div>About the Role:
Join MedPOINT Management as a Claims Support specialist in Sherman Oaks, CA, where you will play a vital role in ensuring smooth claims processing and customer satisfaction.
About Us:
MedPOINT Management has been a leader in healthcare management for over 15 years, providing innovative solutions to streamline operations for healthcare providers.
Woodland Hills, CA23 days ago
Headquartered 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. A key objective of this role is to equip the Associate with the knowledge, skills, and abilities necessary to effectively manage a caseload of 70+ files and successfully complete either the SIP exam or earn the Claims Examiner designation within one year of hire for California.
Thousand Oaks, CA30+ days ago
Knowledge of Regulations: Familiarity with industry regulations, such as those from the National Committee for Quality Assurance (NCQA) and The Joint Commission (TJC), Medicare Provider Enrollment, or other healthcare profession or facility credentialing, is highly preferred. The Field Site Inspector will perform site visit inspection services for Medicare and Medicaid providers/suppliers in accordance with established requirements.
p>Essential Functions: In addition to working as prescribed in our Performance Factors specific responsibilities of this role include:
li>Be able to seamlessly transition between various methods of inspection, including video, or photo, to write a damage estimate: Possess strong organizational, time management, and prioritization skills to handle varying workloads due to seasonal volume changes and catastrophes. Knowledge and Skills:
As a Property Claims Examiner 2, you will:
- Possess the ability to work independently with limited or no supervision over daily activities required to successfully investigate, evaluate, write damage estimates, negotiate, and resolve property claims.
You'll partner with claims teams and leadership to shape strategy, provide direction on high-impact cases, and ensure consistent, best-in-class claim handling. Your work will directly influence claim results, customer experience, and overall business performance, making you a critical player in both daily operations and long-term success.
Demonstrated experience identifying, implementing, and optimizing AI and automation solutions within insurance/claims (e.g., triage models, fraud detection, document ingestion, decision support tools, generative AI for adjuster support), with appropriate governance, risk management, and measurable business outcomes. This leader will sharpen and execute the operating model for the Auto Claims team leveraging data- ensuring the right claims are handled within the team, the right claims are escalated at the right time, and that customers experience fast, empathetic, and accurate service.
li>Strong leader - through formal management experience or a proven track record of peer and project leadership, you have demonstrated the ability to motivate, support, and teach a team to help them excel in their roles. Tech-oriented - You are excited by the prospect of building a tech-driven claims organization while delivering an excellent service and have proven results leveraging technology and analytics.
li>Strong leader - through formal management experience or a proven track record of peer and project leadership, you have demonstrated the ability to motivate, support, and teach a team to help them excel in their roles. Tech-oriented - You are excited by the prospect of building a tech-driven claims organization while delivering an excellent service and have proven results leveraging technology and analytics.
You will join a team of experienced claims professionals and will investigate and resolve Commercial Property and Inland Marine claims to provide the best possible claim outcome and employ best efforts to ensure that the customers' interests are protected. You can find additional information about this type of scam and report any fraudulent employment offers via the Federal Trade Commission''s website (https://consumer.ftc.gov/articles/job-scams), or you can contact your local law enforcement agency.
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. 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.
p>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. Sedgwick is building a diverse, equitable, and inclusive workplace and recognizes that each person possesses a unique combination of skills, knowledge, and experience.
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. 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.