NewSr Examiner - 4850 Workers' Compensation Claims (Full Remote - Southern CA)(Perm) Johnson Service GroupSr Examiner - 4850 Workers' Compensation Claims (Full Remote - Southern CA)(Perm)Pleasant Hill, CARemoteThe 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.
NewSr. Workers Compensation Examiner-4850 Claims - CA (Contract - Full Remote) Johnson Service GroupSr. Workers Compensation Examiner-4850 Claims - CA (Contract - Full Remote)Pleasant Hill, CARemoteThe 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).
NewSr 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, CARemoteThe 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.
NewSenior Workers' Compensation Claims Examiner (FULL Remote - Perm) - CA Johnson Service GroupSenior Workers' Compensation Claims Examiner (FULL Remote - Perm) - CAConcord, CARemoteThe 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 Legal Medical Malpractice Examiner Kaiser PermanenteSenior Legal Medical Malpractice ExaminerOakland, CAPerforming legal risk assessment and managing risk by: promoting strict compliance with the terms and conditions of the programs policy of self- and excess liability insurance and considering the financial exposure, regulatory impact, and reputational risk; and proposing solutions to improve internal matter resolution and notifying relevant parties of significant matter developments. Job Summary: Responsible for the administration of medical malpractice and other professional and general liability claims made during the course of conducting company business across the enterprise, having a material impact on legal reserves that are listed as a separate line item on the company's financial statements.
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.
Fire Inspector III/Plans Examiner City of Fairfield, CAFire Inspector III/Plans ExaminerFairfield, CA$94,295.34–$114,616.53 / yearMay assist with and/or administer special projects, such as open houses and seasonal weed abatement programs; coordinate specific projects, including fostering cooperative working relationships with civic groups, inter-governmental agencies and City staff; help develop, implement and maintain goals, objectives, policies and priorities for assigned projects and service areas; help ensure that established goals and priorities are achieved. Respond to questions and concerns from the general public, business, commercial and industrial property owners and applicants; provide information as appropriate and resolve public service complaints; conduct public education and outreach programs, including school programs and public workshops; create promotional materials, including press releases and public service announcements.
Building Engineering Plans Examiner (Associate Civil Engineer) City of Fairfield, CABuilding Engineering Plans Examiner (Associate Civil Engineer)Fairfield, CA$162,870–$191,290 / yearThis individual is a self-starter who can manage assignments with minimal supervision, prioritize competing deadlines, and confidently navigate complex development and infrastructure projects while building effective working relationships with internal staff, developers, consultants, and the public. The City of Fairfield offers a comprehensive benefit package that includes City contribution toward the Public Employees Retirement System and deferred savings; medical, dental and vision; life insurance; paid holidays, vacation, personal leave and sick leave.
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) .
Mobile Phlebotomist/Paramedical Examiner Quest DiagnosticsMobile Phlebotomist/Paramedical ExaminerUnion City, California$24–$26With 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 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.
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.
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.