Claims Supervisor Health Source MSOClaims SupervisorAlhambra, CAFull timeProviding expertise or general claims support to teams in reviewing, researching, investigating, negotiating, process, and adjusting claims. Responsibilities include, but not limited to: • Maintain up-to-date knowledge of procedures for all ICD-10, CPT, HCPC codes including: Contractual agreement rates.
Claims Adjuster Kinetic Personnel GroupClaims AdjusterMonrovia, CA$55,000–$75,000 / yearTemporaryThe ideal candidate has a strong understanding of coverage analysis, liability evaluation, and California insurance regulations, and is able to resolve claims efficiently and fairly. This role is responsible for providing high-quality customer service while managing a volume of property damage claims.
NewClaims Examiner - Workers Compensation (Hourly) IconmaClaims Examiner - Workers Compensation (Hourly)Brea, CA$43–$48 / hourResponsibilities: 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. Manages claim recoveries, including but not limited to: subrogation, Second Injury Fund excess recoveries and Social Security and Medicare offsets.
Claims 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.
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.
NewQuality Control Supervisor JobotQuality Control SupervisorLos Angeles, CA$75,000–$110,000 / yearInformation collected and processed as part of your Jobot candidate profile, and any job applications, resumes, or other information you choose to submit is subject to Jobot's Privacy Policy, as well as the Jobot California Worker Privacy Notice and Jobot Notice Regarding Automated Employment Decision Tools which are available at jobot.com/legal. Corrective Actions and Continuous Improvement: Identify non-compliant practices on the production floor, propose corrective actions, and collaborate with production leaders to implement improvements.
Environmental, Health & Safety Supervisor JobotEnvironmental, Health & Safety SupervisorVernon, CA$95,000–$125,000 / yearInformation collected and processed as part of your Jobot candidate profile, and any job applications, resumes, or other information you choose to submit is subject to Jobot's Privacy Policy, as well as the Jobot California Worker Privacy Notice and Jobot Notice Regarding Automated Employment Decision Tools which are available at jobot.com/legal. We are a well-established and growing food manufacturing organization and a trusted provider of high-quality poultry and meat products across the United States.
Insurance Unit Manager/Supervisor GEICOInsurance Unit Manager/SupervisorSan Diego, CA$77,900–$133,250Bachelor's or Associate's degree with 2+ years of supervisory experience OR a minimum of 4 years of supervisory experience in lieu of a degree (high school diploma or equivalent required). Factors include, but are not limited to, the scope and responsibilities of the role, the selected candidate’s work experience, education and training, the work location as well as market and business considerations.
NewEnvironmental Health and Safety Supervisor JobotEnvironmental Health and Safety SupervisorCity of Industry, CA$80,000–$100,000 / yearInformation collected and processed as part of your Jobot candidate profile, and any job applications, resumes, or other information you choose to submit is subject to Jobot's Privacy Policy, as well as the Jobot California Worker Privacy Notice and Jobot Notice Regarding Automated Employment Decision Tools which are available at jobot.com/legal. A nationally recognized organization in the foodservice and supply chain industry delivers a broad portfolio of products and support services to a diverse customer base.
NewMedical Billing Specialist JobotMedical Billing SpecialistLos Angeles, CA$25–$29 / hourInformation collected and processed as part of your Jobot candidate profile, and any job applications, resumes, or other information you choose to submit is subject to Jobot's Privacy Policy, as well as the Jobot California Worker Privacy Notice and Jobot Notice Regarding Automated Employment Decision Tools which are available at jobot.com/legal. This role is responsible for preparing, reviewing, and submitting claims, resolving denied or unpaid claims, and maintaining compliance with local, state, and federal billing regulations.
NewHR & Payroll Administrator NucorHR & Payroll AdministratorLos Angeles, CA$23.51–$27.22 / hourWeekly processing of payroll activities; preparation, filing, and reconciliation of quarterly/ annual federal and state tax returns; month-end, quarter-end and year-end closing; preparing W2s; and wage garnishment processing. This role is responsible for providing excellent customer service and a wide range of payroll support to our team members while maintaining the confidentiality and integrity of the payroll data.
NewEnvironmental Heath & Safety Leader - Food Manufacturing Newport Meat CompanyEnvironmental Heath & Safety Leader - Food ManufacturingIRVINE, CAThe role aims to accomplish the following: Supporting their sites in executing on various EHS processes including: EHS-related training, environmental compliance, occupational health and safety, workers’ compensation, transportation safety, contractor management, and business continuity. Support the workers’ compensation claims process by completing OSHA determinations, identifying gaps in claims management, and promoting safe and early return to work as well as any other requirements related to general liability, motor vehicle, and property damage claims.
NewClaims 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.
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 Supervisor Hankey Group ExternalClaims SupervisorLos 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. 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.
Claims Supervisor Athens AdministratorsClaims SupervisorLos Angeles, CaliforniaATHENS POSITION DETAILS Position Title: Claims Supervisor Department: Workers’ Compensation Reports To: Division Claims Manager FLSA Status: Exempt Job Grade: 14 Career Ladder: Next step in progression could include Division Claims Manager ATHENS ADMINISTRATORS Explore the Athens Administrators difference: We have been dynamic, innovative leaders in claims administration since our founding in 1976. Provide direct supervision for 6-10 employees, typically consisting of Senior Claims Examiners, Future Medical Claims Examiners, Claims Examiners, Assistant Claims Examiners and Assistant Claims Examiner Trainees.
California Workers' Compensation Claims Supervisor | Remote King'S Insurance StaffingCalifornia Workers' Compensation Claims Supervisor | RemoteCaliforniaRemoteThis individual will be responsible for leading and mentoring a team of California Workers' Compensation Claims Examiners while providing technical guidance, oversight, and support on moderate to complex Lost Time/Indemnity claims. Qualified candidates must possess extensive knowledge of California Workers' Compensation laws and regulations, along with prior leadership or supervisory experience.
NewClaims Supervisor GallagherClaims SupervisorOakland, CaliforniaRemoteFull timeAbility to actively review work of others via file reviews; identify coaching opportunities, act on needed coaching opportunities and position subordinates for successful development leading to advancement within the organization. As part of Gallagher, a global leader in insurance, risk management, and consulting, you’ll be joining a team that’s passionate about helping individuals and organizations thrive.
Claims Team Lead (Supervisor) - Workers Compensation | Brea, CA Sedgwick Claims Management Services, Inc.Claims Team Lead (Supervisor) - Workers Compensation | Brea, CABrea, CA$105,000–$118,000 / 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 Supervisor, Workers' Compensation GallagherClaims Supervisor, Workers' CompensationCorona, CaliforniaRemoteFull timeEnsures flawless and consistent execution of client service instructions and performance guarantees Ability to actively review work of others via file reviews; identify coaching opportunities, act on needed coaching opportunities and position subordinates for successful development leading to advancement within the organization. We are seeking an experienced Claims Supervisor to provide leadership, technical oversight, and operational guidance within our Workers’ Compensation claims department.
Claims Supervisor Workers Compensation GallagherClaims Supervisor Workers CompensationSacramento, CaliforniaRemoteFull timeHow you'll make an impact : Supervise: Lead and encourage a Workers Compensation claims team handling a variety of caseload sizes and complexities to deliver high-quality and efficient service. Prioritize and Develop: Effectively manage multiple competing priorities, identify coaching opportunities, and position team members for successful development.
Supervisor, Oversight (Payment Integrity Claims Audit) Molina Healthcare IncSupervisor, Oversight (Payment Integrity Claims Audit)CALeads and supervises team responsible for configuration Oversight 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 auditing of 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.
Claims Administrative Supervisor Zenith Insurance CompanyClaims Administrative SupervisorDublin, CA$85,736–$107,170 / 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. Ensure timely workflow and prioritization of clerical tasks, management of diary, and the appropriate training or matching of task complexity to staff capabilities.
Supervisor, Claims Zenith American SolutionsSupervisor, ClaimsSan Francisco, CAFull timeZenith American Solutions is the largest independent Third Party Administrator in the United States and currently operates over 44 offices nationwide. We are currently looking for a dedicated, energetic employee with the necessary skills, initiative, and personality, along with the desire to get the most out of their working life, to help us be our best every day.
Workers' Compensation Claim Supervisor CCMSIWorkers' Compensation Claim SupervisorConcord, CaliforniaRemote$90,000–$100,000 / yearResponsibilities: When we hire supervisors at CCMSI, we look for people-leaders who recognize that every claim impacts a real person’s livelihood, hold themselves and their teams accountable for results, and approach challenges as opportunities to develop others and drive excellence. At CCMSI, we partner with global clients to solve their most complex risk management challenges, delivering measurable results through advanced technology, collaborative problem-solving, and an unwavering commitment to their success.
Supervisor Property Claims Branch Mercury Insurance CompanySupervisor Property Claims BranchRancho Cucamonga, CA$94,458–$179,048 / yearAs a supervisor your role is to provide inspired leadership, technical and administrative oversight for a team of claims adjusters/examiners responsible for the adjudication and settlement of minor to moderate complexity first party property claims through efficient and compassionate service. Position Summary: If you're passionate about helping people restore their lives when the unexpected happens to their homes and providing the best customer experience, then our Mercury Insurance Property Claims team could be the place for you!
Supervisor Property Claims Branch Mercury Insurance Services, LLCSupervisor Property Claims BranchRancho Cucamonga, California$94,458–$179,048 / yearAs a supervisor your role is to provide inspired leadership, technical and administrative oversight for a team of claims adjusters/examiners responsible for the adjudication and settlement of minor to moderate complexity first party property claims through efficient and compassionate service. If you’re passionate about helping people restore their lives when the unexpected happens to their homes and providing the best customer experience, then our Mercury Insurance Property Claims team could be the place for you!
Customer Service Representative Health Source MSOCustomer Service RepresentativeAlhambra, CAFull timeAbility to work regularly scheduled shifts within our hours of operation including the training period, where lunches and breaks are scheduled, with the flexibility to adjust daily schedule, and work over-time as needed. Review and research incoming healthcare claims from members and providers(doctors, clinics, etc) by navigating multiple computer systems and platforms and verifies the data/information necessary for processing (e.g.
Claims Examiner I HCC Service CompanyClaims Examiner IEncino, CaliforniaThe 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. As an insurance company, we comply with certain federal, state and local laws such as the Violent Crime Control and Law Enforcement Act of 1994 (18 USC § 1033(e)), which restricts our ability to employ individuals with certain types of criminal convictions.
Casualty Claims Manager, Ag Zenith Insurance CompanyCasualty Claims Manager, AgRoseville, CA$103,741–$149,552.68 / yearFrom dairies to berries, from almonds to wine, from vegetables to cattle ranches, we recognize the importance of agriculture and the effort it takes to compete in the global agriculture industry. Strengthens team performance by developing new initiatives, efficient processes and procedures to deliver exception claims service according to customer needs and industry trends.
Claims Adjuster II/Senior Claims Adjuster (Senior Workers' Compensation Claims Adjuster) County of Riverside, CaliforniaClaims Adjuster II/Senior Claims Adjuster (Senior Workers' Compensation Claims Adjuster)Riverside, CA$112,778.77–$159,740.22 / yearKnowledge of: State of California Labor Code, Workers Compensation Law and rules and regulations (Title 8); Applicable case law of leading decisions of the Workers Compensation Appeals Board, Court of Appeals, and Supreme Court regarding workers compensation cases; Medical terminology, anatomy and technical terminology used in medical and legal fields regarding industrial cases; Jurisdiction, functions and procedures of the Workers Compensation Appeals Board; Vocational rehabilitation and procedures as it applies to Workers Compensation; Reserving practices and procedures; in-house litigation procedures; WCAB procedures; and hearing processes. Candidates must have achieved the level of Experienced Claims Adjuster (as defined by California Code of Regulations, Title 10, Chapter 5, Subchapter 3) defined as possessing one of the following: 1) Working 5 out of the last 8 years as a California Workers Comp Claims Adjuster, 2) Has worked continuously in California adjusting claims since passing the Self-Insurance Test, or 3) Has passed the Self-Insurance test in the last 2 years.
Workers Compensation Claims Team Lead | Roseville, CA or Long Beach, CA, Sedgwick Claims Management Services, Inc.Workers Compensation Claims Team Lead | Roseville, CA or Long Beach, CA,Long Beach, CAMental: 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. Workers Compensation Claims Team Lead | Roseville, CA or Long Beach, CA, Are you looking for an opportunity to join a global industry leader where you can bring your big ideas to help solve problems for some of the world's best brands?.
Claims Team Lead - Workers Compensation | Roseville, CA or San Diego, CA Sedgwick Claims Management Services, Inc.Claims Team Lead - Workers Compensation | Roseville, CA or San Diego, CARoseville, CA$105,000–$115,000 / 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 (HYBRID- Roseville, CA) Sedgwick Claims Management Services, Inc.Claims Team Lead - Workers Compensation (HYBRID- Roseville, CA)Roseville, CA$95,000–$100,000 / 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. Provides technical and jurisdictional guidance on claims adjudication, including quality reviews and reserve evaluations for high-cost or complex claims.
Claims Examiner I HCC Life Insurance CompanyClaims Examiner IEncino, CA$46,600–$69,800 / yearThe 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. As an insurance company, we comply with certain federal, state and local laws such as the Violent Crime Control and Law Enforcement Act of 1994 (18 USC § 1033(e)), which restricts our ability to employ individuals with certain types of criminal convictions.
Medical Claims Examiner Ultimate Staffing ServicesMedical Claims ExaminerPasadena, California$21–$29 / hourThis role ensures accurate and timely processing of claims while maintaining compliance with federal and state regulations and providing high‑quality service to providers and members. The Medical Claims Examiner is responsible for reviewing, analyzing, and adjudicating medical insurance claims in accordance with policy provisions, regulatory guidelines, and organizational procedures.
Senior Claims Examiner Athens AdministratorsSenior Claims ExaminerConcord, CaliforniaATHENS POSITION DETAILS Position Title: Senior Claims Examiner Department: Workers’ Compensation California Reports To: Claims Supervisor FLSA Status: Non-Exempt Job Grade: 12 Career Ladder: Next step in progression could include Lead Senior Claims Examiner or Claims Supervisor ATHENS ADMINISTRATORS Explore the Athens Administrators difference: We have been dynamic, innovative leaders in claims administration since our founding in 1976. POSITION SUMMARY Athens Administrators has an immediate need for a full-time Senior Claims Examiner to support our workers compensation offices and can be located anywhere in the state of California, however, employees who live less than 26 miles from the Concord, CA or Orange, CA offices are required to work once a week in the office on a day determined by their supervisor between Tuesday – Thursday.
Bilingual Senior Claims Examiner Athens AdministratorsBilingual Senior Claims ExaminerCaliforniaATHENS POSITION DETAILS Position Title: Bilingual Senior Claims Examiner Department: Workers’ Compensation Reports To: Claims Supervisor FLSA Status: Non-Exempt Job Grade: 12 Career Ladder: Next step in progression could include Lead Senior Claims Examiner or Claims Supervisor ATHENS ADMINISTRATORS Explore the Athens Administrators difference: We have been dynamic, innovative leaders in claims administration since our founding in 1976. POSITION SUMMARY Athens Administrators has an immediate need for a full-time Bilingual Senior Claims Examiner to support our workers compensation offices and can be located anywhere in the state of California, however, employees who live less than 26 miles from the Concord, CA or Orange, CA offices are required to work once a week in the office on a day determined by their supervisor between Tuesday – Thursday.
Senior Claims Examiner - Spanish Preferred Athens AdministratorsSenior Claims Examiner - Spanish PreferredLos Angeles, CaliforniaATHENS POSITION DETAILS Position Title: Bilingual Senior Claims Examiner Department: Workers’ Compensation Reports To: Claims Supervisor FLSA Status: Non-Exempt Job Grade: 12 Career Ladder: Next step in progression could include Lead Senior Claims Examiner or Claims Supervisor ATHENS ADMINISTRATORS Explore the Athens Administrators difference: We have been dynamic, innovative leaders in claims administration since our founding in 1976. POSITION SUMMARY Athens Administrators has an immediate need for a full-time Bilingual Senior Claims Examiner to support our workers compensation offices and can be located anywhere in the state of California, however, employees who live less than 26 miles from the Concord, CA or Orange, CA offices are required to work once a week in the office on a day determined by their supervisor between Tuesday – Thursday.
Senior Claims Examiner - Remote or Hybrid Athens AdministratorsSenior Claims Examiner - Remote or HybridOrange, CaliforniaRemoteATHENS POSITION DETAILS Position Title: Senior Claims Examiner Department: Workers’ Compensation California Reports To: Claims Supervisor FLSA Status: Non-Exempt Job Grade: 12 Career Ladder: Next step in progression could include Lead Senior Claims Examiner or Claims Supervisor ATHENS ADMINISTRATORS Explore the Athens Administrators difference: We have been dynamic, innovative leaders in claims administration since our founding in 1976. POSITION SUMMARY Athens Administrators has an immediate need for a full-time Senior Claims Examiner to support our workers compensation offices and can be located anywhere in the state of California, however, employees who live less than 26 miles from the Concord, CA or Orange, CA offices are required to work once a week in the office on a day determined by their supervisor between Tuesday – Thursday.
Senior Claims Examiner - 4850 Athens AdministratorsSenior Claims Examiner - 4850Orange, CaliforniaATHENS POSITION DETAILS Position Title: Senior Claims Examiner Department: Workers’ Compensation California Reports To: Claims Supervisor FLSA Status: Non-Exempt Job Grade: 12 Career Ladder: Next step in progression could include Lead Senior Claims Examiner or Claims Supervisor ATHENS ADMINISTRATORS Explore the Athens Administrators difference: We have been dynamic, innovative leaders in claims administration since our founding in 1976. The Senior Claims Examiner will adjust police and fire 4850 workers’ compensation claims from inception through settlement and closure, ensuring timely processing of claims and payment of benefits, managing, and directing medical treatment, setting reserves, and negotiating settlements.
Commercial Claims Strategy Manager WCF InsuranceCommercial Claims Strategy ManagerRoseville, CA$101,000–$125,000 / yearFull timeThis role leads training, strategy, and compliance efforts for WCF's commercial claims operation, helping ensure consistent claim handling, strong service, and continuous process improvement. WCF Insurance, an "A" rated carrier growing throughout the western states, has an immediate opening for a Commercial Claims Strategy Manager to join our Claims Strategy team.
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.
APeX Claims Analyst UCSF Medical CenterAPeX Claims AnalystSan Francisco, CAYesWorks on complex initiatives to analyze patient care workflow in various clinical departments, and to develop and define information technology solutions for improved system integration and functionality. Ability to work with senior staff and managers, serving as a technical resource and providing advice and counsel on issues of functionality, efficiency, cost-effectiveness, policy, and performance.
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 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 Assistant Argo Group International Holdings IncSenior Claims AssistantLos Angeles, CA$61,098–$71,094 / yearEssential Responsibilities: Under 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.
Managed Care Claims Assistant I Amtrust Financial Services IncManaged Care Claims Assistant IFresno, CA$20–$24 / hourProcess Utilization Review requests: performs data entry functions, reviews multiple criteria to determine eligibility of treatment requests, approves treatment requests based on authority level, refers treatment requests to a clinical resource or sends appropriate response level. Transfers any/all calls where there is clinical information being provided (or a clinically related question surfaces) to a registered nurse for response - Licensed staff are always available to assist non-clinical staff while they are attempting to obtain information.
NewClaims Quality Auditing Specialist IV Kaiser PermanenteClaims Quality Auditing Specialist IVSacramento, CAContributes to efforts to monitor and optimize system improvements by: identifying issues and working with supervisors and other team members to investigate department-wide issues impacting metrics related to pricing, billing, cost containment, and benefit compliance; identifying technology and operational process efficiencies and providing feedback on solutions to improve workforce management and claims processing accuracy; and making changes to policy and implementing strategies to improve internal processes and controls and ensure that assigned processes meet regulatory guidelines as specified by all relevant regulatory agencies. Contributes to compliance working processes by: using advanced knowledge of business practices to work with management and develop training requirements for internal claims team in response to changes in policies, procedures, or findings and trends in claims processing; reviewing and/or participating in the development of instructional material for team members and department stakeholders with limited direction; and participating in approved trainings on topics related to claims systems, processes, data, and policies as instructed.
Claims Analyst I General Dynamics NASSCOClaims Analyst ISan Diego, CA$60,500–$90,800 / yearCommunicate with Claims Examiners, Claims Analysts, Workers' Compensation Admin Supervisor, Workers' Compensation Administrator, Workers' Compensation Manager, Workers' Compensation Assistants, Production, Human Resources, Medical Providers, Vendors, Attorneys, Injured workers, Department of Labor officials, and State WCAB officials. Progressively complete milestones toward assuming the role of Claims Examiner, including designated Workers' Compensation educational modules; company will pay 100% of approved tuition and provide required materials.