Patient Account Representative - Commercial Claims Guidehouse IncPatient Account Representative - Commercial ClaimsEl Segundo, CA$38,000–$64,000 / 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.
Claims Auditor Cohere Health Technologies LLCClaims AuditorCARemote$72,000–$82,000 / yearBacked by leading investors such as Deerfield Management, Define Ventures, Flare Capital Partners, Longitude Capital, and Polaris Partners, Cohere Health drives more transparent, streamlined healthcare processes, helping patients receive faster, more appropriate care and higher-quality outcomes. By unifying pre-service authorization data with post-service claims validation, we're creating a transparent healthcare ecosystem that reduces waste, improves payer-provider collaboration and patient outcomes, and ensures providers are paid promptly and accurately.
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.
NewNational Complex Claims Leader Marsh & McLennan Companies IncNational Complex Claims LeaderVan Nuys, CA$93,700–$174,800 / yearReporting to the SVP, National Claims Director, you will serve as a senior resource and technical authority on complex and high-exposure claims, bringing deep expertise, strategic judgment, and a national perspective to drive resolution on complex, high-stakes commercial P&C claim situations across the organization. In this capacity, you will build and maintain strong relationships with national and regional leadership, industry vertical leaders, and Marsh Risk, ensuring MMA clients receive best-in-class advocacy at every level.
Associate Bond Claims Examiner HCC Life Insurance CompanyAssociate Bond Claims ExaminerLos Angeles, CA$29.44–$40.46 / hourTokio 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.
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.
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 Examiner - Workers Compensation eTeam Inc.Claims Examiner - Workers CompensationLong Beach, CA$45–$50 / hourPRIMARY PURPOSE: 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. 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.
Workers Compensation Claims Technician Liberty Mutual Holding Company IncWorkers Compensation Claims TechnicianLos Angeles, CAEffective analytical skills required to learn and apply basic policy/contract coverage and recognize questionable coverage/contract situations (which necessitate supervisory involvement) along with effective interpersonal skills to explain the facts and logic used to arrive at decisions in a way that the customer understands. Verifies information from claimants, physicians, and medical providers to assess compensability and/or causal relation of medical treatment, and make evaluations for cases with claim specific on-going medical management.
Claims Resolution Specialist Edison InternationalClaims Resolution SpecialistRosemead, CACommunicates with policyholders, witnesses, and claimants in order to gather information regarding claims, refers tasks to auxiliary resources as necessary, and advises as to proper course of action. Once hired, the candidate must complete specified training prior to gaining un-escorted access to assigned work location and performing necessary job duties.
Claims Examiner - Workers Compensation Iconma LLCClaims Examiner - Workers CompensationLong 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. 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.
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.
Claims Examiner City of Compton CAClaims ExaminerCompton, CA$79,747.80–$93,499.20 / yearEducation and Experience: Possession of a Bachelor's degree from an accredited college or university in Business Administration or a related field, AND two (2) years of experience adjusting workers' compensation claims with a public agency or third-party administrator; OR an equivalent combination of education and experience. In all entrance examinations (open-competitive only) for positions in the Classified Service, veterans who served in the armed forces of the United States during time(s) of war, and who attain an overall passing score in the examination are allowed additional preferential credit in accordance with the Personnel Rules and Regulations.
Senior Claims & Participant Services Specialist Ultimate Staffing ServicesSenior Claims & Participant Services SpecialistBurbank, California$55,000–$65,000 / hourThis highly visible role serves as a key point of contact for health plan participants, providers, hospitals, and physicians while also supporting process improvement initiatives across claims operations. This position offers the opportunity to make a meaningful impact by improving participant experiences, resolving complex claims issues, and contributing to operational excellence.
Supervisor, Medicare Claims Clever Care Health PlanSupervisor, Medicare ClaimsHuntington Beach, CA5% - Facilitates and creates a team environment within the unit and with other departments; runs regular unit meetings, attends monthly claims review meetings and/or Clever Care meetings, as appropriate, in order to ensure effective communication between team members and disciplines. Participates in interviewing and hiring of new staff and facilitates or conducts effective onboarding and orientation for new employees; coordinates with the Manager for development of formal training programs; assigns staff to special projects and oversees workflow and workload of staff.
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 Manager - Risk Management Live Nation Entertainment IncClaims Manager - Risk ManagementCA$104,000–$130,000 / yearCollaborates with in-house and outside legal counsel to assure proper handling of litigated files as well as coordination of discovery including but not limited to gathering pertinent legal information and claims documentation, deposition requests, identification and preparation of witnesses and other discovery, as well as assists in developing overall defense strategy. Ability to work autonomously to a significant degree, have a high level of attention to detail, be organized and efficient and able prioritize and successfully manage multiple projects, enjoy working in a fast-paced environment, and place a high value on providing exceptional and timely service to internal and external clients.
Specialist, Claims Recovery (Remote) Molina Healthcare IncSpecialist, Claims Recovery (Remote)CARemoteResearches simple to complex claims payments using tools such as Department of Health and Human Services (DSHS) and Medicare billing guidelines, Molina claims processing policies and procedures, and other resources to validate overpayments made to providers. Enters and updates recovery applications and claim systems for multiple states and prepares/creates overpayment notification letters with accuracy; processes claims as a refund or auto debit in claim systems and in recovery application.
Staff Counsel, Claims Amtrust Financial Services IncStaff Counsel, ClaimsCA$115,000–$180,000 / yearSalaries are based upon a wide range of factors considered in making the compensation decision, including, but not limited to, candidate skills, experience, education and training, the scope and responsibilities of the role, as well as market and business considerations. Ideal candidates bring experience in WC litigation, strong advocacy skills, and a desire to contribute to a supportive, high-performing legal environment.
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.