Claims Delegations Oversight Specialist MedPOINT ManagementClaims Delegations Oversight SpecialistSherman Oaks, CARemoteFull timeMedPOINT Management is a leading Independent Practice Association (IPA) management company serving the greater Los Angeles area, with decades of experience supporting physician organizations and health plan partnerships. Our clients trust us for our deep expertise in managed care operations, and our employees value the collaborative, mission-driven culture we've built.
Workers Compensation Claims Handler IV Zurich Insurance Group LtdWorkers Compensation Claims Handler IVCARemoteTo handle Workers' Compensation claims of moderate to high exposure and complexity within specific authority limits, to ensure that claims are handled in the most efficient, effective way while delivering a customer-centric claims service. Ability to determine the scope and exposure for moderate to complex claimsAbility to leverage knowledge of industry trends and relationships to provide high-quality customer service.
Business Technology Strategy Lead - Claims, Finance, HR, Legal & Compliance L.A. Care Health PlanBusiness Technology Strategy Lead - Claims, Finance, HR, Legal & ComplianceLos Angeles, CAThe TPM II applies functional healthcare systems knowledge to ensure solutions meet business intent and regulatory requirements, leverages data to measure outcomes and validate hypotheses, and promotes disciplined product management practices within the domain. Collaborates with IT and business partners to ensure solutions within the domain comply with Health Insurance Portability and Accountability Act (HIPAA), Centers for Medicare and Medicaid Services (CMS), Department of Health Care Services (DHCS), and other relevant regulatory requirements.
Senior Technical Claims Specialist Argo Group International Holdings IncSenior Technical Claims SpecialistLos Angeles, CA$173,706–$208,386 / yearEssential Responsibilities: Working with limited oversight under broad management direction, adjudicate highly complex claims and insurance coverage disputes mostly for our professional liability line of business, at the highest authority limits on assignments reflecting the highest degree of technical complexity and coordination in liability and litigated claims, potentially with major impact on departmental results. Qualifications / Experience Required: A deep knowledge of claims adjudication and focus on customer service typically achieved through: At least seven years' experience handling insurance coverage issues and disputes, with exposure of $100,000 or more, for Professional Liability claims.
NewClaims Consultant - Cyber - E&O (Hybrid) Intact InsuranceClaims Consultant - Cyber - E&O (Hybrid)Anaheim, CA$143,000–$167,000 / yearWe currently have an opportunity for a Claim Consultant to join our Cyber- E&O team based in our New York City, NY; Chicago, IL; Plymouth, MN; Boston, MA; Canton, MA; Anaheim, CA; Irvine, CA; Denver, CO offices on a hybrid schedule. In return, we promise you support, opportunities and performance-led financial rewards in a flexible work environment where you can: Shape the future: Help us lead an insurance transformation to better protect people, businesses and society.
Claims Analyst/Paralegal Clyde & CoClaims Analyst/ParalegalLos Angeles, CaliforniaOur hiring practice group represents international and domestic insurers in complex insurance coverage and insurance coverage litigation matters in a broad range of liability and first party policies, including energy and construction insurance, concert and event cancellation insurance, as well as disability insurance for athletes and high net worth individuals. The range for this role takes into account the wide range of factors that are considered in making compensation decisions including but not limited to skill sets; experience and training; licensure and certifications; and other business and organizational needs.
Sr Claims Clerk Crawford & CoSr Claims ClerkCATo determine the actual offer, Crawford considers a wide range of factors including the candidate's previous experience and education, market rates, minimum pay requirements for the applicable jurisdiction, business segment, supply/demand, and scheduled hours. All resumes submitted by search firms to any employee at Crawford via-email, the Internet or in any form and/or method without a valid written Statement of Work in place for this position from Crawford HR/Recruitment will be deemed the sole property of Crawford.
Patient Account Representative - Physician Claims Guidehouse IncPatient Account Representative - Physician ClaimsEl Segundo, CA$34,000–$56,000 / yearThe Patient Account Representative has an extensive knowledge of billing, accounts receivable follow-up, timely filing guidelines and the ability to effectively review remittance advices and electronic billing reports from payer to determine the action required. 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.
Claims (Billing) Specialist / Patient Account Representative - Healthcare Guidehouse IncClaims (Billing) Specialist / Patient Account Representative - HealthcareEl Segundo, CA$38,000–$64,000 / yearRepresentatives 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.
Claims Development Specialist Xifin IncClaims Development SpecialistWestlake Village, CA$20–$24 / hourThe Claims Development Specialist is responsible for specific geographic locations, ensuring accurate conversion of files, demographic posting, charge posting and clean up, and review of all outstanding data is completed daily. Our innovative technologies help diagnostic providers, laboratories, and healthcare systems manage complexity, drive better outcomes, and stay focused on what matters most: patient care.
Claims Clinical Specialist Genworth Financial IncClaims Clinical SpecialistCAYou will be responsible for communicating with medical personnel at Long Term Care Facilities, Home Care Agencies, and/or individuals by conducting telephonic assessments for claimants to develop the plan of care and provide tax qualified certifications as required by the policy. At least two years' experience working in a role that required an understanding of single and cumulative medical conditions (particularly those common in the aging process), including their effect on physical/cognitive function, as well as their prognosis and rehabilitative potential.
Sr. 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.
Claims Counsel Capital Insurance GroupClaims CounselLos Angeles, CARemote$114,364–$190,607 / yearResponsible for consultation with claims staff in a variety of claims issues, including but not limited to, coverage, indemnification, policy limit demand reviews, indemnity agreement review, release language review. Under general supervision, this position will be part of the Claims Legal team, which will provide settlement authority and general strategic support for claims/exposures that exceed the line unit’s authority.
Claims Specialist Lead The Progressive CorpClaims Specialist LeadWoodland Hills, CA$39.18–$51.92 / hourFor 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/ . As a claims specialist on our team, you'll play a critical role in our ability to successfully and efficiently resolve large-loss injury claims valued over $60k.
Sr. 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.
Claims Representative- Healthcare Billing Vista Del MarClaims Representative- Healthcare BillingLos Angeles, California$28–$30 / hourIf 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.
Senior 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.
Senior Construction Defect Technical Claims Specialist BP&CSenior Construction Defect Technical Claims SpecialistLos Angeles, CaliforniaRemoteBoston metro area, California outside of Los Angeles & San Francisco metro area, Connecticut, Chicago metro area, Denver metro area, New Jersey (outside of New York City metro area), New York State (outside of New York City metro area, including but limited to Albany county), Washington, D. C. Working under limited oversight under broad management direction, adjudicate construction defect claims at the highest authority limits on assignments reflecting the highest degree of technical complexity, potentially with major impact on departmental results.
Content Claims Specialist - Field - Level I Crawford & CoContent Claims Specialist - Field - Level IPasadena, CARemoteTo determine the actual offer, Crawford considers a wide range of factors including the candidate's previous experience and education, market rates, minimum pay requirements for the applicable jurisdiction, business segment, supply/demand, and scheduled hours. Communicate with adjusters/policyholders and industry vendors to explain their roles as Content Claims Specialists and their respective roles/contributions in the claims handling process.
Senior Claims Manager EPL - Remote Providence St. Joseph HealthSenior Claims Manager EPL - RemoteLos Angeles, CARemoteTogether, 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. Candidate must possess strong communication and litigation management skills to collaborate with business partners and defense counsel to direct litigation activities and claim outcomes while considering the overall impact to the company and individual stakeholders.