Key Responsibilities:Investigates and maintains claims, reviewing coverage and liabilityWorks towards the resolution of claims files and may attend legal proceedingsEnsures timely and accurate issuance of claims paymentsRequired Qualifications:Bachelor's Degree or equivalent experience in Liberal Ar...
Experience with Self-Insured Claims/Programs: Hands-on experience in handling self-insured claims is highly desirable. Strong Technical Background in California Workers' Compensation (CA WC): Proficiency in managing workers' compensation claims, including those that are litigated. A minimum of 5 yea...
A company is looking for a Director of Claims, Billing, and Network Management. ...
This individual contributor position works under general direction, and within broad authority limits, to manage commercial claims with high complexity and exposure for a specialized line of business. Manages an inventory of highly complex commercial claims, with large exposures that require a high ...
Key Responsibilities:Conduct quality checks on electronic medical claimsEnsure validation of all patient information and data points in medical claimsMaintain confidentiality and security of client information per guidelinesRequired Qualifications:1-2 years of medical record experience preferredHigh...
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 req...
Working closely with the Vice President - Surety Claims, the Assistant Vice President - Surety Claims plays an integral role in the collaboration and design of policies and procedures within the Claims department to achieve quality claims handling results while ensuring compliance with company proce...
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 req...
Responsibilities: Performing on-site inspections of damaged property Preparing estimates of repair using Xactimate Preparing inventories of damaged property including valuations Performing investigation including interviews & recorded statements Evaluating insurance coverage Making claim adjustment ...
Knowledge of general claims processing principles, CMS claims coding, and UB-04 claims coding, based on at least three to five (3-5) years experience in claims processing preferably in a managed care environment (IPA,MSO) Req. Enter claims information from CMS 1500 (professional) and UB-04 (fac...
Claims Service Representative III - MobileThe Auto Club of Southern CA is looking for a Mobile Warm Transfer representative that will be responsible for investigation, evaluation and negotiation of low to moderate complexity claims in compliance with established company technical and customer servic...
A Claims Adjuster II is responsible for the timely, good faith adjustment and disposition of self-administered casualty claims in multiple jurisdictions. He/she will manage a caseload ranging from 100-150 casualty claims (the acceptable caseloads vary based on the jurisdiction(s), mix and complexity...
The person in this role works directly with Claims management to communicate trends and patterns on coverage, high severity and complex claims. Provides direction to claims personnel and counsel on complex claims files. This individual provides guidance to management for the handling, strategy, and ...
Work proactively towards claims resolution with defense counsel -Determine if coverage applies for claims reported -Evaluate damages to ascertain compensation amount -Respond to claims calls and e-mails from agents and claimants -Negotiate claim settlements -Participate in claims related audits -Pre...
Join Our Team: Are you actively working as a Licensed Claims Adjuster with 100 claims or more under your belt? If so, that's great! If not, no problem! Let us help you on your career path as a Licensed Claims Adjuster. IS IT TIME FOR A CAREER CHANGE? INDEPENDENT INSURANCE CLAIMS ADJUSTERS NEEDED NOW...
As a Supervisor, you'll lead a team of 7, including 5 Claims Adjusters and 2 Claims Assistants, providing guidance, mentorship, and performance feedback to ensure exceptional claim handling and adherence to company standards and regulations. Workers' Compensation Claims Supervisor - Lead a Dynamic T...
Join Our Team: Are you actively working as a Licensed Claims Adjuster with 100 claims or more under your belt? If so, that's great! If not, no problem! Let us help you on your career path as a Licensed Claims Adjuster. IS IT TIME FOR A CAREER CHANGE? INDEPENDENT INSURANCE CLAIMS ADJUSTERS NEEDED NOW...
We’re seeking a Claims Assistant to work at a premier client in Santa Ana, CA. Why you should apply to be a Claims Assistant:. What’s a typical day as a Claims Assistant? You’ll be:. Performing data entry to ensure timely filing of claims. ...
Join Our Team: Are you actively working as a Licensed Claims Adjuster with 100 claims or more under your belt? If so, that's great! If not, no problem! Let us help you on your career path as a Licensed Claims Adjuster. IS IT TIME FOR A CAREER CHANGE? INDEPENDENT INSURANCE CLAIMS ADJUSTERS NEEDED NOW...
Workers Compensation Claims Adjustor. Workers Compensation Claims Adjustor,. ...
To analyze high-level 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 | Long Beach...
Our client is expanding their Workers' Compensation Department and seeking to add Workers' Compensation Claims Adjusters to their California operations. These positions would be responsible for handling California Workers' Compensation Indemnity claims from inception to close. Handle moderate to com...
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 | Orange, CA (Agile Sch...
As a Senior Claims Representative, you will be responsible for the investigation, evaluation, mitigation and resolution of an inventory of lost time and catastrophic workers’ compensation injury claims in multiple jurisdictions. Manage the claims litigation process to ensure timely and cost-effectiv...
The Claims Examiner II accurately reviews, researches and analyzes professional, ancillary and institutional inpatient and outpatient claims. Process all types of claims, such as, HCFA 1500, outpatient/inpatient UB92, high dollar claims, COB and DRG claim. Comprehensive knowledge of DMHC and CMS gui...