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.
Claims Examiner HCC Life InsuranceClaims 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.
Claims Team Manager - Auto Early Response AAAClaims Team Manager - Auto Early ResponseCosta Mesa, CaliforniaWith our national brand recognition, long-standing reputation since 1900, and constantly growing membership, we are seeking career-minded, service-driven professionals to join our team. Lead meetings in collaboration with unit management to communicate goals with direct reports and reinforce/monitor behavior that furthers technical and customer service performance expectations.
Claims Receivables And Recovery Specialist (50627) Western Growers AssociationClaims Receivables And Recovery Specialist (50627)Irvine, CAThe Claims Receivables and Recovery Specialist reports to the Supervisor, Payment Integrity, and works with various departments within the company to ensure all open claim receivables, which are results of claim overpayments and/or adjustments, are pursued and collected appropriately. Collect receivables for the Western Growers Assurance Trust (WGAT) and clients of the Third-Party Administrator (TPA) that may be a result of overpayments or claims adjustments by researching, writing letters, and actively making phone calls.
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.
Data Analyst Claims Mercury Insurance CompanyData Analyst ClaimsCA$76,829–$142,213 / yearCoordinates and executes reporting; directs and supports underwriting users/leaders in identifying data needed for reporting using Guidewire Database, NextGen Database, and Enterprise Data Warehouse. Position Summary: The primary job function, under general supervision, is interpreting complex data sets related to various operations of the Claims Department and provide data-driven analysis.
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.
NewClaims Solutions Partner ClaimSorted IncClaims Solutions PartnerCAYoull partner with sales to diagnose prospects operational gaps, answer the hard technical questions, provide the expertise behind our RFP and RFI responses, run deep analyses of partner portfolios to surface where we add value, and then ensure a clean technical handoff to account management as new partners onboard. Were looking for a Claims Solutions Partner - the claims-operations expert who sits inside our sales cycle and makes technically complex deals winnable.
ESIS Claims Associate Chubb LtdESIS Claims AssociateChatsworth, CA$47,500–$67,500 / yearThe company is distinguished by its extensive product and service offerings, broad distribution capabilities, exceptional financial strength, underwriting excellence, superior claims handling expertise and local operations globally. With operations in 54 countries, Chubb provides commercial and personal property and casualty insurance, personal accident and supplemental health insurance, reinsurance, and life insurance to a diverse group of clients.
NewFinancial Lines Claims Counsel Mitsui Sumitomo Insurance Company Of AmericaFinancial Lines Claims CounselLos Angeles, CA$150,000–$200,000 / yearThe role focuses primarily on Directors & Officers (D&O), Financial Institutions Professional Liability (E&O), Employment Practices Liability (EPL), Fiduciary, and Fidelity claims, including complex litigation, class actions, securities matters, and high-severity financial loss exposures. Analyze coverage, liability, damages, and exposure issues, establish appropriate reserves, and provide accurate claim assessments involving D&O, Financial Institutions E&O, EPL, Fiduciary, and Fidelity policies.
Facility Inpatient Surgical and Claims Edit Auditor Cedars-Sinai Medical CenterFacility Inpatient Surgical and Claims Edit AuditorLos Angeles, CARemoteMaintains appropriate open communication with internal and external partners and peer departments such as Coding Operations, Clinical Documentation Integrity (CDI), Payor Revenue Management (PRM), and Compliance Revenue Integrity (CRI). Auditors evaluate compliance with all coding guidelines including but not limited to: Internal Coding policies/procedures/handbook, American Hospital Association (AHA) and American Medical Association (AMA) coding references, local, State, and Federal Coding Guidelines.
Claims Examiner HCC Life Insurance CompanyClaims 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.
Sr. Manager, Risks & Claims (Workers' Compensation & General Liability) sweetgreenSr. Manager, Risks & Claims (Workers' Compensation & General Liability)Los Angeles, CA$100,000–$130,000 / yearSitting on the Operations Services team and reporting to the Senior Director of Risk + Safety, you will direct the claims adjusting service provided by our workers' compensation carrier, oversee our general liability carrier, and serve as the internal point of contact connecting our restaurants, carriers, brokers, and defense counsel. Build and partner with the People Team and Restaurant Operations on the return-to-work and modified duty program to reduce lost-time exposure, and serve as a clear, consistent point of contact for injured team members.
Claims Examiner - Workers Compensation IconmaClaims Examiner - Workers CompensationOrange, CA$47–$52 / hourSubject 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. Responsibilities: 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.
Quality Claims Administrator Assistant Bentley Mills IncQuality Claims Administrator AssistantCABentley Mills reserves the right to pay outside of the given range based on a variety of factors including but not limited to: candidate skills and experience, complexity of the job, budgetary factors, and local/geography. Skills: The Quality Claims Administrator Assistant uses strong organizational skills daily to manage multiple claims efficiently and ensure accurate documentation.
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.
Claim Director Chubb LtdClaim DirectorChatsworth, CA$78,100–$114,400 / yearPerform assignments, tasks or activities that contribute to the overall objectives of the business division being supported including but not limited to; conducting audits, providing financial analysis on reserve adequacy, identifying occupational disease exposures, and providing expertise on jurisdictional nuances. Provide direction, reserve and settlement authority to claim handlers as outlined in Chubb North American Claim Handling Guidelines and within Director's authority, elevating requests above authority to appropriate management levels for approval.
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.
Revenue Cycle Specialist Behavioral Health Services IncRevenue Cycle SpecialistGardena, CACollaborate closely with other departments to contribute to cash reconciliation activities and to assist in the assessment of accounts receivable collectability and validation, including the writing off of bad debts. Includes all activities within the scope of the Billing & Accounting Departments including charge/ data entry, insurance follow up, and billing and collection of client balances.
Claims Consultant - Cyber - E&O (Hybrid) Onebeacon Professional Insurance IncClaims Consultant - Cyber - E&O (Hybrid)Irvine, 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.