Claims Service Specialist GEICO GENERAL INSURANCE COMPANYClaims Service SpecialistPoway, CA$22.90–$35.10 / hourCustomer Interaction: Manage incoming calls, collect accident facts, investigate claim details, collect statements from involved parties, and assist in the process of getting our customers back on the road. Factors include, but are not limited to, the scope and responsibilities of the role, the selected candidate's work experience, education and training, the work location as well as market and business considerations.
Medical Claims Specialist Ultimate Staffing ServicesMedical Claims SpecialistCarlsbad, California$55,000–$65,000The ideal candidate will have at least 3 years of experience in managing medical claims processes, ensuring accurate and efficient handling of claims, and delivering exceptional service to clients and providers. Ultimate Staffing is actively seeking an experienced Medical Claims Specialist to join a dedicated team in Carlsbad, CA.
NewDirector, HMO Claims Services Scripps HealthDirector, HMO Claims ServicesSan Diego, CARecognized nationally for excellence, Scripps has earned top rankings from U.S. News & World Report, Fortune, Newsweek, and Becker's Healthcare, and maintains an AA rating with a stable outlook from S&P Global Ratings due to its strong leadership and financial performance. The Director of HMO Payment (Claims) Services for Scripps Health Plan provides strategic and operational leadership for the claims payment function, ensuring the accurate, timely, and compliant processing and payment of professional and institutional provider claims.
Workers Compensation Claims Examiner | Dedicated Account | 3 Days Remote Sedgwick Claims Management Services, Inc.Workers Compensation Claims Examiner | Dedicated Account | 3 Days RemoteSan Diego, CARemote$80,000–$100,000 / 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. 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.
Workers Compensation Claims Examiner Sedgwick Claims Management Services, Inc.Workers Compensation Claims ExaminerSan Diego, CARemote$80,000–$100,000 / 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. 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.
NewClaims Representative UnitedHealth Group IncClaims RepresentativeSan Diego, CA$18–$32 / hourThe fraudulent LinkedIn messages and emails, which do not originate from any Executives LinkedIn account or of UnitedHealth Group's email domains, or those of any of its operating divisions, supposedly conducts an interview via a Zoom meeting, offers a work from home job at Optum, emails an application, sends a fake check by next day delivery through USPS and asks recipients to pay a vendor a large dollar amount. This is a challenging role that takes an ability to thoroughly review, analyze and research complex healthcare claims in order to identify discrepancies, verify pricing, confirm prior authorizations and process them for payment.
NewSenior Litigation Construction Liability Claims Representative The Travelers Companies IncSenior Litigation Construction Liability Claims RepresentativeSan Diego, CA$94,400–$155,800 / yearDirectly investigates each claim through prompt and strategically-appropriate contact with appropriate parties such as policyholders, accounts, claimants, law enforcement agencies, witnesses, agents, medical providers and technical experts to determine the extent of liability, damages, and contribution potential. Actively engages in the identification, selection and direction of appropriate internal and/or external resources for specific activities required to effectively evaluate claims, such as Subrogation, Risk Control, nurse consultants, and fire or fraud investigators, and other experts.
Claims Examiner - Workers'''' Compensation (California) ICW GroupClaims Examiner - Workers'''' Compensation (California)San Diego, CA$61,979.26–$97,736.56 / 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. If hired at ICW Group, your final base salary compensation will be determined by factors unique to each candidate, including experience, education and the location of the role and considers employees performing substantially similar work.
Claims Specialist - Workers'''' Compensation (California) ICW GroupClaims Specialist - Workers'''' Compensation (California)San Diego, CA$78,678.61–$132,686.15 / 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. Bachelor's degree (or equivalent combination of education and experience) required along with a minimum of 8 - 10+ years' related claims handling experience involving complex litigation, reserving, settlement strategy, and high exposure claims.
Epic Certified PB / PB Claims Analyst Waterfall Technology Consulting PartnersEpic Certified PB / PB Claims AnalystSan Diego, CaliforniaThe ideal candidate will bring strong technical expertise, revenue cycle application knowledge, and hands-on experience supporting professional billing and claims workflows. This role is critical in ensuring seamless functionality of Epic's PB and Claims modules, supporting both break/fix issues and application enhancements.
Epic Certified PB / PB Claims Analyst - Remote - San Diego, CA Waterfall Technology Consulting PartnersEpic Certified PB / PB Claims Analyst - Remote - San Diego, CASan Diego, CaliforniaRemoteThe ideal candidate will bring strong technical expertise, revenue cycle application knowledge, and hands-on experience supporting professional billing and claims workflows. This role is critical in ensuring seamless functionality of Epic's PB and Claims modules, supporting both break/fix issues and application enhancements.
General Liability Claims Specialist - Bodily Injury Ultimate Staffing ServicesGeneral Liability Claims Specialist - Bodily InjurySan Diego, California$35–$40 / hourWe're seeking a General Liability Claims Specialist with experience in bodily injury to manage complex General Liability claims, including litigated matters, high-exposure BI losses, mediations, and settlement negotiations. This is a hands-on opportunity to work directly with defense counsel and clients while handling challenging claims from investigation through resolution.
Remote Claims Representative 597004 Metro Public AdjustmentRemote Claims Representative 597004San Diego, CARemote$35,000–$150,000 / yearConduct a virtual walk-through inspection of the property, take some pictures, and fill out about 5 minutes worth of paper work. Benefit from our 32 years of experience in business: We have an AWESOME training program and it's FREE!
Manager, Intellectual Property - Disputes, Claims & Investigations Stout Risius RossManager, Intellectual Property - Disputes, Claims & InvestigationsSan Diego, California$87,000–$195,000 / yearApproach engagements with intellectual curiosity and rigor — asking thoughtful questions, thinking critically about the data and assumptions behind our analysis, and applying attention to detail so our work product is accurate, thorough, and well-reasoned. Strong analytical and technical skills in finance, economics, and/or accounting with the ability to critically analyze financial statements, accounting records, tax returns, and other financial documents.
Director, Claims Management University of CaliforniaDirector, Claims ManagementSan Diego, CARemoteUC San Diego is a student-centered, research-focused, service-oriented public institution recognized as one of the top fifteen research universities worldwide, and a top ten public university. 15 years later, my work improves operational efficiencies, provides valuable programs to the university, and even helps students bring their innovations to life.
Manager, Intellectual Property - Disputes, Claims & Investigations StoutManager, Intellectual Property - Disputes, Claims & InvestigationsSan Diego, CaliforniaApproach engagements with intellectual curiosity and rigor — asking thoughtful questions, thinking critically about the data and assumptions behind our analysis, and applying attention to detail so our work product is accurate, thorough, and well-reasoned. Strong analytical and technical skills in finance, economics, and/or accounting with the ability to critically analyze financial statements, accounting records, tax returns, and other financial documents.
Auto Liability Claim Rep The Travelers CompaniesAuto Liability Claim RepSan Diego, CA$67,000–$110,600 / yearOne-year bodily injury liability claim handling experience or comparable liability claim handling experience, or successful completion of Travelers Claim Representative training program is required. The actual salary for this position will be determined by a number of factors, including the scope, complexity and location of the role; the skills, education, training, credentials and experience of the candidate; and other conditions of employment.
Specialized Sr Workers'''' Compensation Claim Representative The Travelers Companies IncSpecialized Sr Workers'''' Compensation Claim RepresentativeSan Diego, CA$73,900–$122,000 / yearAs a Specialized Senior Claim Rep, you will be responsible for investigating, evaluating, reserving, negotiating, and resolving Workers Compensation claims from Travelers Single Adjuster Model including Constitution State Services (CSS) and Custom Comp claims, which will be the majority of the claims handled, and other Travelers Workers Compensation claims. By providing assurance to our customers during life''s rainy days, the Travelers Workers Compensation Claim team is committed to partnering with our business insurance customers to help their injured employees return to work as soon as medically appropriate.
Specialized Sr Workers' Compensation Claim Representative The Travelers CompaniesSpecialized Sr Workers' Compensation Claim RepresentativeSan Diego, CA$73,900–$122,000 / yearAs a Specialized Senior Claim Rep, you will be responsible for investigating, evaluating, reserving, negotiating, and resolving Workers Compensation claims from Travelers Single Adjuster Model including Constitution State Services (CSS) and Custom Comp claims, which will be the majority of the claims handled, and other Travelers Workers Compensation claims. By providing assurance to our customers during life's rainy days, the Travelers Workers Compensation Claim team is committed to partnering with our business insurance customers to help their injured employees return to work as soon as medically appropriate.
EPL & D&O Liability Claim Counsel The Travelers CompaniesEPL & D&O Liability Claim CounselSan Diego, CA$111,600–$184,200 / yearTravelers' Private/Non-Profit Team provides executive and organizational management liability coverage to privately held companies and non-profit entities of all types and sizes as well as certain governmental public entities. Prepare and present reports for management that accurately reflect loss development, potential/actual financial exposure, reserve adjustments, coverage issues, and claim and recovery strategies.