Claims Resolution Specialist (Customer Service) CalOptimaClaims Resolution Specialist (Customer Service)Orange, CA$53,813–$80,720 / yearWe are hoping you will join us as a Claims Resolution Specialist (Customer Service) and help shape the future of healthcare where you'll be an integral part of our Claims Administration team, helping to strive for excellence while we serve our member health with dignity, respecting the value and needs of each of our members through collaboration with our providers, community partners and local stakeholders. Responds to provider questions and researches issues regarding claims payments, denials, resolves claim issues, contractual and/or CalOptima Health agreements, established payment methodologies, division of financial responsibility, applicable regulatory legislation, claims processing guidelines and company policies and procedures.
Risks & Claims Manager (Workers' Compensation & General Liability) sweetgreenRisks & Claims Manager (Workers' Compensation & General Liability)Los Angeles, CA$84,000–$119,000 / 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 Manager (West Coast) Ledgebrook IncClaims Manager (West Coast)CARemoteWe're looking for someone with: 10+ years handling Commercial General Liability (CGL) Bodily Injury, Property Damage, and Personal & Advertising Injury claims 5+ years managing litigated CGL claims, developing and executing defense strategies 3+ years handling non-admitted market Excess & Surplus Lines claims 2+ years overseeing claims handled by Third-Party Administrators (TPAs) 2+ years supervising claim professionals - coaching, mentoring, and driving performance Proven ability to analyze coverage and prepare reservation of rights or coverage decision letters Strong litigation management skills - selecting, directing, and evaluating defense counsel Experience participating in quality assurance claim file reviews and process improvements Analytical mindset: You dissect complex claims, evaluate exposure, and create actionable strategies Coverage expertise: You interpret and apply policy language with precision and clarity Collaborative communicator: You build alignment across underwriting, legal, product, and operations teams Technology & innovation: You're proficient with modern claims systems, data, and analytics tools - and eager to implement workflow improvements that drive speed, accuracy, and customer satisfaction Customer focus: You combine empathy and responsiveness with professionalism Entrepreneurial drive: You take ownership, challenge the status quo, and help build scalable, forward-thinking solutions Decisive leadership: You make informed, timely decisions with confidence and accountability Exposure to Allied Healthcare and/or Professional Liability claims (a plus) Important - note is only for candidates applying from the U.S. Please note: This position is open only to candidates who are authorized to work in the United States without the need for current or future employer-sponsored work authorization. You bring: A passion for delivering world-class service to both internal and external customers Intellectual curiosity and a desire for innovation, rather than following the status quo A hunger for continuous learning and personal growth Agile prioritization skills and a sense of urgency - you balance getting it right with getting it done A strong drive to win together as a high-performing team A moral compass to "do the right thing, period."
Claims Associate - Workers Compensation Apidel TechnologiesClaims Associate - Workers CompensationBrea, CARemoteContractorSkills & Knowledge Excellent oral and written communication skills PC literate, including Microsoft Office products Analytical and interpretive skills Strong organizational skills Good interpersonal skills Ability to work in a team environment Ability to meet or exceed Performance Competencies. Mental: 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.
Rates Configuration Specialist MedPOINT ManagementRates Configuration SpecialistSherman Oaks, CARemoteFull timeMedPOINT Management is a leading Independent Physician Association (IPA) management company based in Sherman Oaks, CA, with decades of experience supporting healthcare providers across Southern California. In this role, you'll play a critical part in managing and maintaining rate structures that keep healthcare operations running smoothly and accurately.
Sales Development Specialist Shaw Industries, Inc.Sales Development SpecialistCypress, CARemotePosition Overview: As a Sales Development Specialist, you will contribute to sales growth by partnering with Territory Managers, Account Managers, RVP & DVP (Sales Partners) to advance their sales strategies by proactively identifying with key players within targeted accounts, providing information to act strategically and enabling our Sales Partners to increase customer-facing time. Shaw Industries Group, Inc. is a wholly owned subsidiary of Berkshire Hathaway, and is a global leader in delivering carpet, hardwood, tile & stone, laminate, synthetic turf, and other specialty products to residential and commercial markets worldwide.
Junior Claims Processor Southern California Pipe Trades Administrative CorporationJunior Claims ProcessorLos Angeles, CAFull timeJOB RESPONSIBILITIES:Specific:Review and resolve participant repayment accounts, including determining amounts owed and issuing repayment notices through the WEX online benefits platform. Review and resolve vision auto-adjudication claims, including approving claims and requesting additional information through the WEX online benefits platform.
Property & Casualty Claims Manager (Workers Compensation & General Liability) Sweetgreen IncProperty & Casualty Claims Manager (Workers Compensation & General Liability)Los Angeles, CAProperty & Casualty Claims Manager (Workers Compensation & General Liability) - Sweetgreen Inc.
EPIC Applications Analyst (1-4): Hospital Billing Admin and Hospital Billing Claims - IT Services - Full Time SolutionHealthEPIC Applications Analyst (1-4): Hospital Billing Admin and Hospital Billing Claims - IT Services - Full TimeCAEpic Application Analysts 2-4 require current Epic training status (certification, accreditation, and/or proficiency) in primary application required, with a combination of current Epic training statuses in additional area(s) in application maintenance and development required in upper levels. Ideal candidates will possess strong experience as analyst with expert knowledge and experience in leading system analysis with special emphasis on system methodologies, projects management and business process reengineering related to information systems required.
GLOVIS: Temp Analyst, Claims Revenue and Cost Integration Elevated ResourcesGLOVIS: Temp Analyst, Claims Revenue and Cost IntegrationIrvine, CaliforniaThis role will focus on collecting, organizing, validating, and analyzing claims-related data to help develop an AI solution that can review claim photos, inspection reports, repair estimates, and other documentation to identify damages, estimate severity, and assist with determining liability. Collect, organize, and maintain claim photos, inspection reports, repair estimates, invoices, incident reports, and supporting documentation.
Claims Examiner - Workers Compensation (Hourly) Apidel TechnologiesClaims Examiner - Workers Compensation (Hourly)Brea, CAContractorTo 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.
Harbor Chevrolet Service Consultant Harbor Auto GroupHarbor Chevrolet Service ConsultantLong Beach, CaliforniaWe are committed to building a strong team culture, delivering exceptional customer service, and providing a world-class automotive experience. We’re looking for an experienced Service Advisor who is motivated, detail oriented, and passionate about helping customers.
Healthcare Claims Examiner Ultimate Staffing ServicesHealthcare Claims ExaminerEl Monte, California$25–$28 / hourResearch and resolve claim discrepancies, including making payment corrections, recovering overpayments, and reprocessing claims as needed. Evaluate claims for potential fraud, waste, abuse, Workers' Compensation, hospital-acquired conditions, and third-party liability; escalate issues appropriately.
Operations Analyst - National Claims (Hybrid in CA) First AmericanOperations Analyst - National Claims (Hybrid in CA)Santa Ana, CaliforniaFirst American reasonably believes that a criminal history may have a direct, adverse and negative relationship with the following material job duties for this position potentially resulting in the withdrawal of the conditional offer of employment: handling of confidential, proprietary or trade secret information belonging to First American or its customers, administrating or facilitating financial transactions, and the ability to meet customer-imposed criminal history requirements. This position supports title claims and claims-adjacent intake operations across multiple locations and serves as a key partner to senior leadership by providing operational support, audit coordination, advanced reporting, and systems optimization.
Medical Claims Intake Coordinator UCLA Health SystemMedical Claims Intake CoordinatorLos Angeles, CA$26.42–$37.49 / hourb'nn n n n n n n n n n n n nn n n n n n n n n n n n n n n n n n Medical Claims Intake Coordinator - - 29680 - UCLA Healthn n nnnn nn n n n nn n n n n Skip to content nn n n n n n UCLA Health Home Page n n nn nnn n nn n Main menu. Press enter or space keys to expands and escape key to collapse nn n n n n n n Search jobs n n nn...
Claims Quality Auditor UCLA Health SystemClaims Quality AuditorLos Angeles, CA$31.51–$62.64 / hourb'nn n n n n n n n n n n n nn n n n n n n n n n n n n n n n n n Claims Quality Auditor - - 31703 - UCLA Healthn n nnnn nn n n n nn n n n n Skip to content nn n n n n n UCLA Health Home Page n n nn nnn n nn n Main menu. Press enter or space keys to expands and escape key to collapse nn n n n n n n Search jobs n n nn n n n Empl...
Senior Claims Specialist I, Workers Compensation - West Region Liberty Mutual Holding Company IncSenior Claims Specialist I, Workers Compensation - West RegionGlendale, CASenior Claims Specialist I, Workers Compensation - West Region - Liberty Mutual Holding Company Inc.
Senior Geologist/Senior Environmental Scientist/Professional Engineer HYDRO-ENVIRONMENTAL TECHNOLOGIES INCSenior Geologist/Senior Environmental Scientist/Professional EngineerLos Angeles, CARemoteFull timeFounded in 1986, HETI is a full-service, nationwide environmental services company specializing in environmental and indoor air quality site assessment, site remediation, risk characterization, occupational health and safety services, and litigation/expert witness support. The candidate should have experience managing consulting assignments, must work effectively in multi-disciplinary teams, is expected to be proficient in the analysis and communication of information, and must be able to work cooperatively with agencies, organizations, and individuals to guide decision-making.
Spanish Speaking Dental Office Manager -MINIMUM 5 YEARS EXPERIENCE Restore DentalSpanish Speaking Dental Office Manager -MINIMUM 5 YEARS EXPERIENCELos Angeles, CAFull timePosition Summary: As the Dental Office Manager, you will oversee the day-to-day operations of our practice, ensuring efficiency and excellence in all aspects of patient care and administrative functions. Restore Dental is seeking an experienced and enthusiastic Bilingual (Spanish) Dental Office Manager to join our thriving practice in Los Angeles, California.
Lead General Adjuster United Fire Group IncLead General AdjusterCalifornia, CA$103,221–$136,105 / yearConduct a timely and thorough investigation to identify risks/exposures which may include conducting interviews, procuring recorded statements, relevant documents and identify others possessing facts or involvement with the claim - to determine extent and severity of potential loss. Individual pay within this range will be determined based on a variety of factors, including relevant experience, education, certifications, skills, internal equity, geography and market data.