Property & Casualty Insurance Claims Operations Consultant, Manager PricewaterhouseCoopers LLPProperty & Casualty Insurance Claims Operations Consultant, ManagerLos Angeles, CA$99,000–$232,000 / yearPwC does not intend to hire experienced or entry level job seekers who will need, now or in the future, PwC sponsorship through the H-1B lottery, except as set forth within the following policy: https://pwc.to/H-1B-Lottery-Policy . You will analyze client needs, implement solutions, and provide training and support to validate seamless integration and utilization of business applications, enabling clients to achieve their strategic objectives.
Vice President, Litigation & Claims Foxstone RecruitingVice President, Litigation & ClaimsBeverly Hills, CAOur client, a vertically integrated private real estate investment and property management firm headquartered in Beverly Hills, California, is seeking a senior litigation attorney to lead their litigation and claims function as Vice President, Litigation & Claims in either their Los Angeles or Dallas office. They're seeking a person who will manage the full lifecycle of claims arising at our properties, selecting and directing outside counsel, partnering with insurance carriers on the handling and resolution of claims, and overseeing eviction matters across all nine states in which they operate.
Manager, Claims Operations (Field) USAAManager, Claims Operations (Field)Los Angeles, California$122,650–$220,770 / yearCandidates who are willing and able to work in the San Fernando Valley, CA region to include Burbank, Beverly Hills, Van Nuys, Thousand Oaks, Oxnard, Santa Barbara, and North Hollywood are encouraged to apply. This role manages and is accountable for auto operations member service employees who are responsible for serving our members, and providing appropriate solutions as they investigate, evaluate and negotiate the claim.
Sr. Medical Claims Processor Ultimate Staffing ServicesSr. Medical Claims ProcessorPasadena, California$24–$29 / hourEnsure accuracy of claim details, including patient information, coding (ICD-10, CPT, HCPCS), and billing data prior to submission. Investigate and resolve denied, rejected, or pending claims by working with providers, payers, and internal departments.
Medical Claims Examiner Ultimate Staffing ServicesMedical Claims ExaminerPasadena, California$26–$29 / hourWe are seeking an experienced Medical Claims Examiner to review, analyze, and adjudicate medical claims for accuracy, compliance, and medical necessity. Identify coding discrepancies, overpayments, and potential fraud or abuse.
Claims Examiner I Tokio Marine HCCClaims 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.
Managing Director Strategic Claims Oversight - Healthcare Severity CNA Financial CorpManaging Director Strategic Claims Oversight - Healthcare SeverityLos Angeles, CA$97,000–$189,000 / yearDevelops and maintains collaborative working relationships with internal and external business partners including Operations, Underwriting, Actuary and Risk Control and regularly shares claims outcomes, trends, legal developments and other relevant business updates. Responsible for the ongoing management of staff by attracting talent, setting clear direction, providing appropriate guidance, managing performance, recognizing contributions, and developing capabilities.
Claims Team Leader Allstate Insurance CompanyClaims Team LeaderCA$80,000–$136,625 / yearThe Claims Team Leader is responsible for providing our Agents exceptional claims and inquiry service through chat while managing and motivating ten to fifteen adjuster staff or vendors to achieve inspired levels of performance and expert execution of required claim processes. Through our subsidiaries, we provide a variety of insurance products, including personal and commercial automobile, homeowners, umbrella, recreational vehicle, supplemental health, lender-placed and other niche insurance products.
Complex Claims Consultant/Specialist - Lawyers Professional Liability CNA Financial Corp.Complex Claims Consultant/Specialist - Lawyers Professional LiabilityLos Angeles, CA$72,000–$141,000 / yearPerforms 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.
Complex Claims Consultant - Hospitals , Allied Facilities and Physicians CNA Financial CorpComplex Claims Consultant - Hospitals , Allied Facilities and PhysiciansLos Angeles, CA$72,000–$141,000 / yearPerforms a combination of duties in accordance with departmental guidelines: Manages an inventory of highly complex healthcare 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.
Complex Claims Consulting Director - Mass Tort Unit CNA Financial CorpComplex Claims Consulting Director - Mass Tort UnitLos Angeles, CA$97,000–$189,000 / yearManages 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.
Major Litigation Unit Complex Claims Consulting Director CNA Financial Corp.Major Litigation Unit Complex Claims Consulting DirectorLos Angeles, CA$97,000–$189,000 / yearJOB DESCRIPTION: Essential Duties & Responsibilities: Performs a combination of duties in accordance with departmental guidelines: Manages an inventory of the most complex commercial claims, which are generally multi-year and have very 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 complex litigation management. Drives the resolution of 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.
Claims Consultant, Life Sciences CNA Financial CorpClaims Consultant, Life SciencesLos Angeles, CA$72,000–$141,000 / yearPerforms 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 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 complex manage litigation and authorizing payments within scope of authority.
NewManaged Care Contracting Manager Pennant Group IncManaged Care Contracting ManagerCARemote$95,000–$105,000 / yearEngage in complex levels of contract development and negotiation with managed care payors, including but not limited to managed care organizations, ACO's, health systems, hospitals, physician organizations and third-party administrators while working with the Legal and Finance teams in analyzing margins based on costs and rates for existing and newly acquired operations. Instead, they operate independently with support from the "Service Center," a world-class service team that provides the centralized clinical, legal, compliance, risk management, HR, training, accounting, IT, and other resources necessary to allow on-site leaders and caregivers to focus squarely on day-to-day care and business issues in their individual agencies.
Complex Claims Consultant - Medical Malpractice CNA Financial CorpComplex Claims Consultant - Medical MalpracticeLos Angeles, CA$72,000–$141,000 / yearPerforms 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.
General Liability Claims Specialist CNA Financial Corp.General Liability Claims SpecialistLos Angeles, CA$54,000–$103,000 / yearJOB DESCRIPTION: Performs a combination of duties in accordance with departmental guidelines: Manages an inventory of moderate to high complexity and exposure commercial claims by following company protocols to verify policy coverage, conduct investigations, develop and employ resolution strategies, and authorize disbursements within authority limits. Conducts focused investigation to determine compensability, liability and covered damages by gathering pertinent information, such as contracts or other documents, taking recorded statements from customers, claimants, injured workers, witnesses, and working with experts, or other parties, as necessary to verify the facts of the claim.
Workers Compensation Claims Specialist, Complex & Settlement Focus CNA Financial CorpWorkers Compensation Claims Specialist, Complex & Settlement FocusLos Angeles, CA$54,000–$103,000 / yearJOB DESCRIPTION: Essential Duties & Responsibilities: Performs a combination of duties in accordance with departmental guidelines: Manages an inventory of moderate to high complexity and exposure commercial claims by following company protocols to verify policy coverage, conduct investigations, develop and employ resolution strategies, and authorize disbursements within authority limits. Conducts focused investigation to determine compensability, liability and covered damages by gathering pertinent information, such as contracts or other documents, taking recorded statements from customers, claimants, injured workers, witnesses, and working with experts, or other parties, as necessary to verify the facts of the claim.
Major Litigation Unit Complex Claims Consultant CNA Financial CorpMajor Litigation Unit Complex Claims ConsultantLos Angeles, CA$72,000–$141,000 / yearPerforms 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 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 complex manage litigation and authorizing payments within scope of authority.
Complex Claims Consultant , Medical Malpractice and Dental CNA Financial CorpComplex Claims Consultant , Medical Malpractice and DentalLos Angeles, CA$72,000–$141,000 / yearPerforms 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.
Senior Claims Examiner Athens AdministratorsSenior Claims ExaminerLos 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.