GLOVIS: Temp Analyst, Claims Revenue and Cost Integration Elevated ResourcesGLOVIS: Temp Analyst, Claims Revenue and Cost IntegrationIrvine, CaliforniaThis role will focus on collecting, organizing, validating, and analyzing claims-related data to help develop an AI solution that can review claim photos, inspection reports, repair estimates, and other documentation to identify damages, estimate severity, and assist with determining liability. Collect, organize, and maintain claim photos, inspection reports, repair estimates, invoices, incident reports, and supporting documentation.
NewSenior Claims Specialist Macpower Digital Assets Edge Private LimitedSenior Claims SpecialistOrange, CA$110,000–$130,000 / yearJob Summary: Seeking a Senior Claims Specialist to manage a complex caseload of medical malpractice claims, supervise junior claims specialists, and contribute to ongoing training efforts. Key Responsibilities: Manage medical malpractice claims , including assigning and directing defense counsel, following Claims Technical Manual, Defense Attorney Guidelines, and MPT Agreement.
OHS Claims Processor I (Bilingual) FT Kaiser PermanenteOHS Claims Processor I (Bilingual) FTLos Angeles, CAOrdering and photocopying medical records; temporarily cover other desk/functions due to vacation and workload fluctuations; clears designated Health Connect work queues daily, creates patient accounts to register patients and fills in the required KP computerized systems, provides personalized and professional patient/employer/carrier services. Promotes, ensures and improves customer service to internal/external customers by demonstrating skills which are consistent with the organizations philosophy of providing extraordinary customer relations and quality service as well as all other Kaiser Permanente Policy Procedures.
Claims Examiner - Lead Covered California CalOptimaClaims Examiner - Lead Covered CaliforniaOrange, CA$55,966–$83,949 / yearWe are hoping you will join us as a Claims Examiner - Lead Covered California and help shape the future of healthcare where you'll be an integral part of our Claims Administration team, helping to strive for excellence while we serve our member health with dignity, respecting the value and needs of each of our members through collaboration with our providers, community partners and local stakeholders. If you make it through the steps above and are selected for this exciting role, you will be required to undergo a reference and a background check (to include a conviction record) and if applicable also pass a drug screening and/or a post-offer pre-employment medical examination (for specific positions) If you are an Internal CalOptima Health applicant, please apply through the internal portal on InfoNet.
Claims Resolution Specialist, Covered California CalOptimaClaims Resolution Specialist, Covered CaliforniaOrange, CA$53,813–$80,720 / yearWe are hoping you will join us as a Claims Resolution Specialist, Covered California and help shape the future of healthcare where you'll be an integral part of our Claims Administration team, helping to strive for excellence while we serve our member health with dignity, respecting the value and needs of each of our members through collaboration with our providers, community partners and local stakeholders. If you make it through the steps above and are selected for this exciting role, you will be required to undergo a reference and a background check (to include a conviction record) and if applicable also pass a drug screening and/or a post-offer pre-employment medical examination (for specific positions) If you are an Internal CalOptima Health applicant, please apply through the internal portal on InfoNet.
Claims Examiner - Lead CalOptimaClaims Examiner - LeadOrange, CA$55,966–$83,949 / yearWe are hoping you will join us as a Claims Examiner - Lead and help shape the future of healthcare where you'll be an integral part of our CLA - Claims Production team, helping to strive for excellence while we serve our member health with dignity, respecting the value and needs of each of our members through collaboration with our providers, community partners and local stakeholders. If you make it through the steps above and are selected for this exciting role, you will be required to undergo a reference and a background check (to include a conviction record) and if applicable also pass a drug screening and/or a post-offer pre-employment medical examination (for specific positions) If you are an Internal CalOptima Health applicant, please apply through the internal portal on InfoNet.
Assistant Director, Claims Operations Impresiv HealthAssistant Director, Claims OperationsHuntington Beach, CA$95,000–$120,000 / yearThe Assistant Director will provide operational, analytical, administrative, and project support across claims processing, 837 file oversight, payment integrity, issue resolution, provider and IPA coordination, reporting, audit readiness, system initiatives, and process improvement. Track, document, escalate, and help resolve complex claims issues involving providers, IPAs, delegated entities, vendors, and internal departments.
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.
Chief Claims Officer, Argo Group Argo Group International Holdings IncChief Claims Officer, Argo GroupLos Angeles, CAPossesses an extensive knowledge and experience with adjudicating and management claims for a portfolio of commercial products/program lines including surety, auto, general liability, workers' compensation, property, asbestos/environmental, reinsurance and the relevant claims handling practices supporting such products/programs. The Chief Claims Officer, Argo Group provides claim leadership and direction to the Senior Management of all the Argo Group claims operations with a focus on supporting the consistent execution of claims functions and maintenance of operational excellence.
Chief Claims Officer, Argo Group Argo Group International Holdings Ltd.Chief Claims Officer, Argo GroupLos Angeles, CAPossesses an extensive knowledge and experience with adjudicating and management claims for a portfolio of commercial products/program lines including surety, auto, general liability, workers' compensation, property, asbestos/environmental, reinsurance and the relevant claims handling practices supporting such products/programs. The Chief Claims Officer, Argo Group provides claim leadership and direction to the Senior Management of all the Argo Group claims operations with a focus on supporting the consistent execution of claims functions and maintenance of operational excellence.
Claims Examiner Sr CalOptimaClaims Examiner SrOrange, CA$51,744–$72,441 / yearWe are hoping you will join us as a Claims Examiner Sr and help shape the future of healthcare where you'll be an integral part of our Claims Administration team, helping to strive for excellence while we serve our member health with dignity, respecting the value and needs of each of our members through collaboration with our providers, community partners and local stakeholders. If you make it through the steps above and are selected for this exciting role, you will be required to undergo a reference and a background check (to include a conviction record) and if applicable also pass a drug screening and/or a post-offer pre-employment medical examination (for specific positions) If you are an Internal CalOptima Health applicant, please apply through the internal portal on InfoNet.
Claims Examiner Sr, Covered California CalOptimaClaims Examiner Sr, Covered CaliforniaOrange, CA$51,744–$72,441 / yearWe are hoping you will join us as a Claims Examiner Sr, Covered California and help shape the future of healthcare where you'll be an integral part of our Claims Administration team, helping to strive for excellence while we serve our member health with dignity, respecting the value and needs of each of our members through collaboration with our providers, community partners and local stakeholders. If you make it through the steps above and are selected for this exciting role, you will be required to undergo a reference and a background check (to include a conviction record) and if applicable also pass a drug screening and/or a post-offer pre-employment medical examination (for specific positions) If you are an Internal CalOptima Health applicant, please apply through the internal portal on InfoNet.
Claims Quality Auditor UCLA Health SystemClaims Quality AuditorLos Angeles, CA$31.51–$62.64 / hourAs a condition of employment, the final candidate who accepts an offer of employment will be required to disclose if they have been subject to any final administrative or judicial decisions within the last seven years determining that they committed any misconduct; or have filed an appeal of a finding of substantiated misconduct with a previous employer. You will review claims (paid, pending, and denied) for accuracy, appropriate application of benefits, authorization for services, contract interpretation, Division of Financial Responsibility (DOFR), and application/compliance with policies and procedures.
WC Claim Associate I LevelUP CCMSIWC Claim Associate I LevelUPIrvine, CaliforniaRemoteIn simple terms: you’ll learn how to help employees who are injured at work navigate the claim process, communicate with people involved, gather information, document decisions, and keep things moving forward—accurately, timely, and with care. At CCMSI, we partner with global clients to solve their most complex risk management challenges, delivering measurable results through advanced technology, collaborative problem-solving, and an unwavering commitment to their success.
Senior Claim Examiner I, CA AmTrust Financial Services, Inc.Senior Claim Examiner I, CATBD, California$49–$54 / hourFull timeSalaries are based upon a wide range of factors considered in making the compensation decision, including, but not limited to, candidate skills, experience, education and training, the scope and responsibilities of the role, as well as market and business considerations . Your ability to effectively interact with insureds, claimants, and their legal representatives will be essential in driving timely settlements while adhering to AmTrust’s mission, vision, and values.
Sr Claim Examiner- WC TPI Global (formerly Tech Providers, Inc.)Sr Claim Examiner- WCBrea, CAEstablish reserves, using independent judgment and expertise and authorizes payments within scope of authority, settling claims in the most cost-effective manner and ensuring timely issuance of disbursements. Duties: Interprets and makes decisions using independent judgment on more complex and unusual policy coverages and determines if coverages apply to claims submitted.
Claim Examiner- WC TPI Global (formerly Tech Providers, Inc.)Claim Examiner- WCBrea, CAEstablish reserves, using independent judgment and expertise and authorizes payments within scope of authority, settling claims in the most cost-effective manner and ensuring timely issuance of disbursements. Duties:Interprets and makes decisions using independent judgment on more complex and unusual policy coverages and determines if coverages apply to claims submitted.
EPL & D&O Liability Claim Counsel The Travelers CompaniesEPL & D&O Liability Claim CounselGlendale, 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.
Claiming Analyst - Revenue Cycle Management Hathaway-SycamoresClaiming Analyst - Revenue Cycle ManagementLos Angeles, CA$23–$26 / hourUse internal communication to track admissions across all programs, in order to accurately create and open consumers financial profile in both EHRS and IBHIS.In collaboration with eligibility worker, research and resolve consumer eligibility issues. In collaboration with Claiming and Revenue Manager, claim, track and monitor invoice/EDI claims to other funding entities to ensure timely submission.
Claim Examiner- WC Volt Information Sciences IncClaim Examiner- WCBrea, CALocation Brea CA 92821Duration 03 monthsPay Range 29per hour to 30.51per hourPay range offered to a successful candidate will be based on several factors including the candidates education work experience work location specific job duties certifications etc. Establish reserves using independent judgment and expertise and authorizes payments within scope of authority settling claims in the most cost-effective manner and ensuring timely issuance of disbursements.