Job Title - ClaimsProcessor
Hourly Pay - $30/hr
Shift - Day 5x8-Hour (07:00 - 15:30)
Job Description -
SPECIFIC SKILLS NEEDED
Knowledge of HMO/or IPA operations; medical terminology; ICD-10, RVS, and CPT coding knowledge; knowledge of Medicare and Medi-Cal guidelines; 10-key skills by touch; excellent communication skills; knowledge of system applications; ability to function effectively under time deadlines; strong organizational skills.
Required:
Formal training will be indicated by a high school diploma or equivalent;
Four years medical claims processing.
DUTIES AND RESPONSIBILITIES
1. Safeguards and preserves the confidentiality of patient's protected health information in accordance with State and Federal (HIPAA) regulatory requirements, hospital and departmental policies.
2. Ensures a safe patient environment and adherence to safety practices per policy.
3. With consideration to age, employee utilizes the approved process to resolve biophysical, psychological, educational and environmental needs of patient/significant other when administering care.
4. Assist the Claims Director in the training and education of the Claims department staff
5. Coordinate the generation and review of claims audit, status and pending claims reports ensuring authorized claims are paid in accordance with company guidelines
6. Investigate, process and track payment adjustments including refunds, overpayments and underpayments
7. Act as a confidential and professional resource for group providers and other staff.
8. Act as a resource for providers, members, insurance carriers, attorneys and co-workers, researching and responding to questions in a timely manner
9. Create, maintain and generate system reports
10.Review and audit member liability denials and Provider Dispute Resolution claims to ensure compliance with regulatory requirements and passing audit scores from health plans
$30 hourly 2d ago
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Claims Investigator
Apex Investigation
Claim processor job in Los Angeles, CA
About the Company
For over 40 years, APEX Investigation has been dedicated to reducing insurance risk and combating fraud through trusted, high-quality investigations. We build lasting client relationships through integrity, clear communication, and timely, actionable results. Specializing in suspicious claims across multiple coverage areas-including workers' compensation, property, casualty, and auto liability-we provide critical information that supports efficient claims resolution, cost control, and reduced financial loss.
About the Role
The Claims Investigator plays a critical role in the investigation of insurance claims-primarily workers' compensation-by conducting recorded statements, field investigations, scene and medical canvasses, and producing clear, well-documented reports.
This position requires adaptability, strong communication skills, sound judgment, and the ability to manage both fieldwork and detailed administrative responsibilities. Travel and variable schedules are a regular part of this role.
Key Responsibilities
Case Management & Communication
Receive, review, and manage assigned cases from start to completion.
Communicate professionally with clients, claimants, witnesses, and other involved parties.
Provide timely case updates and correspondence in accordance with company guidelines via CaseLink.
Maintain objectivity and professionalism in all interactions.
Investigative Field Work
Conduct recorded statements at various locations, including claimants' homes, workplaces, medical offices, and public settings.
Ask open-ended questions, interpret responses, and conduct appropriate follow-up without reliance on scripted questionnaires.
Perform scene and neighborhood canvasses, including walking on varied terrain.
Meet with treating physicians and medical offices as required.
Travel to designated locations, including overnight stays when necessary.
Respond to rush cases within business hours when required.
Documentation & Reporting
Enter case updates, notes, hours worked, mileage, and expenses into CaseLink on a daily basis.
Upload all obtained statements, documents, recordings, photographs, and evidence to CaseLink the same day they are acquired.
Compose clear, concise, and grammatically correct case updates within 24 hours of obtaining statements.
Prepare and submit comprehensive investigative reports within 72 hours of final update submission.
Evidence & Records Handling
Retrieve records from agencies and entities both in-person and remotely.
Take clear photographs and video when necessary and label all electronic files accurately.
Securely collect, store, and maintain custody of evidence when required.
Maintain organized and protected case files and establish backup procedures to safeguard data in the event of technical failure.
Additional Responsibilities
Identify and recommend additional investigative services outside the scope of the original assignment when appropriate.
Work overtime as needed to meet case demands and deadlines.
Maintain an efficient, safe, and organized telecommuter workspace.
Physical & Work Environment Requirements
Ability to sit for extended periods performing computer-based work and report writing.
Ability to stand for extended periods while conducting interviews and canvasses.
Ability to lift and carry items weighing between 5-30 lbs (e.g., laptop, briefcase, equipment).
Ability to operate digital audio recording equipment.
Qualifications
Experience with workers' compensation claims and investigative processes.
Strong written and verbal communication skills.
Ability to work independently, manage time effectively, and meet strict deadlines.
Willingness and ability to travel up to (but not limited to) 150 miles per assignment.
Possession of a personal credit card with available balance for reimbursable business expenses.
Proficiency with case management systems; CaseLink experience preferred.
Access to a personal scanner for document upload and record handling.
Preferred Qualifications
Prior experience conducting recorded statements and field investigations.
Experience with process service assignments.
Familiarity with evidence handling and documentation standards.
Background in insurance investigations or a related field.
$44k-61k yearly est. 3d ago
Analyst, Healthcare Medical Coding - Disputes, Claims & Investigations
Stout 4.2
Claim processor job in Irvine, CA
At Stout, we're dedicated to exceeding expectations in all we do - we call it Relentless Excellence . Both our client service and culture are second to none, stemming from our firmwide embrace of our core values: Positive and Team-Oriented, Accountable, Committed, Relationship-Focused, Super-Responsive, and being Great communicators. Sound like a place you can grow and succeed? Read on to learn more about an exciting opportunity to join our team.
About Stout's Forensics and Compliance GroupStout's Forensics and Compliance group supports organizations in addressing complex compliance, investigative, and regulatory challenges. Our professionals bring strong technical capabilities and healthcare industry experience to identify fraud, waste, abuse, and operational inefficiencies, while promoting a culture of integrity and accountability. We work closely with clients, legal counsel, and internal stakeholders to support investigations, regulatory inquiries, litigation, and the implementation of sustainable compliance and revenue cycle improvements.What You'll DoAs an Analyst, you will play a hands-on role in client engagements, contributing independently while collaborating closely with senior team members. Responsibilities include:
Support and execute client engagements related to healthcare billing, coding, reimbursement, and revenue cycle operations.
Perform detailed forensic analyses and compliance reviews to identify potential fraud, waste, abuse, and process inefficiencies.
Analyze and document EMR/EHR hospital billing workflows (e.g., Epic Resolute), including charge capture, claims processing, and reimbursement logic.
Assist in audits, investigations, and litigation support engagements, including evidence gathering, issue identification, and corrective action planning.
Collaborate with Stout engagement teams, client compliance functions, legal counsel, and leadership to support project objectives.
Support EMR/EHR implementations and optimization initiatives, including system testing, data validation, workflow review, and post-go-live support.
Prepare clear, well-structured analyses, reports, and client-ready presentations summarizing findings, risks, and recommendations.
Communicate proactively with managers and project teams to ensure alignment, quality, and timely delivery.
Continue developing technical, analytical, and consulting skills while building credibility with clients.
Stay current on healthcare regulations, payer rules, EMR/EHR enhancements, and industry trends impacting compliance and reimbursement.
Contribute to internal knowledge sharing, thought leadership, and practice development initiatives within Stout's Healthcare Consulting team.
What You Bring
Bachelor's degree in Healthcare Administration, Information Technology, Computer Science, Accounting, or a related field required; Master's degree preferred.
Two (2)+ years of experience in healthcare revenue cycle operations, EMR/EHR implementations, compliance, or related healthcare consulting roles.
Experience supporting consulting engagements, audits, or investigations related to billing, coding, reimbursement, or compliance.
Epic Resolute or other hospital billing system experience preferred; Epic certification a plus.
Nationally recognized coding credential (e.g., CCS, CPC, RHIA, RHIT) required.
Additional certifications such as CHC, CFE, or AHFI preferred.
Working knowledge of EMR/EHR system configuration, workflows, issue resolution, and optimization.
Proficiency in Microsoft Office (Excel, PowerPoint, Word); experience with Visio, SharePoint, Tableau, or Power BI preferred.
Understanding of key healthcare regulatory and compliance frameworks, including CMS regulations, HIPAA, and the False Claims Act.
Willingness to travel up to 25%, based on client and project needs.
How You'll Thrive
Analytical and Detail-Oriented: You are comfortable working with complex data and systems, identifying risks, and drawing well-supported conclusions.
Collaborative and Client-Focused: You communicate clearly, work well in team-based environments, and contribute to positive client relationships.
Accountable and Proactive: You take ownership of your work, manage priorities effectively, and deliver high-quality results on time.
Adaptable and Curious: You are eager to learn new systems, regulations, and methodologies in a fast-paced consulting environment.
Growth-Oriented: You seek feedback, develop your technical and professional skills, and build toward increased responsibility.
Aligned with Stout Values: You demonstrate integrity, professionalism, and a commitment to excellence in all client and team interactions.
Why Stout?
At Stout, we offer a comprehensive Total Rewards program with competitive compensation, benefits, and wellness options tailored to support employees at every stage of life.
We foster a culture of inclusion and respect, embracing diverse perspectives and experiences to drive innovation and success. Our leadership is committed to inclusion and belonging across the organization and in the communities we serve.
We invest in professional growth through ongoing training, mentorship, employee resource groups, and clear performance feedback, ensuring our employees are supported in achieving their career goals.
Stout provides flexible work schedules and a discretionary time off policy to promote work-life balance and help employees lead fulfilling lives.
Learn more about our benefits and commitment to your success.
en/careers/benefits
The specific statements shown in each section of this description are not intended to be all-inclusive. They represent typical elements and criteria necessary to successfully perform the job.
Stout is an Equal Employment Opportunity.
All qualified applicants will receive consideration for employment on the basis of valid job requirements, qualifications and merit without regard to race, color, religion, sex, national origin, disability, age, protected veteran status or any other characteristic protected by applicable local, state or federal law.
Stout is required by applicable state and local laws to include a reasonable estimate of the compensation range for this role. The range for this role considers several factors including but not limited to prior work and industry experience, education level, and unique skills. The disclosed range estimate has not been adjusted for any applicable geographic differential associated with the location at which the position may be filled. It is not typical for an individual to be hired at or near the top of the range for their role and compensation decisions are dependent on the facts and circumstances of each case.
A reasonable estimate of the current range is $60,000.00 - $130,000.00 Annual. This role is also anticipated to be eligible to participate in an annual bonus plan. Information about benefits can be found here - en/careers/benefits.
$35k-44k yearly est. 4d ago
Assistant Claims Examiner
Athens Administrators 4.0
Claim processor job in Orange, CA
DETAILS
Assistant Claims Examiner - Flex
Department:
Workers' Compensation
Reports To:
Claims Supervisor
FLSA Status:
Non-Exempt
Job Grade:
6
Career Ladder:
Next step in progression could include Future Medical Examiner or Claims Examiner Trainee
ATHENS ADMINISTRATORS Explore the Athens Administrators difference: We have been dynamic, innovative leaders in claims administration since our founding in 1976. We foster an environment where employees not only thrive but consistently recognize Athens as a “Best Place to Work.” Immerse yourself in our engaging, supportive, and inclusive culture, offering opportunities for continuous professional growth. Join our nationwide family-owned company in Workers' Compensation, Property & Casualty, Program Business, and Managed Care. Embrace a change and come make an impact with the Athens Administrators family today! POSITION SUMMARY Athens Administrators has an immediate need for an experienced Assistant Claims Examiner - Flex to support our Workers' Compensation department and can be located anywhere in the state of California, however, employees who live less than 26 miles from the Concord, CA or Orange, CA offices are required to work once a week in the office on a day determined by their supervisor between Tuesday - Thursday. The remaining days can be worked remotely if technical requirements are met, and the employee resides in California. Athens offices are open for business Monday-Friday from 7:30 a.m. to 5:30 p.m. local time. The schedule for this position is Monday-Friday at 37.5 hours a week with the option of a flex schedule. The Assistant Claims Examiner - Flex will provide clerical and technical assistance to Senior Claims Examiners and administer Medical Only claims, ensuring timely processing of claims and payment of benefits, managing, and directing medical treatment, and setting reserves for a variety of teams and clients at Athens. PRIMARY RESPONSIBILITIES Our new hire should have the skills, ability, and judgment to perform the following essential job duties and responsibilities with or without reasonable accommodation. Additional duties may be assigned:
Process new claims in compliance with client's Service Agreement
Issue all indemnity payments and awards on time
Process all approved provider bills timely
Prepare objection letters to providers for medical bills; delayed, denied, lacking reports.
Answer questions over the phone from medical providers regarding bills
Contact treating physician for disability status
Contact employer for return-to-work status or availability of modified work.
Contact injured worker at initial set up
Send DWC notices timely
Issue SJDB Notices timely
Request Job Description from Employer
Handle Medical Only claim files
Calculate wage statements and adjust disability rates as required
Keep diary for all delay dates and indemnity payments
Documents file activity on computer
Update information on computer, i.e., address changes, etc.
Schedule appointments for AME, QME evaluations
Send appointment letters, issue TD/mileage, send medical file
Schedule interpreter for appointments, depositions, etc.
Request Employer's Report, DWC-1, Doctor's First Report if needed
Verify mileage and dates of treatment for reimbursement to claimant
Subpoena records
File and serve documents on attorneys, WCAB, doctors
Serve PTP's with medical file and Duties of Treating Physician (9785)
Request PD ratings from DEU
Draft Stipulated Awards and C&R's
Submit C&R, Stipulated Awards to WCAB for approval with documentation
Process checks - stop payment, cancellations, void, journal payments
Handle telephone calls for examiner as needed
Complete penalty calculations and prepare penalty worksheets
Complete MPN, HCO and/or EDI coding
Complete referrals to investigators
Complete preparation of documents for overnight delivery
Work collaboratively with Senior Claims Examiners, Nurse Case Managers, and other Assistant Claims Examiners
Contact with clients, injured workers, attorneys, doctors, vendors, and other parties
Provide updates of claims status to Senior Claims Examiners and Athens management
Prepare professional, well written correspondence and other communications
ESSENTIAL POSITION REQUIREMENTS The requirements listed below are representative of the knowledge, skill, and/or ability required. While it does not encompass all job requirements, it is meant to give you a solid understanding of expectations.
High School Diploma or equivalent (GED) required for all positions
AA/AS or BA/BS preferred but not required
2+ years' Claims Assistant experience supporting a workers compensation examiner or team preferred
Medical Only Adjuster designation required
Continuing hours must be current
Mathematical calculating skills
Completion of IEA or equivalent courses
Administrators Certificate from Self-Insurance Plans preferred
Knowledge of workers compensation laws, policies, and procedures
Understanding of medical and legal terminology
Must demonstrate accuracy and thoroughness in work product
Ability to sit for prolonged periods of time
Well-developed verbal and written communication skills with strong attention to detail
Excellent organizational skills and ability to multi-task
Ability to type quickly, accurately and for prolonged periods
Proficient in Microsoft Office Suite
Ability to learn additional computer programs
Reasoning ability, including problem-solving and analytical skills, i.e., proven ability to research and analyze facts, identify issues, and make appropriate recommendations and solutions for resolution
Ability to be trustworthy, dependable, and team-oriented for fellow employees and the organization
Seeks to include innovative strategies and methods to provide a high level of commitment to service and results
Ability to demonstrate care and concern for fellow team members and clients in a professional and friendly manner
Acts with integrity in difficult or challenging situations and is a trustworthy, dependable contributor
Athens' operations involve handling confidential, proprietary, and highly sensitive information, such as health records, client financials, and other personal data. Therefore, maintaining honesty and integrity is essential for all roles within the company.
Must be able to reliably commute to meetings and events as required by this position
APPLY WITH US We look forward to learning about YOU! If you believe in our core values of honesty and integrity, a commitment to service and results, and a caring family culture, we invite you to apply with us. Please submit your resume and application directly through our website at *********************************************** Feel free to include a cover letter if you'd like to share any other details. All applications received are reviewed by our in-house Corporate Recruitment team. The Company will consider qualified applicants with arrest or conviction records in accordance with the Los Angeles Fair Chance Ordinance for Employers and the California Fair Chance Act. Applicants can learn more about the Los Angeles County Fair Chance Act, including their rights, by clicking on the following link: ************************************************************************************************* This description portrays in general terms the type and levels of work performed and is not intended to be all-inclusive or represent specific duties of any one incumbent. The knowledge, skills, and abilities may be acquired through a combination of formal schooling, self-education, prior experience, or on-the-job training. Athens Administrators is an Equal Opportunity/ Affirmative Action employer. We provide equal employment opportunities to all qualified employees and applicants for employment without regard to race, religion, sex, age, marital status, national origin, sexual orientation, citizenship status, veteran status, disability, or any other legally protected status. We prohibit discrimination in decisions concerning recruitment, hiring, compensation, benefits, training, termination, promotions, or any other condition of employment or career development. THANK YOU! We look forward to reviewing your information. We understand that applying for jobs may not be the most enjoyable task, so we genuinely appreciate the time you've dedicated. Don't forget to check out our website at ******************* as well as our LinkedIn, Glassdoor, and Facebook pages! Athens Administrators is dedicated to fair and equitable compensation for our employees that is both competitive and reflective of the market. The estimated rate of pay can vary depending on skills, knowledge, abilities, location, labor market trends, experience, education including applicable licenses & certifications, etc. Our ranges may be modified at any time. In addition, eligible employees may be considered annually for discretionary salary adjustments and/or incentive payments. We offer a variety of benefit plans including Medical, Vision, Dental, Life and AD&D, Long Term Care, Critical Care, Accidental, Hospital Indemnity, HSA & FSA options, 401k (and Roth), Company-Paid STD & LTD and more! Further information about our comprehensive benefits package may be found on our website at https://*******************/careers/why-work-here
$49k-73k yearly est. 60d+ ago
Publishing - Content Claiming Specialist
Create Music Group 3.7
Claim processor job in Los Angeles, CA
Create Music Group is currently looking for a Youtube Publishing Administrator to join our Publishing Department. This role is responsible for ensuring complete delivery of our publishing content, as well as maintaining internal systems and metadata to company standards. This is a full-time position located in our Hollywood office.
YouTube monetization provides an alternative consulting and revenue-generating resource for our clients to grow their audience and earnings. We have helped our clients monetize and collected millions in previously unclaimed revenue for artists and labels.
REQUIREMENTS:
1-3 years work experience
Excellent communication skills, both written and verbal
Internet culture and social media platforms, especially YouTube
Conducting basic level research
Organizing large amounts of data efficiently
Proficiency with Mac OSX, Microsoft Office, and Google Apps
PLUSES:
Strong understanding of the online video market (YouTube, Instagram, TikTok)
Bilingual - any language, although Spanish, Mandarin, and Russian is preferred
RESPONSIBILITIES:
Watching YouTube videos for several hours daily
Content claiming
Uploading and defining intellectual assets
Administrative metadata tasks
Researching potential clients
Staying on top of accounts for current client roster
You are required to bring your own laptop for this position.
BENEFITS:
Paid company holidays, paid time off, and health benefits (medical, dental, vision, and supplementary policies) are included.
TO APPLY:
Send us your resume and cover letter (in one file). After you apply, you will be redirected to take our Culture Index survey here. Otherwise, copy and paste the link to your web browser: ********************************************************* Info.php?cfilter=1&COMPANY_CODE=cYEX5Omste
Applications without a cover letter and Culture Index survey will not be considered. OPTIONAL: Link relevant social media campaigns and/or writing samples from your portfolio.
$44k-75k yearly est. Auto-Apply 60d+ ago
Claims Examiner
Us Tech Solutions 4.4
Claim processor job in Whittier, CA
**Duration: 3+ months contract** **Responsibilities:** + Review, adjudicate, and process medical claims for HMO patients + Work closely with affiliated medical groups and hospitals + Evaluate provider reimbursement terms and flag non-contracted providers
+ Ensure claims are processed accurately and timely per policy guidelines
**Experience:**
2+ years of experience in claims adjudication (HMO, IPA, or hospital environment)
**Skills:**
+ Claims reimbursement knowledge
+ Experience working with DOFR (Division of Financial Responsibility)
+ Hands-on experience processing lab claims
+ Familiar with UB-92 and HCFA-1500 forms
+ Understanding of provider contracts, Medi-Cal, commercial, and senior plan claims
+ Strong knowledge of timeliness, payment accuracy, and compliance standards
+ Basic computer and data entry skills
**Education:**
High school diploma, GED, or higher
**About US Tech Solutions:**
US Tech Solutions is a global staff augmentation firm providing a wide range of talent on-demand and total workforce solutions. To know more about US Tech Solutions, please visit *********************** (********************************** .
US Tech Solutions is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity,
national origin, disability, or status as a protected veteran.
$27k-39k yearly est. 60d+ ago
Examiner II, Claims
Altamed 4.6
Claim processor job in Montebello, CA
Grow Healthy If you are as passionate about helping those in need as you are about growing your career, consider AltaMed. At AltaMed, your passion for helping others isn't just welcomed - it's nurtured, celebrated, and promoted, allowing you to grow while making a meaningful difference. We don't just serve our communities; we are an integral part of them. By raising the expectations of what a community clinic can deliver, we demonstrate our belief that quality care is for everyone. Our commitment to providing exceptional care, despite any challenges, goes beyond just a job; it's a calling that drives us forward every day.
Job Overview
The Claims Examiner II is responsible for analyzing and adjudication of medical claims as it relates to managed care. Performs payment reconciliations and/or adjustments related to retroactive contract rate and fee schedule changes. May resolve claims payment issues as presented through the Provider Dispute Resolution (PDR) process or from claims incidents/inquiries. Identifies root causes of claims payment errors and reports to Management. Responds to provider inquiries/calls related to claims payment. Collaborates with other departments and/or providers in the successful resolution of claims-related issues.
Minimum Requirements
* HS Diploma or GED
* Minimum of 3 years of Claims Processing experience in a managed care environment.
* Experience in reading and interpreting DOFRs and Contracts is required.
* Experience in reading CMS-1500 and UB-04 forms is required.
Compensation
$26.91 - $33.53 hourly
Compensation Disclaimer
Actual salary offers are considered by various factors, including budget, experience, skills, education, licensure and certifications, and other business considerations. The range is subject to change. AltaMed is committed to ensuring a fair and competitive compensation package that reflects the candidate's value and the role's strategic importance within the organization. This role may also qualify for discretionary bonuses or incentives.
Benefits & Career Development
* Medical, Dental and Vision insurance
* 403(b) Retirement savings plans with employer matching contributions
* Flexible Spending Accounts
* Commuter Flexible Spending
* Career Advancement & Development opportunities
* Paid Time Off & Holidays
* Paid CME Days
* Malpractice insurance and tail coverage
* Tuition Reimbursement Program
* Corporate Employee Discounts
* Employee Referral Bonus Program
* Pet Care Insurance
Job Advertisement & Application Compliance Statement
AltaMed Health Services Corp. will consider qualified applicants with criminal history pursuant to the California Fair Chance Act and City of Los Angeles Fair Chance Ordinance for Employers. You do not need to disclose your criminal history or participate in a background check until a conditional job offer is made to you. After making a conditional offer and running a background check, if AltaMed Health Service Corp. is concerned about a conviction directly related to the job, you will be given a chance to explain the circumstances surrounding the conviction, provide mitigating evidence, or challenge the accuracy of the background report.
$26.9-33.5 hourly Auto-Apply 1d ago
Quality Assurance Claims Processor
Pennymac 4.7
Claim processor job in Moorpark, CA
PENNYMAC Pennymac (NYSE: PFSI) is a specialty financial services firm with a comprehensive mortgage platform and integrated business focused on the production and servicing of U. S. mortgage loans and the management of investments related to the U.
S.
mortgage market.
At Pennymac, our people are the foundation of our success and at the heart of our dynamic work culture.
Together, we work towards a unified goal of helping millions of Americans achieve aspirations of homeownership through the complete mortgage journey.
A Typical Day The Quality Assurance (QA) ClaimsProcessor will perform QA reviews in accordance with established procedures and complying with investor requirements and federal and state regulations.
As the QA Processor, you will be responsible for reviewing the default timeline to verify that reported actions occurred as required by the applicable investor and insurer servicing guidelines.
The QA ClaimsProcessor will: Reconcile servicing expenses/corporate advances as required by MI, investor, insurer and internal guidelines including: foreclosure fees and costs, eviction requirements, property inspections and preservation, HOAs, taxes, hazard insurance and expenses during the default process Ensure reviews are performed in a timely manner in accordance with established procedures and investor guidelines Maintain and update various databases to meet departmental and QA requirements Assist in identifying error trends noted during the QA evaluation Achieve key metrics associated with the process and meet departmental monthly goals Perform other related duties as required and assigned Demonstrate behaviors which are aligned with the organization's desired culture and values What You'll Bring Mortgage default-related experience preferred Demonstrated aptitude for data, reporting, data reconciliation desired Familiarity with FHA, VA, USDA, MI and GSE Insurer servicing guidelines Must have experience with auditing and/or filing claims for FHA, VA and/or USDA adhering to the Investor/Insurer's guidelines Must be highly proficient in Excel and Word Why You Should Join As one of the top mortgage lenders in the country, Pennymac has helped over 4 million lifetime homeowners achieve and sustain their aspirations of home.
Our vision is to be the most trusted partner for home.
Together, 4,000 Pennymac team members across the country are guided by our core values: to be Accountable, Reliable and Ethical in all that we do.
Pennymac is committed to conducting a business that makes positive contributions and promotes long-term sustainable growth and to fostering an equitable and inclusive environment, where all employees and customers feel valued, respected and supported.
Benefits That Bring It Home: Whether you're looking for flexible benefits for today, setting up short-term goals for tomorrow, or planning for long-term success and retirement, Pennymac's benefits have you covered.
Some key benefits include: Comprehensive Medical, Dental, and Vision Paid Time Off Programs including vacation, holidays, illness, and parental leave Wellness Programs, Employee Recognition Programs, and onsite gyms and cafe style dining (select locations) Retirement benefits, life insurance, 401k match, and tuition reimbursement Philanthropy Programs including matching gifts, volunteer grants, charitable grants and corporate sponsorships To learn more about our benefits visit: *********************
page.
link/benefits For residents with state required benefit information, additional information can be found at: ************
pennymac.
com/additional-benefits-information Compensation: Individual salary may vary based on multiple factors including specific role, geographic location / market data, and skills and experience as defined below: Lower in range - Building skills and experience in the role Mid-range - Experience and skills align with proficiency in the role Higher in range - Experience and skills add value above typical requirements of the role Some roles may be eligible for performance-based compensation and/or stock-based incentives awarded to employees based on company and individual performance.
Salary $39,000 - $55,000 Work Model OFFICE
$39k-55k yearly Auto-Apply 13d ago
Auto Claims Specialist I (Manheim)
Cox Enterprises 4.4
Claim processor job in Riverside, CA
Company Cox Automotive - USA Job Family Group Vehicle Operations Job Profile Arbitrator I Management Level Individual Contributor Flexible Work Option No remote option; must work at a specified Cox location Travel % No Work Shift Day Compensation Hourly base pay rate is $19.90 - $29.81/hour. The hourly base rate may vary within the anticipated range based on factors such as the ultimate location of the position and the selected candidate's knowledge, skills, and abilities. Position may be eligible for additional compensation that may include commission (annual, monthly, etc.) and/or an incentive program.
Job Description
At Manheim (a Cox Automotive company), we strive to make sure every customer is completely satisfied when they do business with us. On the off-chance we fall short, we do our best to make things right, pronto.
That's where you come in.
We're looking for an Auto Claims Specialist I to learn the ropes of resolving customer complaints and ensuring we don't make the same mistake again. Do you have the skills we're looking for? Keep reading for more details!
Benefits
* We all have lives and responsibilities outside of work. We have an exceptional work/life balance at Cox, with accommodating work schedules and flexible time-off policies.
* We show our appreciation for our talent with a competitive salary package and top-notch bonus & incentive plans.
* How does a great healthcare benefits package from day one sound? Multiple options are available for individuals and families. One employee-only plan could be FREE, if you participate in our health screening program.
* 10 days of free child or senior care through your complimentary Care.com membership.
* Generous 401(k) retirement plans with up to 6% company match.
* Employee discounts on hundreds of items, from cars to computers to continuing education.
* Looking to grow your family? You'll have access to our inclusive parental leave policies, plus comprehensive fertility coverage and adoption assistance.
* Want to volunteer in your community? We encourage that, and even offer paid hours for you to do so.
* We all love our pets-whether they walk, crawl, fly, swim or slither-and we're happy to supply insurance for them as well.
At Cox, we believe in being transparent - please click on this link (Cox Benefits Overview) to learn more about our amazing benefits.
What You'll Do
From your very first day on the job, you'll receive guidance and coaching so you can learn the ropes. You'll work with everyone from buyers to sellers to dealers in coordinating and validating customer returns and claims. With Guidance, responsibilities include:
* Reviews customer claims to verify that they meet Manheim's National Arbitration policies and any account-specific guidelines.
* Investigates basic, less complex cases (e.g., late title claims, basic condition report claims, vehicle availability, post-sale inspection fails, mechanical/structural/undisclosed vehicle damage, etc.) or those requiring more prescriptive decision-making.
* Interfaces with all departments involved in the complaint (i.e., reconditioning, front office, dealer services, vehicle entry, etc.), including during the fact finding and investigative phases.
* Uses appropriate resources to investigate and facilitate relevant inspection, documentation, and communication to ensure appropriate actions are completed to move cases forward or to resolution.
* Uses appropriate levels/limits of financial approval authority to resolve cases.
* Evaluate claims by obtaining, comparing, evaluating, and validating various forms of information.
* Prepares and facilitates communication for resolution via telephone, email, and in-person discussion.
* Mediates disputes and negotiates repair and/or pricing of disputed vehicles to arrive at a mutually acceptable solution and to keep vehicles sold.
* Monitors and maintains accurate files for each arbitration case, verifying the accuracy of all required documentation, including invoices and settlement agreements.
* Engages with supervisor/manager to determine if escalation is required.
* Performs other duties as assigned.
Who You Are
You've got a knack for negotiation. You're ethical, dependable, and trustworthy. You're eager to learn. You also have the following qualifications:
Minimum
* A high school diploma or GED and less than 2 years of related experience.
* Accuracy and attention to detail.
* Organizational and time management skills.
* The ability to adapt in a fluid and changing environment.
Preferred
* 1+ years of automotive or body shop experience.
* Claims adjuster experience.
Cox is a great place to be, wouldn't you agree? Apply today!
Drug Testing
To be employed in this role, you'll need to clear a pre-employment drug test. Cox Automotive does not currently administer a pre-employment drug test for marijuana for this position. However, we are a drug-free workplace, so the possession, use or being under the influence of drugs illegal under federal or state law during work hours, on company property and/or in company vehicles is prohibited.
Benefits
Employees are eligible to receive a minimum of sixteen hours of paid time off every month and seven paid holidays throughout the calendar year. Employees are also eligible for additional paid time off in the form of bereavement leave, time off to vote, jury duty leave, volunteer time off, military leave, and parental leave.
About Us
Through groundbreaking technology and a commitment to stellar experiences for drivers and dealers alike, Cox Automotive employees are transforming the way the world buys, owns, sells - or simply uses - cars. Cox Automotive employees get to work on iconic consumer brands like Autotrader and Kelley Blue Book and industry-leading dealer-facing companies like vAuto and Manheim, all while enjoying the people-centered atmosphere that is central to our life at Cox. Benefits of working at Cox may include health care insurance (medical, dental, vision), retirement planning (401(k)), and paid days off (sick leave, parental leave, flexible vacation/wellness days, and/or PTO). For more details on what benefits you may be offered, visit our benefits page. Cox is an Equal Employment Opportunity employer - All qualified applicants/employees will receive consideration for employment without regard to that individual's age, race, color, religion or creed, national origin or ancestry, sex (including pregnancy), sexual orientation, gender, gender identity, physical or mental disability, veteran status, genetic information, ethnicity, citizenship, or any other characteristic protected by law. Cox provides reasonable accommodations when requested by a qualified applicant or employee with disability, unless such accommodations would cause an undue hardship.
Applicants must currently be authorized to work in the United States for any employer without current or future sponsorship. No OPT, CPT, STEM/OPT or visa sponsorship now or in future.
$19.9-29.8 hourly Auto-Apply 11d ago
Complex Claims Specialist - Cyber, Technology, Media & Crime
Hiscox
Claim processor job in Los Angeles, CA
Job Type: Permanent Build a brilliant future with Hiscox Put your claims skills to the test and join one of the top Professional Liability Insurers in the Industry as a Complex Claims Specialist! Please note that this position is hybrid and requires working in office two (2) days per week. Position can be based near the following office locations:
* West Hartford, CT (preferred)
* Atlanta, GA
* Boston, MA
* Chicago, IL
* Los Angeles, CA
* Manhattan, NY
About the Hiscox Claims team:
The US Claims team at Hiscox is a growing group of professionals with experience across private practice and in-house roles, working together to provide the ultimate product we offer to the market. Complex Claims Specialists are empowered to manage their claims with high levels of authority to provide fair and fast resolution of claims for our insured and broker partners.
The Role:
The primary role of a Complex Claims Specialist is to analyze liability claim submissions for potential coverage, set adequate case reserves, promptly and professionally respond to inquiries from our customers and their brokers, and to proactively drive early resolution of claims arising from our commercial lines of insurance. This particular role is open to Atlanta and will be focused on servicing claims and potential claims arising from our book of Cyber, Tech PL, Media and/or Crime professional liability lines of business. This is a fantastic opportunity to join Hiscox USA, a growing business where you will be able to make a real impact. Together, we aim to be the best people producing the best insurance solutions and delivering the best service possible.
What you'll be doing as the Complex Claims Specialist:
Key Responsibilities: To perform all core aspects of in-house claims management, including but not limited to:
* Reviewing and analyzing claim documentation and legal filings
* Drafting coverage analyses for tech E&O, first and third party cyber claims
* Strategizing and maximizing early resolution opportunities
* Monitoring litigation and managing local defense and breach counsel
* Attending mediations and/or settlement conferences, either in person or by phone as appropriate
* Smartly managing and tracking third-party vendor and service provider spend
* Continually assessing exposures and adequacy of claim reserves, and escalating high exposure and/or volatile claims to line manager
* Liaising directly on daily basis with insureds and brokers
* Maintaining timely and accurate file documentation/information in our claims management system
Our Must-Haves:
* 5+ years of professional lines claims handling experience
* A JD from an ABA-accredited law school and bar admission in good standing may be considered as a supplement to claims handing experience
* A minimum of 2-3 years professional experience in the area of Cyber and Technology coverage experience required
* Proven ability to positively affect complex claims outcomes through investigation, negotiation and effectively leading litigation
* Advanced knowledge of coverage within the team's specialty or focus
* Advanced knowledge of litigation process and negotiation skills
* Excellent verbal and written communication skills
* Advanced analytical skills
* B.A./B.S degree from an accredited College or University, JD degree from an ABA accredited law school is preferred
What Hiscox USA Offers:
* Competitive salary and bonus (based on personal & company performance)
* Comprehensive health insurance, Vision, Dental and FSA (medical, limited purpose, and dependent care)
* Company paid group term life, short-term disability and long-term disability coverage
* 401(k) with competitive company matching
* 24 Paid time off days with 2 Hiscox Days
* 10 Paid Holidays plus 1 paid floating holiday
* Ability to purchase 5 additional PTO days
* Paid parental leave
* 4 week paid sabbatical after every 5 years of service
* Financial Adoption Assistance and Medical Travel Reimbursement Programs
* Annual reimbursement up to $600 for health club membership or fees associated with any fitness program
* Company paid subscription to Headspace to support employees' mental health and wellbeing
* Recipient of 2024 Cigna's Well-Being Award for having a best-in-class health and wellness program
* Dynamic, creative and values-driven culture
* Modern and open office spaces, complimentary drinks
* Spirit of volunteerism, social responsibility and community involvement, including matching charitable donations for qualifying non-profits via our sister non-profit company, the Hiscox USA Foundation
About Hiscox USA:
Hiscox USA was established in 2006 to focus primarily on the needs of small and middle market commercial clients, via both the broker and direct distribution channels and is today the fastest-growing business unit within the Hiscox Group.
Today, Hiscox USA has a talent force of about 420 employees mostly operating out of 6 major cities - New York, Atlanta, Dallas, Chicago, Los Angeles and San Francisco. Hiscox USA offers a broad portfolio of commercial products, including technology, cyber & data risk, multiple professional liability lines, media, entertainment, management liability, crime, kidnap & ransom, commercial property and terrorism.
You can follow Hiscox on LinkedIn, Glassdoor and Instagram (@HiscoxInsurance)
Salary Range: $125,000- $160,000
The actual salary for this position will be determined by a number of factors, including the scope, complexity and location of the role; the skills, education, training, credentials and experience of the candidate; and other conditions of employment.
We are an Equal Opportunity Employer and do not discriminate against any employee or applicant for employment because of race, color, sex, age, national origin, religion, sexual orientation, gender identity, status as a veteran, and basis of disability or any other federal, state or local protected class.
#LI-RM1
Work with amazing people and be part of a unique culture
$39k-66k yearly est. Auto-Apply 10d ago
Claims Specialist
Elite Sourcing
Claim processor job in Costa Mesa, CA
Property Damage Claims Specialist
Elite Sourcing is seeking an experienced Property Damage Claim Specialist to join a well-known Law Firm in Costa Mesa, CA. You 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.
Responsibilities:
Investigate property damage claims involving auto accidents, including reviewing police reports, witness statements, and damage assessments
Evaluate claims and determine fair and reasonable settlements, considering policy coverage, damages, and other relevant factors
Maintain accurate and detailed records of claims, investigations, and settlements
Communicate effectively with customers, agents, and other stakeholders throughout the claims process
Stay up-to-date with industry developments, regulations, and best practices to ensure compliance and minimize risk
Collaborate with other adjusters, supervisors, and support staff to resolve complex claims and ensure efficient claims handling
Requirements:
1+ years of experience as an auto claims adjuster or in CA personal injury law (preferred)
Bilingual in Spanish (preferred)
Strong understanding of CA insurance laws and regulations
Ability to work in large teams and be computer savvy.
Experienced with Microsoft Office Suite
Excellent time management, communication, organizational, and analytical skills
Experienced working in a paperless environment.
Must be able to type at least 40 wpm
Pay/Benefits:
$50K-$70K DOE
Medical, Dental, Vision
401K
PTO
$50k-70k yearly 60d+ ago
Claims Specialist, Risk Management
Heritage Grocers
Claim processor job in Ontario, CA
At Heritage Grocers Group, LLC, how we work is defined by shared values that include absolute integrity, respect, and collaboration. But it's more than that, it's smart and highly driven people united in purpose to serve one another. Bring your energy and unique perspective and you'll have the opportunity to grow with us professionally, personally, and financially. You'll be part of a team that genuinely cares about helping you succeed, and you'll work alongside talented colleagues, while making a difference in our communities.
POSITION SUMMARY:
The Claims Specialist will be responsible for directing, monitoring, and processing all workers' compensation and general liability claims for HGG business units. A successful candidate will provide high-level support and customer service to team members across the organization. Primarily communicating with store administrators, store directors, human resources department, industrial clinics, insurance adjusters and legal representatives.
ESSENTIAL DUTIES AND RESPONSIBILITIES:
The essential duties and responsibilities of this position include, but are not limited to, the following:
* Oversee and navigate the complete lifecycle of the workers' compensation claims and general liability claims, guaranteeing precise and punctual resolution.
* Evaluate and review all claim intake paperwork for accuracy.
* Ensure the claim files follow company best practices.
* Report on-the-job injuries of team members to the third-party administrator via online portal within 24-hours of receipt of injury.
* Report customer incidents and injuries to the third-party administrator via online portal within 24-hours of receipt of Letter of Representation or failure to resolve the incident in-house.
* Maintain incident and claim information in the claims' assignment log and in the SharePoint folder.
* Monitor to ensure all the necessary paperwork is submitted to the third-party administrator.
* Communicate with injured team members, store administrators, store directors and insurance adjusters to provide updates on claims and medical status.
* Monitor the claims to ensure they are processed accordingly, and that proper medical treatment is provided to the injured team member.
* Provide support to store administrators/store directors for submission of transitional work report documents and ensure modified work restrictions are being followed.
* Investigate, address, and resolve any inconsistencies in the handling of the claims.
* Communicate to insurance adjusters, legal representatives, and other outside parties with questions involving medical/indemnity/litigated claims within 24 hours.
* Collaborate with the Safety Department when a workplace danger or safety risk is recognized for investigation and documentation.
* Prepare and analyze various reports - disbursement expenses such as replenishment and claim activity payments from Third Party Administrators.
* Adhere to strict confidentiality and ethical standards when handling sensitive claim information.
* Other projects and duties as assigned.
EDUCATION AND EXPERIENCE:
* High School Graduate (college degree, professional certifications and licenses preferred).
* Minimum 1-3 years of claims management experience; workers' compensation preferred.
* Must be bilingual in Spanish including in writing.
SKILLS AND QUALIFICATIONS:
* Attention to detail and thoroughness of work completed.
* Positive attitude and ability to manage multiple tasks at once.
* Timely execution of deliverables.
* Proficiency in typing required.
* Basic to intermediate proficiency with Microsoft Office applications.
* Excellent communication, collaboration, organizational, and critical thinking skills.
PHYSICAL DEMANDS AND WORK CONDITIONS:
The physical demands and work conditions below represent those that must be met to successfully perform the essential functions of this job. Some requirements may be modified to accommodate individuals with disabilities:
* While performing the duties of this job, the employee is regularly required to sit, stand, and use the hands to handle objects, tools or controls.
* Successful performance requires vision abilities that include close vision and the ability to adjust focus.
* The work environment is that typical of an office.
* Ability to lift up to 10lbs.
IMPORTANT DISCLAIMER NOTICE
The job duties, elements, responsibilities, skills, functions, experience, educational factors, and the requirements and conditions listed in this are representative only and not exhaustive of the tasks that an employee may be required to perform. The Employer reserves the right to revise this job description at any time and to require employees to perform other tasks as circumstances or conditions of its business or the work environment change.
Disclaimer :
Pay Scale $22 to $23
The pay scale above is the salary or hourly wage range that the Company reasonably expects to pay for this position.
Within this range, individual pay is determined by location and other factors including, but not limited to, specific skills, relevant work experience, and relevant education and/or training. This information is provided to applicants in accordance with California Labor Code § 432.3 and state and local minimum wage standards.
$38k-66k yearly est. 31d ago
Claims Specialist
Dk Law's Open Roles
Claim processor job in Costa Mesa, CA
The Role
We are seeking an experienced Claims Specialist - Liability & Damages to join our Pre-Litigation team in Costa Mesa, CA. This role is ideal for candidates with a background in insurance claims or personal injury who excel at evaluating liability, coverage, and damages. You will play a critical part in investigating claims, determining case value, and supporting negotiations that drive successful outcomes for our clients.
Closing Statement
We're excited to grow our team and are handling all hiring in-house. To be considered for this position, please apply directly through Indeed, LinkedIn, or our official company website. All updates, contact, or communication should come straight from our internal recruiting team.
What You Will Do
Investigate and evaluate liability and damages on personal injury claims
Review police reports, witness statements, and client testimony to establish liability
Analyze medical records and bills to assess injury-related damages
Work closely with attorneys to prepare case strategy and determine claim value
Support negotiations with insurance carriers to reach fair settlements
Maintain accurate, detailed case documentation in a paperless environment
Communicate with clients, providers, and carriers to ensure claims move efficiently
Stay up to date on California insurance laws, coverage standards, and best practices
Role may include other relevant duties as assigned.
Required Qualifications:
2+ years of experience as an auto claims adjuster, bodily injury adjuster, or in California personal injury law
Strong knowledge of insurance coverage, liability assessment, and damages evaluation
Proficient in Microsoft Office Suite and case management systems
Excellent time management, organizational, and analytical skills
Strong written and verbal communication skills
Must be able to type at least 40 WPM
Comfortable working in large teams and fast-paced environments
Preferred Qualifications:
Bilingual in Spanish or Korean
Experience negotiating settlements with insurance carriers
Background in pre-litigation claims or personal injury law firm environment
Familiarity with reviewing and summarizing medical records
Experience using Filevine, Clio, Litify, or other legal case management systems
$38k-66k yearly est. 60d+ ago
Claims Specialist
Hyatttalentsolutions
Claim processor job in Orange, CA
Job Description
Here's a clean, modern, and ATS-friendly rewrite that tightens the language while keeping all responsibilities intact and professional. This version works well for job boards, internal postings, or client submissions.
Job Title: Senior Claims Specialist - Medical Malpractice
Location: Orange County, CA
Job Summary
Our client is seeking an experienced Senior Claims Specialist to support their Orange County office. This role is responsible for managing assigned medical malpractice claim files, including a higher volume of complex cases with significant financial exposure. The Senior Claims Specialist also provides guidance, training, and oversight to Claims Specialist I and II team members while ensuring compliance with internal policies and regulatory requirements.
Key Responsibilities
Manage medical malpractice claims in compliance with the Claims Technical Manual, Defense Attorney Guidelines, and MPT Agreement
Assign, direct, and oversee defense counsel under appropriate supervision
Investigate and evaluate claim files by interviewing members, reviewing medical records, coordinating with plaintiff attorneys, and obtaining preliminary expert evaluations
Prepare detailed case evaluation reports for presentation to the CRC and CSC
Develop case evaluations for discretionary authority on selected claims
Manage and participate in litigation activities, including discovery planning, mediation, mandatory settlement conferences (MSC), and negotiations as needed
Monitor trials and arbitrations, providing daily updates and supporting members and defense counsel
Prepare claim resolution documentation and maintain accurate claim file records
Update claims databases, chronologies, coding, and index documents within the OnBase system in a timely manner
Identify, investigate, and follow up on coverage issues
Respond to hotline calls and prepare hotline documentation as required
Assist management with special projects and departmental initiatives
Support training and mentoring of Claims Specialist I and II staff
Attend staff and departmental meetings as required
Perform additional duties as assigned
Qualifications
Bachelor's degree from an accredited four-year college or university
Legal and/or medical education background or equivalent experience
Minimum of five (5) years of medical malpractice claims management experience or three (3) years of CAP claims experience
Valid California driver's license
$38k-66k yearly est. 26d ago
Claims Specialist
TCI Transportation 3.6
Claim processor job in Commerce, CA
Schedule: Full-time | Monday-Friday, 8:00 a.m. - 5:00 p.m. Compensation: Starting $25.00/hour plus quarterly incentives
About Us At TCI, we're committed to delivering outstanding logistics solutions with integrity, teamwork, and innovation. We're seeking a detail-oriented and motivated Claims Specialist to join our team. This is a great opportunity to work in a fast-paced environment where your organizational skills and problem-solving abilities will make a real impact.
Position Overview:
The Claims Specialist is responsible for investigating, evaluating, and resolving claims involving auto, bodily injury, property damage, freight, and subrogation. This role requires direct interaction with claimants, insurance carriers, attorneys, vendors, and internal stakeholders to ensure claims are handled efficiently, fairly, and in compliance with company policies. The claims specialist plays a key role in controlling costs while delivering responsive, customer-focused claims service.
What You'll Do
Investigate and evaluate claims by reviewing incident reports, inspecting damages, interviewing involved parties, and gathering supporting documentation.
Determine liability and damages by assessing coverage, establishing responsibility, and calculating fair settlements for auto, property, bodily injury, and freight claims.
Negotiate and resolve claims with claimants, attorneys, and carriers to reach fair and timely settlements.
Communicate with stakeholders, including insurance carriers, internal departments, and external partners, throughout the claims process.
Manage claim files by documenting all activities, maintaining detailed notes, and ensuring compliance with company requirements.
Work with the team to approve repairs, determine fair market value, and manage asset salvage, disposal, or sale decisions.
Respond to inquiries from claimants, vendors, and internal teams, providing updates and follow-up information.
Prepare reports on claim activity, outcomes, and trends for management review.
Support continuous improvement by identifying opportunities to improve claims handling processes and outcomes.
What We're Looking For
Strong administrative, organizational, and customer service skills.
Excellent written and verbal communication.
Ability to thrive in a fast-paced environment with accuracy and attention to detail.
A team-oriented, flexible, and solution-driven mindset.
High level of confidentiality and professional ethics.
Preferred Skills & Experience
Proficiency in Microsoft Excel, Word, Teams, Adobe, DocuSign, and Outlook
Prior experience in transportation, logistics, or insurance claims adjusting
Familiarity with freight and subrogation claim processes
Why Join Us?
Be part of a dedicated, supportive team in a growing company.
Contribute directly to resolving claims and improving processes.
Work in a culture that values innovation, accountability, and teamwork.
Compensation:
Starting at $25/Hourly plus quarterly incentives
About Us:
We are a family-owned company doing business since 1978.
We are dedicated and committed to safety, each other, and our customers.
Our team is positive and passionate and come to work each day with a "Can Do" attitude. We strive to be creative problem solvers who bring innovative thinking in all our work.
Being ethical, transparent, and accountable has helped shape our team and how we do business. We are looking for more people that match our core values to join our team.
$25 hourly 11d ago
Insurance Claims Specialist
Actalent
Claim processor job in Long Beach, CA
We are seeking an Insurance Claim Specialist to support the vehicle fleet for our Field Services Group, for an engineering firm. This role is pivotal in maintaining operational efficiency and asset management within the organization. This role will focus in filing insurance claims for vehicles that have been damaged. Also will setup fuel cards with pin numbers, selling vehicles and purchasing vehicles. Prior experience with a vehicle insurance claim company or submitting vehicle insurance claims is required.
Responsibilities
+ Manage the assignment of equipment such as vehicles, ATVs/UTVs, and PIN numbers.
+ Maintain and update the asset schedule.
+ Assist in asset purchasing when necessary.
+ Submit insurance claims for vehicles.
+ Order transponders, fuel cards, and vehicle registrations as required.
+ Process vendor invoices efficiently.
+ Oversee the sales of company-owned assets.
+ Maintain documentation for vehicles, trailers, and ATVs/UTVs.
+ Manage vehicle registrations and renewals, ensuring communication with relevant staff about requirements.
+ Assist in preparing asset inventory for tracking installations.
+ Update and maintain various databases.
+ Process fuel cards and insurance documentation for new vehicle purchases.
+ Handle incoming mail distribution related to the fleet.
+ Process the cancellation of Telematics devices.
+ Dispatch necessary fleet-related items via FedEx to dealerships or upon driver requests.
Essential Skills
+ Ability to work effectively in with employees who work in the field.
+ Experience submitting insurance claims for vehicles.
+ Skilled in Excel, experience with pivot tables is ideal.
+ Proficiency in Adobe PDF editor or Adobe Acrobat Pro is a plus.
+ Competency in Microsoft Office Suite.
Additional Skills & Qualifications
+ Ability to complete tasks within 24 hours, particularly for urgent matters such as fuel cards and registrations.
+ Maintain a 24-hour response rate for emails to ensure timely communication.
Work Environment
This is a full-time, 40-hour in-office position, operating Monday through Friday from 7:30 am to 4:30 pm. You will work in the office supporting field staff nationally. A company laptop and phone will be provided. The dress code is business casual, allowing jeans without holes.
Job Type & Location
This is a Contract to Hire position based out of Long Beach, CA.
Pay and Benefits
The pay range for this position is $27.00 - $27.00/hr.
Eligibility requirements apply to some benefits and may depend on your job classification and length of employment. Benefits are subject to change and may be subject to specific elections, plan, or program terms. If eligible, the benefits available for this temporary role may include the following: - Medical, dental & vision - Critical Illness, Accident, and Hospital - 401(k) Retirement Plan - Pre-tax and Roth post-tax contributions available - Life Insurance (Voluntary Life & AD&D for the employee and dependents) - Short and long-term disability - Health Spending Account (HSA) - Transportation benefits - Employee Assistance Program - Time Off/Leave (PTO, Vacation or Sick Leave)
Workplace Type
This is a fully onsite position in Long Beach,CA.
Application Deadline
This position is anticipated to close on Jan 29, 2026.
About Actalent
Actalent is a global leader in engineering and sciences services and talent solutions. We help visionary companies advance their engineering and science initiatives through access to specialized experts who drive scale, innovation and speed to market. With a network of almost 30,000 consultants and more than 4,500 clients across the U.S., Canada, Asia and Europe, Actalent serves many of the Fortune 500.
The company is an equal opportunity employer and will consider all applications without regard to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.
If you would like to request a reasonable accommodation, such as the modification or adjustment of the job application process or interviewing due to a disability, please email actalentaccommodation@actalentservices.com (%20actalentaccommodation@actalentservices.com) for other accommodation options.
$27-27 hourly 3d ago
Claims Investigator
Apex Investigation
Claim processor job in Riverside, CA
About the Company
For over 40 years, APEX Investigation has been dedicated to reducing insurance risk and combating fraud through trusted, high-quality investigations. We build lasting client relationships through integrity, clear communication, and timely, actionable results. Specializing in suspicious claims across multiple coverage areas-including workers' compensation, property, casualty, and auto liability-we provide critical information that supports efficient claims resolution, cost control, and reduced financial loss.
About the Role
The Claims Investigator plays a critical role in the investigation of insurance claims-primarily workers' compensation-by conducting recorded statements, field investigations, scene and medical canvasses, and producing clear, well-documented reports.
This position requires adaptability, strong communication skills, sound judgment, and the ability to manage both fieldwork and detailed administrative responsibilities. Travel and variable schedules are a regular part of this role.
Key Responsibilities
Case Management & Communication
Receive, review, and manage assigned cases from start to completion.
Communicate professionally with clients, claimants, witnesses, and other involved parties.
Provide timely case updates and correspondence in accordance with company guidelines via CaseLink.
Maintain objectivity and professionalism in all interactions.
Investigative Field Work
Conduct recorded statements at various locations, including claimants' homes, workplaces, medical offices, and public settings.
Ask open-ended questions, interpret responses, and conduct appropriate follow-up without reliance on scripted questionnaires.
Perform scene and neighborhood canvasses, including walking on varied terrain.
Meet with treating physicians and medical offices as required.
Travel to designated locations, including overnight stays when necessary.
Respond to rush cases within business hours when required.
Documentation & Reporting
Enter case updates, notes, hours worked, mileage, and expenses into CaseLink on a daily basis.
Upload all obtained statements, documents, recordings, photographs, and evidence to CaseLink the same day they are acquired.
Compose clear, concise, and grammatically correct case updates within 24 hours of obtaining statements.
Prepare and submit comprehensive investigative reports within 72 hours of final update submission.
Evidence & Records Handling
Retrieve records from agencies and entities both in-person and remotely.
Take clear photographs and video when necessary and label all electronic files accurately.
Securely collect, store, and maintain custody of evidence when required.
Maintain organized and protected case files and establish backup procedures to safeguard data in the event of technical failure.
Additional Responsibilities
Identify and recommend additional investigative services outside the scope of the original assignment when appropriate.
Work overtime as needed to meet case demands and deadlines.
Maintain an efficient, safe, and organized telecommuter workspace.
Physical & Work Environment Requirements
Ability to sit for extended periods performing computer-based work and report writing.
Ability to stand for extended periods while conducting interviews and canvasses.
Ability to lift and carry items weighing between 5-30 lbs (e.g., laptop, briefcase, equipment).
Ability to operate digital audio recording equipment.
Qualifications
Experience with workers' compensation claims and investigative processes.
Strong written and verbal communication skills.
Ability to work independently, manage time effectively, and meet strict deadlines.
Willingness and ability to travel up to (but not limited to) 150 miles per assignment.
Possession of a personal credit card with available balance for reimbursable business expenses.
Proficiency with case management systems; CaseLink experience preferred.
Access to a personal scanner for document upload and record handling.
Preferred Qualifications
Prior experience conducting recorded statements and field investigations.
Experience with process service assignments.
Familiarity with evidence handling and documentation standards.
Background in insurance investigations or a related field.
$44k-60k yearly est. 3d ago
Analyst, Healthcare Medical Coding - Disputes, Claims & Investigations
Stout 4.2
Claim processor job in Los Angeles, CA
At Stout, we're dedicated to exceeding expectations in all we do - we call it Relentless Excellence . Both our client service and culture are second to none, stemming from our firmwide embrace of our core values: Positive and Team-Oriented, Accountable, Committed, Relationship-Focused, Super-Responsive, and being Great communicators. Sound like a place you can grow and succeed? Read on to learn more about an exciting opportunity to join our team.
About Stout's Forensics and Compliance GroupStout's Forensics and Compliance group supports organizations in addressing complex compliance, investigative, and regulatory challenges. Our professionals bring strong technical capabilities and healthcare industry experience to identify fraud, waste, abuse, and operational inefficiencies, while promoting a culture of integrity and accountability. We work closely with clients, legal counsel, and internal stakeholders to support investigations, regulatory inquiries, litigation, and the implementation of sustainable compliance and revenue cycle improvements.What You'll DoAs an Analyst, you will play a hands-on role in client engagements, contributing independently while collaborating closely with senior team members. Responsibilities include:
Support and execute client engagements related to healthcare billing, coding, reimbursement, and revenue cycle operations.
Perform detailed forensic analyses and compliance reviews to identify potential fraud, waste, abuse, and process inefficiencies.
Analyze and document EMR/EHR hospital billing workflows (e.g., Epic Resolute), including charge capture, claims processing, and reimbursement logic.
Assist in audits, investigations, and litigation support engagements, including evidence gathering, issue identification, and corrective action planning.
Collaborate with Stout engagement teams, client compliance functions, legal counsel, and leadership to support project objectives.
Support EMR/EHR implementations and optimization initiatives, including system testing, data validation, workflow review, and post-go-live support.
Prepare clear, well-structured analyses, reports, and client-ready presentations summarizing findings, risks, and recommendations.
Communicate proactively with managers and project teams to ensure alignment, quality, and timely delivery.
Continue developing technical, analytical, and consulting skills while building credibility with clients.
Stay current on healthcare regulations, payer rules, EMR/EHR enhancements, and industry trends impacting compliance and reimbursement.
Contribute to internal knowledge sharing, thought leadership, and practice development initiatives within Stout's Healthcare Consulting team.
What You Bring
Bachelor's degree in Healthcare Administration, Information Technology, Computer Science, Accounting, or a related field required; Master's degree preferred.
Two (2)+ years of experience in healthcare revenue cycle operations, EMR/EHR implementations, compliance, or related healthcare consulting roles.
Experience supporting consulting engagements, audits, or investigations related to billing, coding, reimbursement, or compliance.
Epic Resolute or other hospital billing system experience preferred; Epic certification a plus.
Nationally recognized coding credential (e.g., CCS, CPC, RHIA, RHIT) required.
Additional certifications such as CHC, CFE, or AHFI preferred.
Working knowledge of EMR/EHR system configuration, workflows, issue resolution, and optimization.
Proficiency in Microsoft Office (Excel, PowerPoint, Word); experience with Visio, SharePoint, Tableau, or Power BI preferred.
Understanding of key healthcare regulatory and compliance frameworks, including CMS regulations, HIPAA, and the False Claims Act.
Willingness to travel up to 25%, based on client and project needs.
How You'll Thrive
Analytical and Detail-Oriented: You are comfortable working with complex data and systems, identifying risks, and drawing well-supported conclusions.
Collaborative and Client-Focused: You communicate clearly, work well in team-based environments, and contribute to positive client relationships.
Accountable and Proactive: You take ownership of your work, manage priorities effectively, and deliver high-quality results on time.
Adaptable and Curious: You are eager to learn new systems, regulations, and methodologies in a fast-paced consulting environment.
Growth-Oriented: You seek feedback, develop your technical and professional skills, and build toward increased responsibility.
Aligned with Stout Values: You demonstrate integrity, professionalism, and a commitment to excellence in all client and team interactions.
Why Stout?
At Stout, we offer a comprehensive Total Rewards program with competitive compensation, benefits, and wellness options tailored to support employees at every stage of life.
We foster a culture of inclusion and respect, embracing diverse perspectives and experiences to drive innovation and success. Our leadership is committed to inclusion and belonging across the organization and in the communities we serve.
We invest in professional growth through ongoing training, mentorship, employee resource groups, and clear performance feedback, ensuring our employees are supported in achieving their career goals.
Stout provides flexible work schedules and a discretionary time off policy to promote work-life balance and help employees lead fulfilling lives.
Learn more about our benefits and commitment to your success.
en/careers/benefits
The specific statements shown in each section of this description are not intended to be all-inclusive. They represent typical elements and criteria necessary to successfully perform the job.
Stout is an Equal Employment Opportunity.
All qualified applicants will receive consideration for employment on the basis of valid job requirements, qualifications and merit without regard to race, color, religion, sex, national origin, disability, age, protected veteran status or any other characteristic protected by applicable local, state or federal law.
Stout is required by applicable state and local laws to include a reasonable estimate of the compensation range for this role. The range for this role considers several factors including but not limited to prior work and industry experience, education level, and unique skills. The disclosed range estimate has not been adjusted for any applicable geographic differential associated with the location at which the position may be filled. It is not typical for an individual to be hired at or near the top of the range for their role and compensation decisions are dependent on the facts and circumstances of each case.
A reasonable estimate of the current range is $60,000.00 - $130,000.00 Annual. This role is also anticipated to be eligible to participate in an annual bonus plan. Information about benefits can be found here - en/careers/benefits.
$35k-44k yearly est. 4d ago
Claims Examiner I
Altamed 4.6
Claim processor job in Montebello, CA
Grow Healthy If you are as passionate about helping those in need as you are about growing your career, consider AltaMed. At AltaMed, your passion for helping others isn't just welcomed - it's nurtured, celebrated, and promoted, allowing you to grow while making a meaningful difference. We don't just serve our communities; we are an integral part of them. By raising the expectations of what a community clinic can deliver, we demonstrate our belief that quality care is for everyone. Our commitment to providing exceptional care, despite any challenges, goes beyond just a job; it's a calling that drives us forward every day.
Job Overview
A Claims Examiner is responsible for analyzing and adjudication of medical claims as it relates to managed care. Performs payment reconciliations and/or adjustments related to retroactive contract rate and fee schedule changes. Resolve claims payment issues as presented through the Provider Dispute Resolution (PDR) process or from claims incidents/inquiries. Identifies root causes of claims payment errors and reports to Management. Responds to provider inquiries/calls related to claims payments. Collaborates with other departments and/or providers in the successful resolution of claims-related issues.
Minimum Requirements
* HS Diploma or GED.
* Must have some knowledge of Medi-Cal regulations.
* Must have some Knowledge of medical terminology.
* Must understand to read and interpret DOFRs and Contracts.
* Preferred knowledge of Medicare and Commercial rules and regulations.
* Must have an understanding of how to read a CMS-1500 and UB-04 form.
* Must have strong organizational and mathematical skills.
* Must be able to multi-task
Compensation
$25.00 - $29.32 hourly
Compensation Disclaimer
Actual salary offers are considered by various factors, including budget, experience, skills, education, licensure and certifications, and other business considerations. The range is subject to change. AltaMed is committed to ensuring a fair and competitive compensation package that reflects the candidate's value and the role's strategic importance within the organization. This role may also qualify for discretionary bonuses or incentives.
Benefits & Career Development
* Medical, Dental and Vision insurance
* 403(b) Retirement savings plans with employer matching contributions
* Flexible Spending Accounts
* Commuter Flexible Spending
* Career Advancement & Development opportunities
* Paid Time Off & Holidays
* Paid CME Days
* Malpractice insurance and tail coverage
* Tuition Reimbursement Program
* Corporate Employee Discounts
* Employee Referral Bonus Program
* Pet Care Insurance
Job Advertisement & Application Compliance Statement
AltaMed Health Services Corp. will consider qualified applicants with criminal history pursuant to the California Fair Chance Act and City of Los Angeles Fair Chance Ordinance for Employers. You do not need to disclose your criminal history or participate in a background check until a conditional job offer is made to you. After making a conditional offer and running a background check, if AltaMed Health Service Corp. is concerned about a conviction directly related to the job, you will be given a chance to explain the circumstances surrounding the conviction, provide mitigating evidence, or challenge the accuracy of the background report.
$25-29.3 hourly Auto-Apply 1d ago
Auto Claims Specialist I (Manheim)
Cox Enterprises 4.4
Claim processor job in Anaheim, CA
Company Cox Automotive - USA Job Family Group Vehicle Operations Job Profile Arbitrator I Management Level Individual Contributor Flexible Work Option No remote option; must work at a specified Cox location Travel % No Work Shift Day Compensation Hourly base pay rate is $19.90 - $29.81/hour. The hourly base rate may vary within the anticipated range based on factors such as the ultimate location of the position and the selected candidate's knowledge, skills, and abilities. Position may be eligible for additional compensation that may include commission (annual, monthly, etc.) and/or an incentive program.
Job Description
At Manheim (a Cox Automotive company), we strive to make sure every customer is completely satisfied when they do business with us. On the off-chance we fall short, we do our best to make things right, pronto.
That's where you come in.
We're looking for an Arbitrator I to learn the ropes of resolving customer complaints and ensuring we don't make the same mistake again. Do you have the skills we're looking for? Keep reading for more details!
Benefits
* We all have lives and responsibilities outside of work. We have an exceptional work/life balance at Cox, with accommodating work schedules and flexible time-off policies.
* We show our appreciation for our talent with a competitive salary package and top-notch bonus & incentive plans.
* How does a great healthcare benefits package from day one sound? Multiple options are available for individuals and families. One employee-only plan could be FREE, if you participate in our health screening program.
* 10 days of free child or senior care through your complimentary Care.com membership.
* Generous 401(k) retirement plans with up to 6% company match.
* Employee discounts on hundreds of items, from cars to computers to continuing education.
* Looking to grow your family? You'll have access to our inclusive parental leave policies, plus comprehensive fertility coverage and adoption assistance.
* Want to volunteer in your community? We encourage that, and even offer paid hours for you to do so.
* We all love our pets-whether they walk, crawl, fly, swim or slither-and we're happy to supply insurance for them as well.
At Cox, we believe in being transparent - please click on this link (Cox Benefits Overview) to learn more about our amazing benefits.
What You'll Do
From your very first day on the job, you'll receive guidance and coaching so you can learn the ropes. You'll work with everyone from buyers to sellers to dealers in coordinating and validating customer returns and claims. With Guidance, responsibilities include:
* Reviews customer claims to verify that they meet Manheim's National Arbitration policies and any account-specific guidelines.
* Investigates basic, less complex cases (e.g., late title claims, basic condition report claims, vehicle availability, post-sale inspection fails, mechanical/structural/undisclosed vehicle damage, etc.) or those requiring more prescriptive decision-making.
* Interfaces with all departments involved in the complaint (i.e., reconditioning, front office, dealer services, vehicle entry, etc.), including during the fact finding and investigative phases.
* Uses appropriate resources to investigate and facilitate relevant inspection, documentation, and communication to ensure appropriate actions are completed to move cases forward or to resolution.
* Uses appropriate levels/limits of financial approval authority to resolve cases.
* Evaluate claims by obtaining, comparing, evaluating, and validating various forms of information.
* Prepares and facilitates communication for resolution via telephone, email, and in-person discussion.
* Mediates disputes and negotiates repair and/or pricing of disputed vehicles to arrive at a mutually acceptable solution and to keep vehicles sold.
* Monitors and maintains accurate files for each arbitration case, verifying the accuracy of all required documentation, including invoices and settlement agreements.
* Engages with supervisor/manager to determine if escalation is required.
* Performs other duties as assigned.
Who You Are
You've got a knack for negotiation. You're ethical, dependable, and trustworthy. You're eager to learn. You also have the following qualifications:
Minimum
* A high school diploma or GED and less than 2 years of related experience.
* Accuracy and attention to detail.
* Organizational and time management skills.
* The ability to adapt in a fluid and changing environment.
Preferred
* 1+ years of automotive or body shop experience.
* Claims adjuster experience.
Cox is a great place to be, wouldn't you agree? Apply today!
Drug Testing
To be employed in this role, you'll need to clear a pre-employment drug test. Cox Automotive does not currently administer a pre-employment drug test for marijuana for this position. However, we are a drug-free workplace, so the possession, use or being under the influence of drugs illegal under federal or state law during work hours, on company property and/or in company vehicles is prohibited.
Benefits
Employees are eligible to receive a minimum of sixteen hours of paid time off every month and seven paid holidays throughout the calendar year. Employees are also eligible for additional paid time off in the form of bereavement leave, time off to vote, jury duty leave, volunteer time off, military leave, and parental leave.
About Us
Through groundbreaking technology and a commitment to stellar experiences for drivers and dealers alike, Cox Automotive employees are transforming the way the world buys, owns, sells - or simply uses - cars. Cox Automotive employees get to work on iconic consumer brands like Autotrader and Kelley Blue Book and industry-leading dealer-facing companies like vAuto and Manheim, all while enjoying the people-centered atmosphere that is central to our life at Cox. Benefits of working at Cox may include health care insurance (medical, dental, vision), retirement planning (401(k)), and paid days off (sick leave, parental leave, flexible vacation/wellness days, and/or PTO). For more details on what benefits you may be offered, visit our benefits page. Cox is an Equal Employment Opportunity employer - All qualified applicants/employees will receive consideration for employment without regard to that individual's age, race, color, religion or creed, national origin or ancestry, sex (including pregnancy), sexual orientation, gender, gender identity, physical or mental disability, veteran status, genetic information, ethnicity, citizenship, or any other characteristic protected by law. Cox provides reasonable accommodations when requested by a qualified applicant or employee with disability, unless such accommodations would cause an undue hardship.
Applicants must currently be authorized to work in the United States for any employer without current or future sponsorship. No OPT, CPT, STEM/OPT or visa sponsorship now or in future.
How much does a claim processor earn in Altadena, CA?
The average claim processor in Altadena, CA earns between $27,000 and $74,000 annually. This compares to the national average claim processor range of $26,000 to $62,000.
Average claim processor salary in Altadena, CA
$44,000
What are the biggest employers of Claim Processors in Altadena, CA?
The biggest employers of Claim Processors in Altadena, CA are: