Claims Administrative Specialist The Doctors CompanyClaims Administrative SpecialistSherman Oaks, CA$46,436–$60,947 / yearYou will also provide clerical, administrative, and technical assistance to the assigned claims staff; maintain specific, timely, accurate coding and file updates to support data warehouse searches for claims processing and TDC research projects. Benefits: The Doctors Company offers competitive compensation, an incentive bonus plan, outstanding career opportunities, an exceptional work environment, and an impressive benefits package, which starts with medical, family and bereavement leave; same-sex domestic partner benefits; short- and long-term disability programs; and an employee assistance program.
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.
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.
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 Representative (Iap) - Workers Compensation Training Program | Ontario, CA Sedgwick Claims Management Services, Inc.Claims Representative (Iap) - Workers Compensation Training Program | Ontario, CAOntario, 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. Adjusting various levels of workers' compensation claims under close supervision, which includes: Processing and responding to incoming mail, emails and other claim related documents according to status of the claim.
Claims Assistant (On-Site Ontario, CA) Sedgwick Claims Management Services, Inc.Claims Assistant (On-Site Ontario, CA)Ontario, CA$18–$20 / hourMental: Clear and conceptual thinking ability; excellent judgment 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- Ontario, California) Sedgwick Claims Management Services, Inc.Claims Team Lead - Workers Compensation (Hybrid- Ontario, California)Ontario, CA$100,000–$102,000 / 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 Associate - Workers Compensation (On-Site - Rancho Cucamonga) Sedgwick Claims Management Services, Inc.Claims Associate - Workers Compensation (On-Site - Rancho Cucamonga)Rancho Cucamonga, CA$25–$28 / hourMental: 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 Representative (Iap) - Workers Compensation Training Program | Brea, CA Sedgwick Claims Management Services, Inc.Claims Representative (Iap) - Workers Compensation Training Program | Brea, CABrea, 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. Adjusting various levels of workers' compensation claims under close supervision, which includes: Processing and responding to incoming mail, emails and other claim related documents according to status of the claim.
Claims Assistant Iconma LLCClaims AssistantLos Angeles, CAProficient computer skills and extensive knowledge of the Microsoft suite of Office products, including Outlook (use templates that are provided), Word (utilizing templates), Excel (data entry), and PowerPoint (basic creation of slide deck); knowledge of state EDI systems and/or familiarity with CA Workers Compensation terminology are a plus. Responsibilities: This worker will be assisting Lost Time Examiners with benefit notices, settlement documents, requesting records, and indemnity payments.
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.
Claims Account Manager II (Northern California) ICW GroupClaims Account Manager II (Northern California)CARemote$90,559.93–$152,723.07 / yearHeadquartered in San Diego with regional offices located throughout the United States, ICW Group has been named for ten consecutive years as a Top 50 performing P&C organization offering the stability of a large, profitable and growing company combined with a focus on all things people. Identifies service levels of each account and balances Claims Account Manager staffing/ratio, in conjunction with the Customer Relations Manager, to ensure claim service meets our brand level.
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.
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.
Associate Claims Clinical/Care Advocacy Genworth Financial IncAssociate Claims Clinical/Care AdvocacyCA$55,800–$81,000 / yearUnlike other traditional Care Advocacy roles, your responsibilities will not stop there but will extend to working with digital product teams to help infuse your patient-centered knowledge into the design process and provide feedback that will help create incredible digital user experiences for millions of care-seekers and care-managers at a tremendous scale. Regular document key and frequent needs of users and report qualitative data (such as quotes and anecdotal stories that representative of user needs) and quantitative data (such as frequency of user needs and trends in gaps in local care environments and resources) to the digital product and design teams.
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.
Insurance Collections Specialist Your Behavioral HealthInsurance Collections SpecialistTorrance, CA$21–$24At YBH, we pride ourselves on being a centralized hub teeming with resources designed to aid clients and their families in pinpointing the optimal support tailored to their distinct needs and aspirations for well-being. Answering questions from patients, clerical staff and insurance companies, Compiling and tracking outstanding balances owed to our providers.
NewAccount Executive Crawford & CoAccount ExecutiveLos Angeles, CATo 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. Manages assigned accounts by analyzing, directing and coordinating the service needs of these clients, including those related to claim handling loss data, and cost containment, and assists with billing and collections.
Temp-Senior Workers' Compensation Claims Adjuster Argo Group International Holdings Ltd.Temp-Senior Workers' Compensation Claims AdjusterLos Angeles, CA$48.65–$57.59 / hourBoston 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), Washington, D. C. Essential Responsibilities: Working under limited technical direction and within broad limits and authority, adjudicate highly complex indemnity workers' compensation claims on assignments reflecting potentially with significant impact on departmental results.
Claims Examiner - Workers Compensation (Hourly) Iconma LLCClaims Examiner - Workers Compensation (Hourly)Brea, CAResponsibilities: 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.