Claims Examiner I Clever Care Health PlanClaims Examiner IHuntington Beach, CAThis position requires considerable interaction with clients, claimants on the phone, with management, other Claims Examiners, and other staff in the office; therefore, consistently being at work in the office or home office location as applicable, in a timely manner, is inherently required of this position. At Clever Care, you'll have the opportunity to make a real difference, shape the future of healthcare, and be part of a fast-moving, game-changing organization that celebrates diversity and innovation.
Claims Examiner - Workers Compensation Iconma LLCClaims Examiner - Workers CompensationLong Beach, CASubject 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. Responsibilities: 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.
Claims Examiner VenbrookClaims ExaminerLos Angeles, CaliforniaVenbrook works across the claims lifecycle with services that include Third Party Administration (TPA), Complex Claims Management, Catastrophe, Independent Adjusting, subrogation recovery, litigation management, investigative, and special investigations unit (SIU) services. Venbrook's team of experts and industry specialists partners with their clients to manage their risks, create security, promote growth, and add value by delivering best-in-class commercial property & casualty, employee benefits, and personal risk insurance products and programs.
Senior Claims Examiner, Professional Liability Arch Capital Group LtdSenior Claims Examiner, Professional LiabilityLos Angeles, CARemote$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 I HCC Life Insurance CompanyClaims Examiner IEncino, CA$46,600–$69,800 / yearThe Company will consider for employment all qualified applicants, including those with criminal histories, in a manner consistent with the requirements of applicable federal, state and local laws, such as the Violent Crime Control and Law Enforcement Act of 1994 (18 USC § 1033(e))(the "VCCLEA"), which restricts financial institutions and insurers such as TMHCC from employing individuals with certain types of criminal convictions. As an insurance company, we comply with certain federal, state and local laws such as the Violent Crime Control and Law Enforcement Act of 1994 (18 USC § 1033(e)), which restricts our ability to employ individuals with certain types of criminal convictions.
NewRemote Workers Compensation Claims Examiner | CA Jurisdiction Sedgwick Claims Management Services, Inc.Remote Workers Compensation Claims Examiner | CA JurisdictionSimi Valley, CARemote$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.
NewWorkers Compensation Claims Examiner Sedgwick Claims Management Services, Inc.Workers Compensation Claims ExaminerCARemote$85,000–$110,000 / 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.
Claims Examiner - Workers Compensation (Hybrid- West Hills, CA) Sedgwick Claims Management Services, Inc.Claims Examiner - Workers Compensation (Hybrid- West Hills, CA)West Hills, CA$80,000–$92,000 / 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.
Plans Examiner Bureau Veritas SAPlans ExaminerMalibu, CABureau Veritas is a global leader in Testing, Inspection, and Certification services, helping clients to manage risk and enhance their performance in the fields of quality, health and safety, environment, and social responsibility. Guaranteeing quality, ensuring health and safety, mitigating risks, and improving performance as well as environmental protection and social responsibility… This is what Bureau Veritas is about, truly believing that it contributes to bettering society.
Claims Examiner Workers Compensation I CA experienced required I Remote Sedgwick Claims Management Services, Inc.Claims Examiner Workers Compensation I CA experienced required I RemoteCARemote$63,404–$95,000 / yearTo analyze California 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. PRIMARY PURPOSE OF THE ROLE: We are looking for driven individuals that embody our caring counts model and core values that include empathy, accountability, collaboration, growth, and inclusion.
Workers Compensation Claims Examiner | Long Beach or Roseville, CA Sedgwick Claims Management Services, Inc.Workers Compensation Claims Examiner | Long Beach or Roseville, CALong Beach, CA$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 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 CALong Beach, 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, Auto | Bodily Injury Sedgwick Claims Management Services, Inc.Claims Examiner, Auto | Bodily InjuryMSEducation & Licensing: Five (5) years of claims management experience or equivalent combination of education and experience required to include in-depth knowledge of personal and commercial line auto policies, coverages, principles, and laws. Processes complex auto commercial and personal line claims, including bodily injury and ensures claim files are properly documented and coded correctly.
Claims Examiner - Workers Compensation (Hybrid- West Hills, Ca/3 Days Remote) Sedgwick Claims Management Services, Inc.Claims Examiner - Workers Compensation (Hybrid- West Hills, Ca/3 Days Remote)West Hills, CARemote$80,000–$90,000 / 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.
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.
Claims Examiner - Workers Compensation (HYBRID- West Hills, CA/3 Days Remote) Sedgwick Claims Management Services, Inc.Claims Examiner - Workers Compensation (HYBRID- West Hills, CA/3 Days Remote)West Hills, CARemote$80,000–$90,000 / 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.
Claims Examiner - Workers Compensation ObjectWin TechnologyClaims Examiner - Workers CompensationLong Beach, CATo 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.
BusinessOperations - Claims Examiner (Operations) 1 - 700092 MindlanceBusinessOperations - Claims Examiner (Operations) 1 - 700092Woodland Hills, CA$23 / hourImpact and Purpose Candidate Requirements Education/Certification Required: High school diploma or higher education Preferred: High school diploma or higher education Licensure Required: No License Required Preferred: CA Pharmacy Technician License Years of experience required. Projected HM Candidate Review Date: 1-2 days post shortlisting Number and Type of Interviews: 1 Interview (Panel of 3) Extra Interview Prep for Candidate: No Required Testing or Assessment (by Vendor): Manager Communication Preferences & Next Steps
Senior Claims Examiner, Lawyers and Financial Advisors Professional Liability Markel Group IncSenior Claims Examiner, Lawyers and Financial Advisors Professional LiabilityWoodland Hills, CA$78,000–$134,090 / yearThis includes race; color; sex; religion; creed; national origin or place of birth; ancestry; age; disability; affectional or sexual orientation; gender expression or identity; genetic information, sickle cell trait, or atypical hereditary cellular or blood trait; refusal to submit to genetic tests or make genetic test results available; medical condition; citizenship status; pregnancy, childbirth, or related medical conditions; marital status, civil union status, domestic partnership status, familial status, or family responsibilities; military or veteran status, including unfavorable discharge from military service; personal appearance, height, or weight; matriculation or political affiliation; expunged juvenile records; arrest and court records where prohibited by applicable law; status as a victim of domestic or sexual violence; public assistance status; order of protection status; status as a smoker or nonsmoker; membership or activity in local commissions; the use or nonuse of lawful products off employer premises during non-work hours; declining to attend meetings or participate in communications about religious or political matters; or any other classification protected by applicable law. Manage litigation filed nationwide against insureds; appoint, direct and manage defense counsel; proactively work toward expeditious and economical resolution of claims; assist Company claims vendor management, disbursement and legal collections teams with defense counsel, bill payment and collection issues.
Claims Examiner - Workers Compensation Apidel TechnologiesClaims Examiner - Workers CompensationLong Beach, 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. 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.