Xcelys Medical Claims Examiner (Remote) NTT DATAXcelys Medical Claims Examiner (Remote)Ontario, CARemoteAs part of NTT DATA, a $30 billion trusted global innovator with a combined global reach of over 80 countries, we help clients transform through business and technology consulting, industry and digital solutions, applications development and management, managed edge-to-cloud infrastructure services, BPO, systems integration and global data centers. Outsourcing is not just a method of gaining a one-time cost advantage, but an effective strategy for gaining and maintaining competitive advantages when executed as part of an overall sourcing strategy.
Claims Adjuster II/Senior Claims Adjuster (Senior Workers' Compensation Claims Adjuster) County of Riverside, CaliforniaClaims Adjuster II/Senior Claims Adjuster (Senior Workers' Compensation Claims Adjuster)Riverside, CA$112,778.77–$159,740.22 / yearKnowledge of: State of California Labor Code, Workers Compensation Law and rules and regulations (Title 8); Applicable case law of leading decisions of the Workers Compensation Appeals Board, Court of Appeals, and Supreme Court regarding workers compensation cases; Medical terminology, anatomy and technical terminology used in medical and legal fields regarding industrial cases; Jurisdiction, functions and procedures of the Workers Compensation Appeals Board; Vocational rehabilitation and procedures as it applies to Workers Compensation; Reserving practices and procedures; in-house litigation procedures; WCAB procedures; and hearing processes. Candidates must have achieved the level of Experienced Claims Adjuster (as defined by California Code of Regulations, Title 10, Chapter 5, Subchapter 3) defined as possessing one of the following: 1) Working 5 out of the last 8 years as a California Workers Comp Claims Adjuster, 2) Has worked continuously in California adjusting claims since passing the Self-Insurance Test, or 3) Has passed the Self-Insurance test in the last 2 years.
NewWorkers Compensation Claims Examiner TEEMA GroupWorkers Compensation Claims ExaminerChino, CA$93,000–$104,000This role requires strong technical expertise, sound judgment, and the ability to handle highly complex indemnity claims within established authority limits. This is a highly interactive role requiring regular communication with clients, claimants, attorneys, medical providers, and internal stakeholders.
Associate Bond Claims Attorney HCC Service CompanyAssociate Bond Claims AttorneySanta Ana, California$85,400–$117,500 / yearAs an insurance company, however, we must comply with certain Federal and state laws such as the Violent Crime Control and Law Enforcement Act of 1994 (18 USC § 1033(e)), which limits our ability to employ individuals with certain types of criminal convictions. After making a conditional offer and running a background check, if the Company is concerned about a conviction that is directly related to the job, you will be given the chance to explain the circumstances surrounding the conviction or challenge the accuracy of the background report.
Claims Coordinator RiversideClaims CoordinatorRiverside, CaliforniaAs the hub of all claims, the coordinator is responsible for speaking with the customer, ongoing customer follow up, handling service complaints, logistics of dispatching field personnel to jobs while ensures that the required Cycle Time and insurance Service Level Agreement tasks deadlines are met. Ensure that uploading photos, and other documents are appropriately described, titled and uploaded in real time, as well as follows up to get missing required data from homeowner and insurance/mortgage information not obtained on initial call.
Assistant Claims Adjuster GpacAssistant Claims AdjusterSanta Ana, CA50000–70000Instead, the Assistant Claims Adjuster serves as a liaison between the insured, insurance carriers, and claims adjusters to ensure clear communication, timely follow-up, and exceptional client service throughout the life of each claim. We are seeking a detail-oriented and customer-focused Assistant Claims Adjuster to support the management of Workers' Compensation claims for a select group of commercial clients.
Claims Resolution Specialist (Customer Service) CalOptimaClaims Resolution Specialist (Customer Service)Orange, CA$53,813–$80,720 / yearWe are hoping you will join us as a Claims Resolution Specialist (Customer Service) 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. Responds to provider questions and researches issues regarding claims payments, denials, resolves claim issues, contractual and/or CalOptima Health agreements, established payment methodologies, division of financial responsibility, applicable regulatory legislation, claims processing guidelines and company policies and procedures.
Associate Bond Claims Attorney HCC Life InsuranceAssociate Bond Claims AttorneySanta Ana, CA$85,400–$117,500 / yearAs an insurance company, however, we must comply with certain Federal and state laws such as the Violent Crime Control and Law Enforcement Act of 1994 (18 USC § 1033(e)), which limits our ability to employ individuals with certain types of criminal convictions. After making a conditional offer and running a background check, if the Company is concerned about a conviction that is directly related to the job, you will be given the chance to explain the circumstances surrounding the conviction or challenge the accuracy of the background report.
Claims Specialist Elite SourcingClaims SpecialistCosta Mesa, CaliforniaYou will be responsible for investigating and evaluating property damage claims arising from automobile accidents, working closely with the demands team and clients to ensure fair compensation for damages. Investigate property damage claims involving auto accidents, including reviewing police reports, witness statements, and damage assessments.
Claims Team Leader Allstate Insurance CompanyClaims Team LeaderCA$80,000–$136,625 / yearThe Claims Team Leader is responsible for providing our Agents exceptional claims and inquiry service through chat while managing and motivating ten to fifteen adjuster staff or vendors to achieve inspired levels of performance and expert execution of required claim processes. Through our subsidiaries, we provide a variety of insurance products, including personal and commercial automobile, homeowners, umbrella, recreational vehicle, supplemental health, lender-placed and other niche insurance products.
Claims Manager - Risk Management Live Nation Entertainment IncClaims Manager - Risk ManagementCA$104,000–$130,000 / yearCollaborates with in-house and outside legal counsel to assure proper handling of litigated files as well as coordination of discovery including but not limited to gathering pertinent legal information and claims documentation, deposition requests, identification and preparation of witnesses and other discovery, as well as assists in developing overall defense strategy. Ability to work autonomously to a significant degree, have a high level of attention to detail, be organized and efficient and able prioritize and successfully manage multiple projects, enjoy working in a fast-paced environment, and place a high value on providing exceptional and timely service to internal and external clients.
Claims Coordinator ServiceMaster Restore 9430 - RiversideClaims CoordinatorRiverside, CAFull timeAs the hub of all claims, the coordinator is responsible for speaking with the customer, ongoing customer follow up, handling service complaints, logistics of dispatching field personnel to jobs while ensures that the required Cycle Time and insurance Service Level Agreement tasks deadlines are met. Ensure that uploading photos, and other documents are appropriately described, titled and uploaded in real time, as well as follows up to get missing required data from homeowner and insurance/mortgage information not obtained on initial call.
Manager, Claims Reso AmTrust Financial Services, Inc.Manager, Claims ResoIrvine, California$105,000–$130,000 / yearFull timeOverview: The Resolution Manager is responsible for leading a team of resolution claim adjusters who are responsible for prompt, efficient review and disposition of workers compensation claims through effective investigation, settlement evaluation, negotiation, including direct telephonic interaction and negotiation, with insureds, claimants, and counsel. AmTrust values excellence and recognizes that by embracing the diverse backgrounds, skills, and perspectives of its workforce, it will sustain a competitive advantage and remain an employer of choice.
NewClaims Examiner - Workers Compensation (Hourly) eTeam Inc.Claims Examiner - Workers Compensation (Hourly)Brea, CARemote$45–$48.57 / hourPRIMARY PURPOSE: To 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. Analyzing and processing claims through well-developed action plans to an appropriate and timely resolution by investigating and gathering information to determine the exposure on the claim.
Senior Claims Examiner W. R. Berkley CorpSenior Claims ExaminerIrvine, CA$110,000–$125,000 / yearThis role actively supports and participates in the company's culture of continuous learning and innovation, including engagement in innovation groups focused on identifying opportunities for process improvement, enhancement, and transformational change. Key functions include but are not limited to: Adjust all aspects of complex claims and loss notices, including coverage and compensability analysis, reserve setting, reinsurance reporting, and coverage litigation.
Claims Specialist Pavement Recycling Systems, IncClaims SpecialistJurupa Valley, California$85,000–$115,000 / yearFull timeThe Claims Specialist is responsible for evaluating, processing, and managing liability, property, auto, general liability claims, and employment claims in compliance with state regulations; documenting activities; conveying information regarding claims and/or benefits; and providing testimony in benefit disputes while exercising discretion, independent judgment, critical thinking skills and demonstrate exemplary customer services skills. Serve as the face of the company in providing frequent, proactive verbal communication with our claimants, customers and/or their representatives demonstrating empathy and active listening while providing clear updates, direction and explanations regarding the claim process, benefits, and other pertinent policy provisions.
Claims Examiner - Workers Compensation eTeam Inc.Claims Examiner - Workers CompensationPasadena, CARemote$45–$50 / hourPRIMARY PURPOSE: To 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. 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.
Processor I, DNA (Temp-To-Hire) Collaborative SolutionsProcessor I, DNA (Temp-To-Hire)Santa Ana, CaliforniaThe right candidate will be primarily responsible for accurately itemizing packages, entering information into the designated system, creating specification numbers for each item and helping to manage incoming packages. Excellent interpersonal and interdepartmental communication skills; can communicate clearly and intelligently with other departments and others outside of the organization, and has a desire and willingness to work with others.
Independent Insurance Claims Adjuster in Brea, California MileHigh Adjusters HoustonIndependent Insurance Claims Adjuster in Brea, CaliforniaBrea, CaliforniaHow We Can Help You Succeed: At MileHigh Adjusters Houston, we offer comprehensive training programs tailored to equip you with the essential skills and knowledge needed to excel in the field of claims adjusting. You can also find us on YouTube at: ( https://www.youtube.com/channel/UC9nTRXrwnbC2TuYphDUVhWg ) and Facebook at: ( https://www.facebook.com/milehighadjustershouston ) for additional resources and updates.
Independent Insurance Claims Adjuster in Dana Point, California MileHigh Adjusters HoustonIndependent Insurance Claims Adjuster in Dana Point, CaliforniaDana Point, CaliforniaHow We Can Help You Succeed: At MileHigh Adjusters Houston, we offer comprehensive training programs tailored to equip you with the essential skills and knowledge needed to excel in the field of claims adjusting. You can also find us on YouTube at: ( https://www.youtube.com/channel/UC9nTRXrwnbC2TuYphDUVhWg ) and Facebook at: ( https://www.facebook.com/milehighadjustershouston ) for additional resources and updates.