Claims Examiner/Senior Claims Examiner BerkleyClaims Examiner/Senior Claims ExaminerWalnut Creek, California$65,000–$115,000 / yearIn these roles, you will be responsible for the analysis and management of moderate to complex workers’ compensation claims, including reviewing, investigating, and making determinations around coverage, compensability, and claim appropriateness. Success in this role requires strong judgment, consistent performance, and a high level of competency in negotiating settlements, managing subrogation, and delivering sound, compliant outcomes.
Claims Examiner/Senior Claims Examiner W. R. Berkley CorpClaims Examiner/Senior Claims ExaminerWalnut Creek, CA$65,000–$115,000 / yearIn these roles, you will be responsible for the analysis and management of moderate to complex workers' compensation claims, including reviewing, investigating, and making determinations around coverage, compensability, and claim appropriateness. Success in this role requires strong judgment, consistent performance, and a high level of competency in negotiating settlements, managing subrogation, and delivering sound, compliant outcomes.
Rep, Mobile Examiner - (P/T) - ExamOne/Walnut Creek, CA area Quest Diagnostics IncRep, Mobile Examiner - (P/T) - ExamOne/Walnut Creek, CA areaWalnut Creek, CA$13.97–$26.71 / hourEnsures facilities or work areas are neat, clean and in good repair, takes appropriate action to advise Manager or Supervisor of required repairs and maintenance; Disposes of biohazard containers when scheduled. Under the direction of the Branch Manager or Field Leader, the Mobile Examiner''s primary responsibility is to provide coverage in the field ensuring that mobile exams are completed accurately and on time.
Sr Examiner - 4850 Workers' Compensation Claims (Full Remote - Northern CA)(Perm) Johnson Service GroupSr Examiner - 4850 Workers' Compensation Claims (Full Remote - Northern CA)(Perm)Pleasant Hill, CARemote$98,000–$103,500 / yearThe Senior Claims Examiner will adjust police and fire 4850 workers compensation claims from inception through settlement and closure, ensuring timely processing of claims and payment of benefits, managing, and directing medical treatment, setting reserves, and negotiating settlements. The Senior Claims Examiner will adjust workers compensation claims from inception through settlement and closure, ensuring timely processing of claims and payment of benefits, managing, and directing medical treatment, setting reserves, and negotiating settlements.
Senior Workers' Compensation Claims Examiner (FULL Remote - Contract) - CA Johnson Service GroupSenior Workers' Compensation Claims Examiner (FULL Remote - Contract) - CAConcord, CARemote$50.25–$55.89 / hourThe Senior Claims Examiner will adjust workers compensation claims from inception through settlement and closure, ensuring timely processing of claims and payment of benefits, managing, and directing medical treatment, setting reserves, and negotiating settlements. Must possess a current Experienced Indemnity Claims Adjuster Designation, provided by an insurer, as defined in California Code of Regulations, Title 10, Chapter 5, Subchapter 3, Section 2592.01(f) .
Senior Workers' Compensation Claims Examiner (FULL Remote - Perm) - CA Johnson Service GroupSenior Workers' Compensation Claims Examiner (FULL Remote - Perm) - CAConcord, CARemote$98,000–$109,000 / yearThe Senior Claims Examiner will adjust workers compensation claims from inception through settlement and closure, ensuring timely processing of claims and payment of benefits, managing, and directing medical treatment, setting reserves, and negotiating settlements. Must possess a current Experienced Indemnity Claims Adjuster Designation, provided by an insurer, as defined in California Code of Regulations, Title 10, Chapter 5, Subchapter 3, Section 2592.01(f).
Mobile Phlebotomist/Paramedical Examiner Quest DiagnosticsMobile Phlebotomist/Paramedical ExaminerPalo Alto, California$22–$24With customized statistical reports, an electronic voice response system, and a team of solution experts dedicated to solving your business’s challenges, we are focused on helping underwriters achieve maximum efficiency. With customized statistical reports, an electronic voice response system and a team of solution experts dedicated to solving your business’s challenges, we are focused on helping underwriters achieve maximum efficiency
Senior Claims Examiner Athens AdministratorsSenior Claims ExaminerConcord, CaliforniaATHENS POSITION DETAILS Position Title: Senior Claims Examiner Department: Workers’ Compensation California Reports To: Claims Supervisor FLSA Status: Non-Exempt Job Grade: 12 Career Ladder: Next step in progression could include Lead Senior Claims Examiner or Claims Supervisor ATHENS ADMINISTRATORS Explore the Athens Administrators difference: We have been dynamic, innovative leaders in claims administration since our founding in 1976. POSITION SUMMARY Athens Administrators has an immediate need for a full-time Senior Claims Examiner to support our workers compensation offices and can be located anywhere in the state of California, however, employees who live less than 26 miles from the Concord, CA or Orange, CA offices are required to work once a week in the office on a day determined by their supervisor between Tuesday – Thursday.
CLAIMS EXAMINER I MSO North East Medical ServiceCLAIMS EXAMINER I MSOBurlingame, CAESSENTIAL JOB FUNCTIONS: Perform the daily examination, auditing and adjudication activities to submitted professional claims based on established utilization criteria, Medi-Cal and/or Medicare guidelines, member's Evidence of Benefit, and policies and procedures outlined in the MSO Claims Manual. Working knowledge of managed care and/or healthcare claim reimbursement or medical billing in Medi-Cal and Medicare Advantage program preferred.
Plans Examiner Willdan Group IncPlans ExaminerSan Anselmo, CAThrough our subsidiary Public Agency Resources (PARS), we are proud to be "Envisioning the Future" of Building & Safety-partnering with cities, buildings, and transportation projects to create safer, more sustainable communities. As a Plans Examiner, you'll play a key role in ensuring building safety and compliance while working closely with public agencies, architects, contractors, and the community.
Senior Claims Examiner, Workers' Compensation GallagherSenior Claims Examiner, Workers' CompensationPleasanton, CaliforniaRemote$75,000–$105,000 / yearFull 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.
Claims Examiner II Partnership HealthPlan of CaliforniaClaims Examiner IIFairfield, California$31.45–$37.74 / hourFull timeReviews, researches, and resolves pended claims for Medi-Cal types: medical, ancillary, long term care, CHDP, encounter data, other coverage, and batch claims within established. The job duties, elements, responsibilities, skills, functions, experience, educational factors and the requirements and conditions listed in this job description are representative only and not exhaustive or definitive of the tasks that an employee may be required to perform.
Senior Claims Examiner, Professional Liability Arch Capital Group LtdSenior Claims Examiner, Professional LiabilityCARemote$111,100–$172,465 / yearTotal individual compensation (base salary, short & long-term incentives) offered will take into account a number of factors including but not limited to geographic location, scope & responsibilities of the role, qualifications, talent availability & specialization as well as business needs. Exceptional communication (written and verbal), evaluating, influencing, negotiating, listening, and interpersonal skills to effectively develop productive working relationships with internal/external peers and other professionals across organizational lines.
Claims Examiner II North East Medical ServiceClaims Examiner IIBurlingame, CAESSENTIAL JOB FUNCTIONS: Perform the daily examination, auditing and adjudication activities to submitted hospital and professional claims based on established utilization criteria, Medi-Cal and/or Medicare guidelines, member's Evidence of Benefit, and policies and procedures outlined in the MSO Claims Manual. Responsible to prepare files and documents for the annual health plan delegation oversight audits, assist Claims Supervisor with MSO management reports, and other special projects as needed.
Claims Examiner I MSO North East Medical ServiceClaims Examiner I MSOBurlingame, CAESSENTIAL JOB FUNCTIONS: Perform the daily examination, auditing and adjudication activities to submitted professional claims based on established utilization criteria, Medi-Cal and/or Medicare guidelines, member's Evidence of Benefit, and policies and procedures outlined in the MSO Claims Manual. Identify claims payment errors and/or system configuration flaws during day-to-day operation, report to department manager/supervisor and MSO System Configuration team to correct/resolve them.
Tissue Recovery Coordinator I Donor Network WestTissue Recovery Coordinator ISan Ramon, CAFull timeThe Tissue Recovery Coordinator is responsible for the intraoperative leadership of the recovery team and communication to a team of other medical professional, including hospital personnel, funeral home staff and coroner or medical examiner professionals. Ability to clearly and effectively speak and communicate to accurately convey information to internal DNWest staff, hospital staff, processing partners, and others involved in the donation process.
Claims Examiner - Workers Compensation (Hybrid - Concord, CA) Sedgwick Claims Management Services, Inc.Claims Examiner - Workers Compensation (Hybrid - Concord, CA)Concord, CA$80,000–$85,000 / 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. PRIMARY PURPOSE OF THE ROLE: To analyze workers' compensation claims on behalf of our valued clients to determine benefits due, while ensuring ongoing adjudication of claims within service expectations, industry best practices, and specific client service requirements.
Litigation Examiner - General Liability | Must Reside in CA Sedgwick Claims Management Services, Inc.Litigation Examiner - General Liability | Must Reside in CAConcord, CA$85,000–$105,000 / yearNewsweek Recognizes Sedgwick as America's Greatest Workplaces National Top Companies Certified as a Great Place to Work Fortune Best Workplaces in Financial Services & Insurance Litigation Examiner - General Liability | Must Reside in CA Are you looking for an opportunity to join a global industry leader where you can bring your big ideas to help solve problems for some of the world's best brands? 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 Physical: Computer keyboarding, travel as required Auditory/Visual: Hearing, vision and talking TAKING CARE OF YOU Flexible work schedule.
Claims Examiner - Workers Compensation (HYBRID - Concord, CA) Sedgwick Claims Management Services, Inc.Claims Examiner - Workers Compensation (HYBRID - Concord, CA)Concord, CA$80,000–$85,000 / 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. PRIMARY PURPOSE OF THE ROLE: To analyze workers' compensation claims on behalf of our valued clients to determine benefits due, while ensuring ongoing adjudication of claims within service expectations, industry best practices, and specific client service requirements.
Liability Claims Examiner Sedgwick Claims Management Services, Inc.Liability Claims ExaminerCA$85,000–$105,000 / 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. PRIMARY PURPOSE: To address and handle high end General Liability cases with serious injuries, complex coverage scenarios and legal inquiries or disputes; to develop a strategy to bring a case to satisfactory resolution.