Hospital Claims Examiner MedPOINT ManagementHospital Claims ExaminerSherman Oaks, CARemoteFull timeJoin MedPOINT Management as a Hospital Claims Examiner in Sherman Oaks, CA, where you'll play a crucial role in ensuring accurate and timely processing of hospital claims. Our commitment to quality and innovation has earned us a reputation for excellence, making us a preferred partner in the healthcare industry.
Claims Follow-Up Lead-CA WellPsycheClaims Follow-Up Lead-CALos Angeles, CARemote$25–$30 / hourWe are a lean and fast-growing organization , which means every team member plays a meaningful role in improving operations, strengthening revenue cycle performance, and supporting our mission to help patients become the best version of themselves. The Claims Follow-Up Lead is a senior, hands-on revenue cycle professional responsible for resolving complex denials, accelerating accounts receivable, and supporting daily claims workflow execution.
Workers Compensation Claims Examiner | Brea, CA | Sign-On Bonus Eligible Sedgwick Claims Management Services, Inc.Workers Compensation Claims Examiner | Brea, CA | Sign-On Bonus EligibleBrea, CARemote$85,000–$105,000 / yearPRIMARY 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. 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.
NewConsulting Manager, Claims modernization Program Manager (healthcare) Cognizant Technology Solutions CorpConsulting Manager, Claims modernization Program Manager (healthcare)Long Beach, CARemote$105,000–$129,500 / yearYou will be a valued member of the Healthcare Consulting team and work collaboratively with business leaders, product owners, architects, UX/UI teams, API developers, vendors, and client stakeholders to successfully execute complex claims modernization initiatives. In this role, you will combine program leadership, stakeholder management, and healthcare domain expertise to drive the successful delivery of enterprise-scale transformation programs while enhancing member and provider experiences.
Senior Claims Examiner, Workers' Compensation GallagherSenior Claims Examiner, Workers' CompensationAnaheim, CaliforniaRemoteFull timeBehaviors: Ability to think critically, solve problems, plan and organize activities, serve clients, negotiate, effectively communicate verbally and in writing and embrace new challenges. Introduction : At Gallagher, we help clients face risk with confidence because we believe that when businesses are protected, they’re free to grow, lead, and innovate.
Claims Adjuster Senior GallagherClaims Adjuster SeniorTorrance, CaliforniaRemoteFull timeThe actual compensation will be influenced by a wide range of factors including, but not limited to previous experience, education, pay market/geography, complexity or scope, specialized skill set, lines of business/practice area, supply/demand, and scheduled hours. Behaviors: Ability to think critically, solve problems, plan and organize activities, serve clients, negotiate, effectively communicate verbally and in writing and embrace new challenges.
NewClaims Supervisor, Complex General Liability GallagherClaims Supervisor, Complex General LiabilityTorrance, CaliforniaRemoteFull timeAbility to actively review work of others via file reviews; identify coaching opportunities, act on needed coaching opportunities and position subordinates for successful development leading to advancement within the organization. As part of Gallagher, a global leader in insurance, risk management, and consulting, you’ll be joining a team that’s passionate about helping individuals and organizations thrive.
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 Examiner - Workers Compensation Apidel TechnologiesClaims Examiner - Workers CompensationOrange, CARemoteContractorTo 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.
Senior Fire Investigator , IAAI-CFI EFI Global IncSenior Fire Investigator , IAAI-CFIPasadena, CARemote$85,000–$95,000 / yearOver the last four decades, we have grown from a boutique firm specializing in handling insurance fraud and arson cases and providing expert witness testimony, into a recognized global leader in engineering failure analysis, origin-and-cause investigations, environmental consulting, laboratory testing and specialty consulting. PRIMARY PURPOSE: To independently conduct extensive and detailed investigations to determine origin & cause of fires and explosions, primarily involving structures and determining the cause of fires in commercial buildings or residences.
Enterprise Architect (Lead Data Integration & Streaming Architect) Farmers Group, Inc.Enterprise Architect (Lead Data Integration & Streaming Architect)Los Angeles, CARemote$166,725–$283,250 / yearProven experience leading and delivering enterprise-wide architectural initiatives that resulted in measurable business outcomes (example, cost savings, improved agility, reduced risk) required. Possesses adequate hearing, with or without correction, to communicate with co-workers, respond promptly to auditory signals or alarms, and discern sounds essential for maintaining safety and productivity in the workplace.
Professional Liability Claims Advisor Sedgwick Claims Management Services, Inc.Professional Liability Claims AdvisorCARemote$100,000–$145,000 / 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. Analyzes and processes complex or technically difficult liability 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.
Claims Specialist Next Insurance IncClaims SpecialistCARemote$100,000–$143,000 / yearLeverage a working knowledge of insurance contracts, Unfair Claims Settlement Practices, insurance codes, civil codes, vehicle codes, arbitration rules and regulations, tort law, claims best practices handling and management as part of your ongoing adjudication of claims. High degree of comfort with navigating sometimes ambiguous environments and a willingness to dive in and assist coworkers with workloads or contribute to organizational needs/projects when needed.
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."
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.
Senior Construction Specialties Risk Engineering Consultant Zurich Insurance Group LtdSenior Construction Specialties Risk Engineering ConsultantLos Angeles, CARemoteRisk Engineering services will include remote and onsite surveys and risk assessments of construction companies and projects to include large data centers and the energy sector, as well as the overall operations review of existing and prospective customers. Experience in energy projects (i.e. solar panel installations, geothermal power plants, hydroelectric dams, biomass power plants, nuclear power stations and SMR's, power transmission lines, energy storage facilities).
Workers'''' Compensation Claims Examiner | CA WC Experience Required Sedgwick Claims Management Services, Inc.Workers'''' Compensation Claims Examiner | CA WC Experience RequiredCARemote$80,000–$105,000 / yearPRIMARY PURPOSE OF THE ROLE To analyze complex or technically difficult California 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. 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.
Senior Claims Examiner, Complex General Liability GallagherSenior Claims Examiner, Complex General LiabilityTorrance, CaliforniaRemoteFull timeThe actual compensation will be influenced by a wide range of factors including, but not limited to previous experience, education, pay market/geography, complexity or scope, specialized skill set, lines of business/practice area, supply/demand, and scheduled hours. Behaviors: Ability to think critically, solve problems, plan and organize activities, serve clients, negotiate, effectively communicate verbally and in writing and embrace new challenges.
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.