurance/Stoploss Medical Claims Adjustor CVS Health Corp

$18.50–$42.35 / hour

Research and determine Reinsurance/Stoploss plan year, identify claim payments made by client versus the Stoploss carriers, and interpret complex plan language to ensure accurate handling of complex adjustments. Review, research, and adjust complex Reinsurance/Stoploss medical claims, splitting claims into multiple claim statuses; adjudicates high-dollar complex, sensitive, and/or specialized medical claims in accordance with claim processing guidelines.

5 days ago

Claims Specialist I - Provider Claims Inland Empire Health Plan

California, CA

$25.90–$33.02 / hour

Under the direction of the Provider Claims Resolution & Recovery Supervisor, the Claims Specialist I - Provider Claims is responsible for evaluating professional, high dollar and outpatient/inpatient institutional claims while determining coverage and payment levels. IEHP is not only committed to healing and inspiring the human spirit of our Members, but we also aim to match our team members with the same energy by providing prime benefits and more.

16 days ago

RCIS Crop Claims Specialist or Claims Crop Field Adjuster CA Zurich Insurance Group Ltd

Remote

$51,300–$89,100 / year

RCIS 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.

30+ days ago

Claims Examiner I Workers Compensation I CA experience Sedgwick Claims Management Services, Inc.

$60,234–$95,000 / year

To analyze workers compensation claims on behalf of our valued clients to determine benefits due, while ensuring ongoing adjudication of claims within service expectations, industry best practices, and specific client service requirements. PRIMARY PURPOSE OF THE ROLE: We are looking for driven individuals that embody our caring counts model and core values that include empathy, accountability, collaboration, growth, and inclusion.

5 days ago

Claims (Billing) Specialist / Patient Account Representative - Healthcare Guidehouse Inc

El Segundo, CA

$38,000–$64,000 / year

Representatives are responsible for maintaining knowledge, skills, and abilities that contribute to various accounting/administrative tasks involved in preparing billing data for agencies Guidehouse works with. Compensation 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.

10 days ago

Claims Supervisor Hankey Group External

Los Angeles, California

$75,000–$98,000 / year

The 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. We are looking for a candidate with a minimum of 8 years of experience in claims who can bring leadership, expertise, and dedication to our team.

5 days ago

Complex Claims Consulting Director - Mass Tort Unit CNA Financial Corp.

Los Angeles, CA

$97,000–$189,000 / year

Manages 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.

11 days ago

Senior Claims Specialist, Auto & Liability Mitsui Sumitomo Insurance Company Of America

Los Angeles, CA

Remote

$90,000–$110,000 / year

Manages claims proactively from assignment through resolution, establishes sound reserves, develops resolution strategies and delivers timely communication to insureds, brokers and internal stakeholders in accordance with company claim handling guidelines, delegated authority, regulatory requirements and applicable fair claims practices laws. Manages litigated claims with approved defense counsel, including litigation plans, budgets, discovery, experts, mediation and trial preparation; monitors counsel performance, legal expenses and compliance with litigation management expectations.

9 days ago

Complex Claims Advisor | Workers Compensation California Expert | OSIP Licensing | Litigation Strategy & Resolution Sedgwick Claims Management Services, Inc.

Remote

$95,000–$100,000 / year

PRIMARY PURPOSE OF THE ROLE To act as a department subject matter expert by providing guidance to the complex claims team to ensure consistency resolving matters optimally while creating a culture of continual quality improvement destined to elevate the overall claim handling to benefit our stakeholders; to ensure the consistency in the developed targeted solutions, and technical guidance and oversight provided to claims team. Proactively and strategically oversee a complex claim inventory by assessing highly complex claims issues, utilizing jurisdictional expertise, providing oversight, and helping direct the handling to achieve the best possible resolution.

6 days ago

Complex Claims Consultant - Professional Liability (Architects & Engineers) CNA Financial Corp.

Los Angeles, CA

$72,000–$141,000 / year

Performs a combination of duties in accordance with departmental guidelines: Manages an inventory of highly complex commercial 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.

12 days ago

Claims Trainer Next Insurance Inc

Remote

$75,000–$98,000 / year

At ERGO NEXT, we are dedicated to building a diverse, inclusive and respectful workplace, so if you're excited about this role but your past experience doesn't align perfectly with every qualification in the job description, we encourage you to apply anyways. We're doing that by building the only technology-led, full-stack provider of small business insurance in the industry, taking on the entire value chain and transforming the customer experience.

12 days ago

Claims Examiner - Workers'''' Compensation (Remote) ICW Group

Remote

$61,979.26–$97,736.56 / year

Headquartered in San Diego with regional offices located throughout the United States, ICW Group has been named for the twelfth consecutive year in a row and for the 20th time overall as a Top 50 performing P&C organization offering the stability of a large, profitable and growing company combined with a focus on all things people. If hired at ICW Group, your final base salary compensation will be determined by factors unique to each candidate, including experience, education and the location of the role and considers employees performing substantially similar work.

13 days ago

Sr. Casualty Claims Examiner Construction Defect Howden Group Holdings Ltd

Remote

$125,000–$145,000 / year

Draft well written and comprehensive captioned reports to request reserve and settlement authority on higher exposure cases that outline all critical aspects of the case in preparation for roundtable presentations to the carrier partners. Supporting the Construct Defect Claims team, you will independently manage moderate to high exposure claims involving alleged defects in residential and commercial construction.

5 days ago

Senior Casualty Claims Examiner Construction Defect Howden Group Holdings Ltd

Remote

$130,000–$160,000 / year

Construction Defect Claims team, you will independently manage low to moderate exposure claims involving alleged defects in residential and commercial construction. The focus on being a People First business has always been at the very heart of the Group; Our vision was to create an independent business with a unique culture and one that would survive and thrive as a business controlled by the people working for it.

5 days ago

Manager, Claims Vendor Management Pie Insurance Holdings Inc

Remote

$110,000–$140,000 / year

This role manages Claims vendor relationships including managed care services (medical bill review, pharmacy benefit management, utilization review, provider networks), legal vendors (law firms and litigation support), investigative services, support vendors (transportation, translation), and API-integrated technology vendors. The Manager, Claims Vendor Management leads Pie''s Claims Vendor Management program for assigned strategic claims vendors, with a strong focus on oversight of managed care program vendors.

9 days ago

Claims Assistant - Litigation Mitsui Sumitomo Insurance Company Of America

Los Angeles, CA

$45,000–$55,000 / year

The Claims Assistant - Litigation provides combined operational, administrative, and legal-support services to the Financial Lines and Cyber Claims teams, with additional support for Trade Credit & Political Risk and Environmental claims as business needs require. Coordinate with claims professionals, Claims Operations, coverage counsel, defense counsel, brokers, vendors, and other stakeholders; escalate items requiring legal, coverage, management, or claims-handling judgment.

12 days ago

Manager Claims ICW Group

Woodland Hills, CA

$104,125.20–$175,599.98 / year

These responsibilities include interviewing, hiring, and training employees; planning, assigning, and directing work; conducting performance and salary reviews; rewarding and disciplining employees; addressing complaints and resolving problems; coaching, mentoring, and developing team members to further their skills and knowledge; creating and monitoring development plans; setting performance expectations/goals; forecasting staffing needs and planning for peak times and absences; enforcing department policies and procedures. Headquartered in San Diego with regional offices located throughout the United States, ICW Group has been named for the twelfth consecutive year in a row and for the 20th time overall as a Top 50 performing P&C organization offering the stability of a large, profitable and growing company combined with a focus on all things people.

12 days ago

Senior Claims Specialist- Workers'''' Compensation Great American Insurance Company

California, CA

Remote

$105,000–$125,000 / year

This role is responsible for investigating claims, determining compensability, establishing reserves, negotiating settlements, and developing strategies that drive effective claim resolution. We take an extremely aggressive and proactive approach to claims adjusting and are looking for a person who not only knows their jurisdiction's comp laws but also enjoys the role of putting that experience to good use.

12 days ago

Associate Bond Claims Litigation Representative Tokio Marine HCC

Los Angeles, California

$28.46–$42.72 / hour

Tokio Marine HCC – Surety Group, a member of the Tokio Marine Group of Companies, has an opportunity for Associate Bond Claims Litigation Representative at our Los Angeles, CA branch office. Knowledgeable of industry changes, legal updates, and technical developments related to applicable area of the Company's business to proactively respond to changing business environment.

9 days ago

Property General Claims Adjuster - Field USAA

Los Angeles, California

$82,420–$162,550 / year

As a dedicated Property General Adjuster, you will work within defined guidelines and framework to investigate, evaluate, negotiate and settle the highest complexity property insurance claims presented by or against our members. Supports workload surges and/or Catastrophe (CAT) operations as needed to include working significant overtime; may require deployment travel during designated CATs.

6 days ago

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Claims Jobs in Venice, CA

Reinsurance/Stoploss Medical Claims Adjustor CVS Health Corp

Claims Specialist I - Provider Claims Inland Empire Health Plan

RCIS Crop Claims Specialist or Claims Crop Field Adjuster CA Zurich Insurance Group Ltd

Claims Examiner I Workers Compensation I CA experience Sedgwick Claims Management Services, Inc.

Claims (Billing) Specialist / Patient Account Representative - Healthcare Guidehouse Inc

Claims Supervisor Hankey Group External

Complex Claims Consulting Director - Mass Tort Unit CNA Financial Corp.

Senior Claims Specialist, Auto & Liability Mitsui Sumitomo Insurance Company Of America

Complex Claims Advisor | Workers Compensation California Expert | OSIP Licensing | Litigation Strategy & Resolution Sedgwick Claims Management Services, Inc.

Complex Claims Consultant - Professional Liability (Architects & Engineers) CNA Financial Corp.

Claims Trainer Next Insurance Inc

Claims Examiner - Workers'''' Compensation (Remote) ICW Group

Sr. Casualty Claims Examiner Construction Defect Howden Group Holdings Ltd

Senior Casualty Claims Examiner Construction Defect Howden Group Holdings Ltd

Manager, Claims Vendor Management Pie Insurance Holdings Inc

Claims Assistant - Litigation Mitsui Sumitomo Insurance Company Of America

Manager Claims ICW Group

Senior Claims Specialist- Workers'''' Compensation Great American Insurance Company

Associate Bond Claims Litigation Representative Tokio Marine HCC

Property General Claims Adjuster - Field USAA

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