Claim processor jobs in Clovis, CA

United Legacy is a privately owned alternative investment firm specializing in real estate-based investment opportunities. With offices in Del Mar, La Jolla, Honolulu, and Tampa, our mission- Funding Freedom -reflects our commitment to helping clients achieve long-term financial independence through transparency, precision, and trust. We're a fast-growing, high-performance firm built on accountability, collaboration, and results. Every team member plays an essential role in delivering an exceptional client experience. Position Summary The Investment Processor is a key operational role responsible for managing the documentation, coordination, and communication behind each client investment. This role ensures that every transaction-from initial paperwork to final funding-is handled with accuracy, professionalism, and efficiency. You'll work closely with Advisors, Custodians, and the Client Portfolio Manager (CPM) to ensure clients experience seamless service at every stage of the investment process. This position is full-time, onsite at our Del Mar office, reporting directly to the Client Portfolio Manager. Responsibilities Client Communication & Service Act as a liaison between clients, custodians, and internal departments. Provide timely updates and maintain professional, proactive communication. Support client calls, verification calls, and document coordination. Communicate exclusively through company-approved systems (Outlook, Zoom Phone, CRM, client portal). Transaction Processing Manage assigned transactions end-to-end, ensuring accuracy and compliance. Prepare and process subscription agreements, W-9s, KYC forms, and transfer documentation. Coordinate wires, ACH transfers, IRA transfers, and rollovers with custodians and clients. Set up IRA accounts for our clients using self-directed custodians such as Equity Trust Company and Midland Trust Company. Verify investment amounts, account allocations, and all supporting documentation. Complete and submit quality control checklists for every transaction. Compliance & Record Keeping Maintain accurate, organized records in CRM, SharePoint, and client portals. Use systems such as Platform Eleven, Wealthbox, and Agora. Log all communications and updates in real time to ensure audit-ready documentation. Send written recaps of all client and custodian communications. Uphold 100% compliance with company and regulatory standards. Team Collaboration & Training Work closely with Advisors, Client Portfolio Managers, and Operations staff. Participate in ongoing training, team meetings, and process improvement initiatives. Provide cross-departmental support during high-volume periods or special projects. This role offers hands-on mentorship and a clear growth path into client portfolio management or advisory operations. You'll receive ongoing training from senior team members and have direct exposure to real estate-backed investment transactions and private fund operations. United Legacy fosters a collaborative environment where team members are empowered to take ownership, contribute ideas, and continuously improve processes. Events & Travel Attend local United Legacy events, including seminars, client dinners, and masterclasses. Business travel may be required or expected based on company needs and event schedules. Qualifications Bachelor's degree not required; preferred fields include finance, economics, business, or related disciplines. 1-3 years of experience in financial services, consulting, asset management, or a related field. Exposure to private markets or alternative investments is a plus but not required. Strong written and verbal communication skills with excellent attention to detail. Ability to prioritize and manage multiple projects in a fast-paced environment. Collaborative mindset with a willingness to learn and contribute across teams. Proficiency in Microsoft Office Suite (Excel, PowerPoint, Word); familiarity with CRM systems or data visualization tools is a plus. High level of professionalism, integrity, and accountability in all work performed. The Skills You Bring A strong understanding of financial planning concepts and a desire to help clients make informed investment decisions. The ability to understand client needs and identify appropriate solutions through effective communication. A relationship-driven approach with a genuine interest in serving clients and being their advocate. Motivation toward success and ownership of your responsibilities-you follow through and deliver results. Comfort with outbound communication, including client check-ins and follow-ups. A growth mindset and eagerness to develop within a dynamic, high-performing organization. Compensation & Benefits Base Salary: $68,640 annually Bonus: Discretionary, based on performance and company policy Benefits Include: 401(k) retirement plan Unlimited paid time off (PTO) - after 90 probation Sick days and paid holidays Comprehensive health coverage Schedule Hours: Monday-Friday, 9:00 AM - 5:30 PM Location: Fully onsite at United Legacy's Del Mar office

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

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 Provider Dispute Claims Examiner is responsible for analyzing and the adjudication of medical claims as it relates to managed care. Resolve claims payment issues as presented through Provider Dispute Resolution (PDR) process or from claims incident/inquiries. Identifies root causes of claims payment errors and reports to Management. Responds to provider inquiries/calls related to claims payments. Generates and develop reports which include but not limited to root causes of PDRs and Incidents. Collaborates with other departments and/or providers in successful resolution of claims related issues. Minimum Requirements HS Diploma or GED 2+ years of Claims Processing experience in a managed care environment. Must understand to read and interpret DOFRs and Contracts. Must have an understanding of how to read a CMS-1500 and UB-04 form. Must have strong organizational and mathematical skills. 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.

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.

**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.

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. Job Overview The Claims Processor is a specialized role within the mortgage industry, primarily focused on the financial aspects and reimbursement of fees, costs and advances that incurred during the foreclosure process. A Typical Day The Claims Processor will take direction from the department supervisor for post-sale functions, such as: evictions, property maintenance, conveyance of title, title delivery, and adherence to GSE servicing requirements during the REO process. As the Claims Processor, you will be responsible for filing MI, investor, and insurer claims timely and accurately, providing all back-up as requested, and the reconciliation and posting of claim proceeds. The Claims Processor will: Perform post-foreclosure servicing functions as required by MI, investor, insurer, and internal guidelines including: eviction management, property inspection and maintenance, conveyance of title, title delivery, maintenance of HOA, taxes, and property insurance during the GSE REO process File claims for reimbursement of expenses Reconcile claim proceeds File supplemental claims as needed Ensure data accuracy 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 High School Diploma / GED 1+ years of relevant work experience Default-related experience preferred Demonstrated aptitude for data, reporting, and working with numbers, desired Familiar with GSE and Insurer servicing 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

Now Hiring: Impact Claims Negotiation Specialist - Inspire, Lead, and Transform! Are you a driven leader with a passion for empowering others and creating lasting impact? We are looking for ambitious individuals to join our team as Claims Negotiation Specialist, where you'll mentor, develop, and guide individuals toward financial success and leadership excellence. Who We're Looking For: ✅ Visionary entrepreneurs & business professionals ready to lead ✅ Mentors and coaches who thrive on helping others grow ✅ Licensed & aspiring Life & Health Insurance Agents (We'll guide you through licensing!) ✅ Individuals eager to inspire and drive meaningful success As a Claims Negotiation Specialist, you'll be at the forefront of mentoring, coaching, and leading high-potential individuals, helping them unlock new levels of success while also scaling your own leadership and financial growth. Is This You? ✔ Passionate about mentorship, leadership, and personal growth? ✔ A natural motivator who thrives on empowering others? ✔ Self-motivated, disciplined, and committed to success? ✔ Open to ongoing mentorship and leadership development? ✔ Looking for a recession-proof and scalable career opportunity? If you answered YES, keep reading! Why Become a Claims Negotiation Specialist? 🚀 Work from anywhere - Build a flexible, high-impact career. 💰 Uncapped earning potential - Part-time: $40,000-$60,000+/year | Full-time: $70,000-$150,000+++/year. 📈 No cold calling - Work with individuals who have already requested guidance. ❌ No sales quotas, no pressure, no pushy tactics. 🏆 Leadership & Ownership Opportunities - Build and scale your own team. 🎯 Daily pay & performance-based bonuses - Direct commissions from top carriers. 🎁 Incentives & rewards - Earn commissions starting at 80% (most carriers) + salary. 🏥 Health benefits available for qualified participants. This isn't just a job-it's an opportunity to create impact, lead with purpose, and build a lasting legacy. 👉 Apply today and take your first step as a Claims Negotiation Specialist! (Results may vary. Your success depends on effort, skill, and commitment to learning and execution.)

We're delighted you're considering joining us! At Hill Physicians Medical Group, we're shaping the healthcare of the future: actively managed care that prevents disease, supports those with chronic conditions and anticipates the needs of our members. Join Our Team! Hill Physicians has much to offer prospective employees. We're regularly recognized as one of the “Best Places to Work in the Bay Area” and have been recognized as one of the “Healthiest Places to Work in the Bay Area.” When you join our team, you're making a great choice for your professional career and your personal satisfaction. DE&I Statement: At PriMed, your uniqueness is valued, celebrated, encouraged, supported, and embraced. Whatever your relationship with Hill Physicians, we welcome ALL that you are. We value and respect your race, ethnicity, gender identity, sexual orientation, age, religion, disabilities, experiences, perspectives, and other attributes. Our celebration of diversity and foundation of inclusion allows us to leverage our differences and capitalize on our similarities to better serve our communities. We do it because it's right! Job Description: We are seeking a Benefit Analyst to join our Business Operations team. This role is responsible for interpreting Evidence of Coverage (EOC) documents and translating them into accurate benefit configuration within the Epic Tapestry system, which includes member cost shares, maximum out of pockets and benefit limits. The Benefit Analyst will work hand in hand with IT Application Analysts to ensure new or changed benefits, and necessary corrections are implemented timely and accurately. The ideal candidate will have strong critical thinking and analytical skills, experience with benefit interpretation, medical coding and claims adjudication. Key Responsibilities Benefit interpretation and analysis of EOCs across multiple health plans Mapping and/or configuration of new benefit plans and plan elements to support various health plan designs including HMO, POS, Medi-Cal, Medicare, and Exchange plans Analysis and alignment of CPT, HCPCS, REV, ICD-10 codes to benefit categories Analysis of authorization rules and Division of Financial Responsibility (DOFR) Conduct detailed analysis/quality assurance of benefit plan documentation and validate coverage and cost shares configured in Epic Tapestry system, including benefit limits and accumulators Assist with testing new benefits and complex benefit configuration changes within the claims processing system as part of analysis and validation Perform review and analysis of pending claims resulting from benefit configuration issues and assist with resolution Identify potential errors in configuration and notify IT working to troubleshoot and make corrections in a timely manner, submitting and tracking necessary corrections to completion, documenting outcomes, and making recommendations as necessary Adjudicate/finalize pending claims while resolution of issue is in progress and assist with necessary adjustments of claims that were unintentionally denied because of benefit configuration issue(s) Assist with maintenance of benefit requirements and configuration decisions and policies and procedures Continuous improvement of strategies to drive efficiencies and ensure process viability in the future and across systems Perform workflow analysis and consult on workflow/process improvement changes related to new functionality, applications, or systems Collaborate with IT, Enrollment, Claims, and Contracting teams to ensure benefit accuracy and compliance Other duties as assigned Requirements 5+ years of experience in benefits and claims in Managed Care, delegated model setting Experience with benefit analysis and/or quality assurance College degree in healthcare (preferred) or equivalent experience/knowledge Certified Medical Coder (preferred), or equivalent experience/knowledge of medical coding Proficiency in CPT, HCPCS, REV Coding & Billing, and ICD-10. Experience with Epic Tapestry (preferred) Understanding of various health plan types and regulations including HMO, POS, Medicare, Medi-Cal, CMS mandates, NCDs, and LCDs Strong analytical, communication, and documentation skills. Knowledge/Skills/Abilities Knowledge of how benefit configuration relates to claims adjudication and payment processes. Knowledge of member responsibility, cost shares, accumulators and out-of-pocket maximums. Experience with testing, reviewing, and validating benefit plans Critical thinking skills, decisive judgement, and the ability to work with minimal supervision. Must be able to work in a fast-paced environment with frequently shifting priorities and take appropriate action. Ability to build and maintain interpersonal relationships with management, core Benefits staff, and interdepartmental colleagues. Strong excel and Microsoft office 360 skills. Additional Information No of positions available: 2 Salary: $75,000 - $97,000 Annual Hill Physicians is an Equal Opportunity Employer

We're delighted you're considering joining us! At Hill Physicians Medical Group, we're shaping the healthcare of the future: actively managed care that prevents disease, supports those with chronic conditions and anticipates the needs of our members. Join Our Team! Hill Physicians has much to offer prospective employees. We're regularly recognized as one of the "Best Places to Work in the Bay Area" and have been recognized as one of the "Healthiest Places to Work in the Bay Area." When you join our team, you're making a great choice for your professional career and your personal satisfaction. DE&I Statement: At PriMed, your uniqueness is valued, celebrated, encouraged, supported, and embraced. Whatever your relationship with Hill Physicians, we welcome ALL that you are. We value and respect your race, ethnicity, gender identity, sexual orientation, age, religion, disabilities, experiences, perspectives, and other attributes. Our celebration of diversity and foundation of inclusion allows us to leverage our differences and capitalize on our similarities to better serve our communities. We do it because it's right! Job Description: We are seeking a Benefit Analyst to join our Business Operations team. This role is responsible for interpreting Evidence of Coverage (EOC) documents and translating them into accurate benefit configuration within the Epic Tapestry system, which includes member cost shares, maximum out of pockets and benefit limits. The Benefit Analyst will work hand in hand with IT Application Analysts to ensure new or changed benefits, and necessary corrections are implemented timely and accurately. The ideal candidate will have strong critical thinking and analytical skills, experience with benefit interpretation, medical coding and claims adjudication. Key Responsibilities * Benefit interpretation and analysis of EOCs across multiple health plans * Mapping and/or configuration of new benefit plans and plan elements to support various health plan designs including HMO, POS, Medi-Cal, Medicare, and Exchange plans * Analysis and alignment of CPT, HCPCS, REV, ICD-10 codes to benefit categories * Analysis of authorization rules and Division of Financial Responsibility (DOFR) * Conduct detailed analysis/quality assurance of benefit plan documentation and validate coverage and cost shares configured in Epic Tapestry system, including benefit limits and accumulators * Assist with testing new benefits and complex benefit configuration changes within the claims processing system as part of analysis and validation * Perform review and analysis of pending claims resulting from benefit configuration issues and assist with resolution * Identify potential errors in configuration and notify IT working to troubleshoot and make corrections in a timely manner, submitting and tracking necessary corrections to completion, documenting outcomes, and making recommendations as necessary * Adjudicate/finalize pending claims while resolution of issue is in progress and assist with necessary adjustments of claims that were unintentionally denied because of benefit configuration issue(s) * Assist with maintenance of benefit requirements and configuration decisions and policies and procedures * Continuous improvement of strategies to drive efficiencies and ensure process viability in the future and across systems * Perform workflow analysis and consult on workflow/process improvement changes related to new functionality, applications, or systems * Collaborate with IT, Enrollment, Claims, and Contracting teams to ensure benefit accuracy and compliance * Other duties as assigned Requirements * 5+ years of experience in benefits and claims in Managed Care, delegated model setting * Experience with benefit analysis and/or quality assurance * College degree in healthcare (preferred) or equivalent experience/knowledge * Certified Medical Coder (preferred), or equivalent experience/knowledge of medical coding * Proficiency in CPT, HCPCS, REV Coding & Billing, and ICD-10. * Experience with Epic Tapestry (preferred) * Understanding of various health plan types and regulations including HMO, POS, Medicare, Medi-Cal, CMS mandates, NCDs, and LCDs * Strong analytical, communication, and documentation skills. Knowledge/Skills/Abilities * Knowledge of how benefit configuration relates to claims adjudication and payment processes. * Knowledge of member responsibility, cost shares, accumulators and out-of-pocket maximums. * Experience with testing, reviewing, and validating benefit plans * Critical thinking skills, decisive judgement, and the ability to work with minimal supervision. * Must be able to work in a fast-paced environment with frequently shifting priorities and take appropriate action. * Ability to build and maintain interpersonal relationships with management, core Benefits staff, and interdepartmental colleagues. * Strong excel and Microsoft office 360 skills. Additional Information No of positions available: 2 Salary: $75,000 - $97,000 Annual Hill Physicians is an Equal Opportunity Employer

What part will you play? If you're looking for a place where you can make a meaningful difference, you've found it. The work we do at Markel gives people the confidence to move forward and seize opportunities, and you'll find your fit amongst our global community of optimists and problem-solvers. We're always pushing each other to go further because we believe that when we realize our potential, we can help others reach theirs. Join us and play your part in something special! This position will be the acknowledged technical expert and be responsible for the resolution of high complexity and high exposure claims. The position will have significant responsibility for decision making and work autonomously within their authority.Responsibilities: High complexity coverage interpretation, liability investigation, multiple vehicles, potential extra-contractual, litigation or significant injuries. Direct involvement in litigation claims management to reach desired outcomes and minimize expenses Investigate, negotiate and settle complex liability cases. Maintain and make sure alignment to Markel's guidelines and procedures. Ensure proper adherence to internal large loss reporting requirements. Promptly communicate with Claims Manager on case developments and provide information on issues affecting the lines of business Chip in and assist in the implementation of a range of initiatives, discussion and action plans brought forth by the Claims Manager Connect with underwriting as needed to handle claims and to alert of any significant developments Participate in agent related functions and meetings as required Requirements: 7-10+ years of Liability claims handling experience with a commercial insurance company Successful Liability claim handling experience is critical College degree and/or professional designation preferred Sound comprehension of personal and commercial liability coverages. Excellent written and oral communication skills. Experience in resolving contractual obligations, coverage analyses, and investigations. Ability to run sophisticated large liability exposures, set loss and expense reserves and evaluate settlement values. Ability to proactively self-manage an active caseload. Ability to analyze and convey summations of complex issues; recognize alternative approaches and develop action plans, both orally and in written form. Travel required as necessary (less than 15%). Adjuster license in multiple states or across the US strongly preferred. US Work Authorization US Work Authorization required. Markel does not provide visa sponsorship for this position, now or in the future. Pay information: The base salary offered for the successful candidate will be based on compensable factors such as job-relevant education, job-relevant experience, training, licensure, demonstrated competencies, geographic location, and other factors. The salary for the position is $97,520 - $134,000 with a 25% bonus potential. Who we are: Markel Group (NYSE - MKL) a fortune 500 company with over 60 offices in 20+ countries, is a holding company for insurance, reinsurance, specialist advisory and investment operations around the world. We're all about people | We win together | We strive for better We enjoy the everyday | We think further What's in it for you: In keeping with the values of the Markel Style, we strive to support our employees in living their lives to the fullest at home and at work. We offer competitive benefit programs that help meet our diverse and changing environment as well as support our employees' needs at all stages of life. All full-time employees have the option to select from multiple health, dental and vision insurance plan options and optional life, disability, and AD&D insurance. We also offer a 401(k) with employer match contributions, an Employee Stock Purchase Plan, PTO, corporate holidays and floating holidays, parental leave. Are you ready to play your part? Choose ‘Apply Now' to fill out our short application, so that we can find out more about you. Caution: Employment scams Markel is aware of employment-related scams where scammers will impersonate recruiters by sending fake job offers to those actively seeking employment in order to steal personal information. Frequently, the scammer will reach out to individuals who have posted their resume online. These "job offers" include convincing offer letters and frequently ask for confidential personal information. Therefore, for your safety, please note that: All legitimate job postings with Markel will be posted on Markel Careers. No other URL should be trusted for job postings. All legitimate communications with Markel recruiters will come from Markel.com email addresses. We would also ask that you please report any job employment scams related to Markel to ***********************. Markel is an equal opportunity employer. We do not discriminate or allow discrimination on the basis of any protected characteristic. This includes race; color; sex; religion; creed; national origin or place of birth; ancestry; age; disability; affectional or sexual orientation; gender expression or identity; genetic information, sickle cell trait, or atypical hereditary cellular or blood trait; refusal to submit to genetic tests or make genetic test results available; medical condition; citizenship status; pregnancy, childbirth, or related medical conditions; marital status, civil union status, domestic partnership status, familial status, or family responsibilities; military or veteran status, including unfavorable discharge from military service; personal appearance, height, or weight; matriculation or political affiliation; expunged juvenile records; arrest and court records where prohibited by applicable law; status as a victim of domestic or sexual violence; public assistance status; order of protection status; status as a smoker or nonsmoker; membership or activity in local commissions; the use or nonuse of lawful products off employer premises during non-work hours; declining to attend meetings or participate in communications about religious or political matters; or any other classification protected by applicable law. Should you require any accommodation through the application process, please send an e-mail to the ***********************. No agencies please.

The Senior Claims Specialist will report directly to the Director of Risk Management. Duties include overseeing and monitoring the timely response and proper handling of General Liability, Auto and Property claims on behalf of Superior Grocers. Moreover, attendance of Small Claims court matters will be ensured as required. Position will have the autonomy and authority to make settlement decisions within a pre-determined range. Responsible for timely feedback/response and providing necessary documentation to insurance company/TPA, defense counsel and corporate office staff as instructed. Display and communicate an understanding of insurance concepts, internal practices and procedures. DAILY JOB DUTIES: 1. Claim documentation * Respond timely to incoming claims and monitor ongoing open claim inventory 2. Claim investigation as needed * Telephone and on-site investigation * Employee and customer interviews * Referrals to outside vendors 3. Review and oversee new and existing customer related claims * Accident Reports and related support documentation must be completed timely, thoroughly and objectively, thereafter provided to TPA/defense counsel/necessary parties. * Assist with determination of liability and corresponding/appropriate defense tactics * Ensure the timely logging of all new claims (delegate to Claims Assistant if necessary) and timely reporting to our Insurance Carrier, with guidance by the Dir of Risk Management 4. Review, oversee and manage legacy customer claims continuously and ongoing * Utilize TPA website/database (if appl.) or internal tracking system to review the status and monitor claims being handled by outside adjusters. * Review and approve the status of any claim, any reserve changes, and maintain communication with the adjuster handling the claim. * Vice-Versa the adjuster can communicate with Senior Claims Specialist for added information a. Authority requests are presented to the Director of Risk Management b. Other Samples of requests from adjusters * Coordinate employee recorded statements * Coordinate internal/external investigations of incidents * Copy and analyze video tapes * Provide information on employees; current and terminated a. When a claim is sent to our Attorney, same duties as above apply b. Follow instructions communicated to pass on to defense attorney c. Defense attorney is assigned in coordination with the Director of Risk Management * Be prepared with monthly status report (when requested) concerning any significant changes on our position of liability or damages * Calendar deposition appearances as necessary * Calendar hearings as necessary * Calendar Mediation or settlement conferences WEEKLY JOB DUTIES: 1. Maintain customer claim files in order * Systematically inspect and maintain the claims database to ensure all reported claims are accurately logged, properly classified according to protocols, and fully accounted for * Ensure all supporting evidence, including video footage and investigation reports, is collected on new claims, promptly updated as information becomes available, and efficiently forwarded to the assigned insurance adjuster * Manage the open claims inventory through disciplined diary maintenance, conducting a weekly review of all active files and utilizing a 45- to 60-day diary system to monitor case progression and address pending issues 2. Store Inspections * Store visits will be done as instructed by the Director of Risk Management Inspect for adverse liability conditions and/or store operations a. Report to manager my findings and discuss a solution b. Report to manager if a sweep compliance is unacceptable 3. Porter Inspections * Meet with a Store and Safety personnel as instructed * Review porter inspections * Review porter schedules for each store * Provide porter training on using scanners, the purpose for a sweep, and the need to be diligent in doing their job and in using the scanner 4. Insurance Certificate Program * Assist to Maintain up to date our Insurance Certificate Program a. Insurance certificates from vendors and contractors as needed. b. Requests are made as needed c. New Vendor Application process 5. Insurance Needs * Handle any General Liability Auto, and Property insurance needs a. Add new vehicles as instructed b. Add new stores as instructed MONTHLY JOB DUTIES: 1. Claims * Generate monthly reports, regarding frequency and location of customer claims a. Analyze report; recommend preventative measures share with store management * Review monthly billing and present to Director of Risk Management timely a. Check figures, claims, etc. ensuring reimbursement is appropriate b. Perform monthly store inspections as needed QUARTERLY JOB DUTIES: 1. Claims * Quarter end reports (same as monthly) * Participate in quarterly claim reviews with TPA YEARLY JOB DUTIES: 1. Assist where necessary regarding General Liability, Auto, and Property Insurance renewal * Administrative duties only Job Requirements: Education: * Bachelor's degree in business is preferred * In addition, attend insurance seminars and insurance classes with emphasis in insurance concepts, including, premises liability and related tort applicable to the position. Experience: * At least 5 years work experience in the field if no bachelor's degree Knowledge: * Working knowledge of Excel and Word. Skills and Ability: * Excellent verbal and written communication skills * Ability to multi-task * Bilingual (Spanish and English) helpful, but not mandatory Wage: $90,000 - $100,000 annually [1] Cal. Civ. Code § 1798.100 et seq . [2] Código Cal. Civ. § 1798.100 et seq.

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 $19.38 - $29.09/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.

Job Description 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

What you can expect! Find joy in serving others with IEHP! We welcome you to join us in “healing and inspiring the human spirit” and to pivot from a “job” opportunity to an authentic experience! Under the direction of the Covered California Claims (CCA) Manager, the CCA Claims Specialist is responsible for analyzing, managing, and investigating complex and high-dollar healthcare claims that require in-depth research to determine accuracy and mitigate payment errors. The Claims Specialist is also responsible for adjusting first-pass and post-pay claims that result in overpayment or underpayment due to claim processing system issues, contract amendments, processing errors, or other issues. This position collaborates with internal stakeholders, assists with claim audits (internal and regulatory) and utilizes strong analytical skills and independent judgement skills to make effective and accurate decisions. This position will also be responsible for responding to inquiries from the Provider Payment Resolution team on claims that may have been paid incorrectly. Commitment to Quality: The IEHP Team is committed to incorporate IEHP's Quality Program goals including, but not limited to, HEDIS, CAHPS, and NCQA Accreditation. Additional Benefits Perks IEHP is not only committed to healing and inspiring the human spirit of our Members, but we also aim to match our team members with the same energy by providing prime benefits and more. Competitive salary Telecommute schedule State of the art fitness center on-site Medical Insurance with Dental and Vision Life, short-term, and long-term disability options Career advancement opportunities and professional development Wellness programs that promote a healthy work-life balance Flexible Spending Account - Health Care/Childcare CalPERS retirement 457(b) option with a contribution match Paid life insurance for employees Pet care insurance Key Responsibilities Work effectively with other departments (i.e., Special Investigation Unit, Provider Payment Resolution team, and other departments/stakeholders) to investigate and identify fraud, respond to escalated provider inquiries timely, and support the claims process. Investigate and process complex and high-dollar claims determining accuracy and making timely decisions. Advise leadership and internal business units (as applicable) of findings and outcomes on identified claim issues. Research and analyze medical claims adjustment requests along with related documentation to determine payment accuracy and adjust/adjudicate as needed in the Health Rules Processing system and other platforms. Research claims that may have been paid incorrectly and communicate findings for adjustment. Adjust claims based on findings (i.e., correct coding, rates of reimbursement, authorizations, contracted amounts, etc.) ensuring that all relevant information is considered. Assist with internal and regulatory claim audits, reviewing claim accuracy. Identify trends and recommend improvements to IEHP's claim processing system. Analyze and investigate insurance claims to discover or prevent fraud. Be an active participant in the Claims Department's initiatives and participate in Claims Huddles, etc. Remain current with all claim processing changes/updates (i.e. internal processes, regulatory guidelines). Perform any other duties as required to ensure Health Plan operations and department business needs are successful. Qualifications Education & Requirements Three (3) years of experience in examining and processing complex and high-dollar institutional and professional claims Experience in a managed care environment helpful. Commercial, Exchange, and Medicare preferred High school diploma or GED required Associate's degree from an accredited institution preferred Key Qualifications ICD-9/ ICD-10 and CPT coding and general practices of claims processing CMS/DMHC and Affordable Care Act regulations and guidelines Commercial line of business specifically Covered California/Exchange Excellent communication and interpersonal skills Excellent analytical, critical thinking, customer service, and organizational skills Ability to think critically with the capacity to work independently All IEHP positions approved for telecommute work locations may periodically be required to report to IEHP's main campus for mandatory in-person meetings or for other business needs as determined by IEHP leadership Start your journey towards a thriving future with IEHP and apply TODAY! Work Model Location Telecommute (All IEHP positions approved for telecommute work locations may periodically be required to report to IEHP's main campus for mandatory in-person meetings or for other business needs as determined by IEHP leadership) Pay Range USD $25.90 - USD $33.02 /Hr.

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 $19.38 - $29.09/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.

Role and Responsibilities will identify, prevent, and mitigate potential penalties as well as assistant the claims department: Input date entry on all new claims Provide indemnity payment and cycles. Identify, prevent, and mitigate potential case penalties. Deliver 3-point contact ( Medical Only &/ or Indemnity files) to verify the mechanics of the injury, compensability, and discharge. - Calculate and pay mileage benefits. Verify lost time and waiting periods. Perform maintenance of current legal claims Identify issues requiring conversion to Indemnity to include supporting documentation. Input basic notes relating to claim, status and treatment. Process medical/legal bills daily to avoid penalty and interest. Return phone calls on a timely manner. Input status letters, delay letters, or any other required initial letters. Comply to subpoenas Interaction with nurse on case management regarding return to work status. New hires protocol Background checks Coordinating PPE supplies request. Assist safety team on identifying injury trends. Performs other related duties as assigned

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.

HealthCare Support Staffing, Inc. (HSS), is a proven industry-leading national healthcare recruiting and staffing firm. HSS has a proven history of placing talented healthcare professionals in clinical and non-clinical positions with some of the largest and most prestigious healthcare facilities including: Fortune 100 Health Plans, Mail Order Pharmacies, Medical Billing Centers, Hospitals, Laboratories, Surgery Centers, Private Practices, and many other healthcare facilities throughout the United States. HealthCare Support Staffing maintains strong relationships with top providers in healthcare and can assure healthcare professionals they will receive fast access to great career opportunities that best fit their expertise. Connect with one of our Professional Recruiting Consultants today to see how a conversation can turn into a long-lasting and rewarding career! Are you an experienced Claims Specialist looking for a new opportunity with a prestigious healthcare company? Do you want the chance to advance your career by joining a rapidly growing company? If you answered “yes" to any of these questions - this is the position for you! Company Job Description/Essential Functions: Review and process provider dispute resolutions according to state and federally defined timeframes. Research issues; adjust claims, including computation of interest owed as appropriate. Send written responses to providers in a professional manner within required timelines. Forward cases to the IRE or the DMHC as needed. Answer provider inquiries regarding disputes that have been submitted. Maintain and track disputes through HPSM's grievance and appeals database. Maintain knowledge of claims procedures and all appropriate reference materials; participate in ongoing training as needed. Qualifications 2+ years' experience working with medical claims (Example: Claims Examiner, Claims Provider Services Rep) Must have experience in a health services and/or managed care setting Medi-Cal & Medicare program knowledge Must be well-versed in medical claims and reimbursement process Experience with Microsoft Office software Additional Information Advantages of this Opportunity: • Hours for this Position: Monday- Friday 8:00am to 5:00pm • Pay up to $22 per hour, negotiable • Immediate opening, Temp-to-Perm position with excellent benefits offered. If you know of someone looking for a new opportunity, please pass along the information! We offer referral bonuses of up to $100.00 for each placement.

Introduction The San Joaquin County District Attorney's Office mission is clear: to serve and support victims of crime with unwavering dedication. The office has a staff of over 300 employees comprised of attorneys, investigators, and support personnel located in downtown Stockton, the Juvenile Justice Center in French Camp, and within branches of the Superior Court in Lodi and Manteca. This departmental promotional recruitment is being held to fill (1) vacancy in the District Attorney's Office and to establish a list that may be used to fill future vacancies. To qualify for this position, you must currently be employed with the San Joaquin District Attorney's Office. Resumes will not be accepted in lieu of an application. A completed application must be postmarked or received online by the final filing deadline. NOTE: All correspondences relating to this recruitment will be delivered via e-mail. The e-mail account used will be the one provided on your employment application during time of submittal. Please be sure to check your e-mail often for updates. If you do not have an e-mail account on file, Human Resources will send you correspondences via US Mail. Pre-employment Drug Screening and Background: Potential new hires into this classification are required to successfully pass a pre-employment drug screen and a background as a condition of employment. Final appointment cannot be made unless the eligible has passed the drug screen and background. The County pays for the initial drug screen. TYPICAL DUTIES * Reviews and evaluates victim-of-crime applications for adherence to California State statutory and eligibility requirements; obtains and analyzes crime reports and other documents from the appropriate law enforcement agency to verify factual case information; contacts law enforcement officers, court officials, attorneys, and others to obtain pertinent information in order to determine initial and on-going Program eligibility; establishes appropriate computer records for applicants based on approval or denial of victim application. * Reviews and processes a variety of claims submitted by victims including medical bills, mental health bills, funeral/burial bills, wage loss requests and other expenses; researches information as required to establish a link to the qualifying crime and to verify losses claimed by the victim; calculates losses to victims and determines reimbursements considering all other sources of compensation available; approves or denies claim reimbursement and level of services; notifies victims of claim determinations. * Acts as a lead worker as assigned; identifies staff training needs and learning opportunities; develops and oversees training plans; assesses and assigns work to staff as appropriate; may provide input to supervisory staff regarding staff assignments and performance; audits staff work for quality control and training purposes; may be assigned to complete special reports or projects. * Interacts effectively with victims, families, law enforcement personnel and others; obtains accurate information and identifies potential problem issues; acts as a liaison between victims, families and other organizations/individuals regarding Program benefits; interacts with other counties in order to fulfill contract obligations for claims processing. * Keeps accurate logs of all claims submitted; creates detailed computer files on all claims processed, whether approved or denied; processes approved bills for payment; creates pre-authorization statements as appropriate. * Monitors caseload data and develops comprehensive, periodic summary reports as required to receive State credit; prepares various memorandums and correspondence. * Coordinates victim claim services with the Victim Witness Advocates; refers victims to other agencies as appropriate. MINIMUM QUALIFICATIONS PLEASE NOTE: This is a departmental promotion. Qualified applicants must currently be employed with San Joaquin County District Attorney's Office and meet the promotional eligibility requirements as stated in Civil Service Rule 10, Section 3-Eligiblity for Promotional Examinations. Experience: One year performing claims review and/or program eligibility determination at a level comparable to or higher than Victim Claims Specialist II in San Joaquin County. Note: Individuals employed in the San Joaquin County classes of Victim Claims Technician II at the time of adoption of this class specification by the Civil Service Commission will be credited with their experience on a year-for-year basis. Special Requirement: Successful completion of the State of California Victims of Crime Introductory/Basic Training Course. License: Possession of a valid California driver's license. KNOWLEDGE Principles and practices of leadership and training; standard office procedures including the use of computers and other technological equipment; mathematics, reading and writing skills; technical research methods as they apply to evaluating and processing financial claims; principles of interviewing and gathering information; fundamental aspects of human behavior; basic medical and legal terminology. ABILITY Lead, train and audit the work of others; follow oral and written directions; read, understand, and apply regulations and other job related materials; maintain records and prepare reports; deal tactfully with the public; interview, gather, record and evaluate information; establish effective working relationships with a wide variety of people. PHYSICAL/MENTAL REQUIREMENTS Mobility-Frequent keyboard operation, sitting; occasional pushing, pulling, bending, squatting; Lifting-Frequent lifting up to 5 pounds; Vision-Constant reading and close-up work requiring good overall vision; frequent eye/hand coordination; occasional color/depth perception and peripheral vision; Dexterity-Frequent holding, gripping, writing and repetitive motion; occasional reaching; Hearing/Talking-Constant hearing normal speech, hearing/talking in person and on the telephone; occasional hearing faint sounds; Emotional/Special Conditions-Frequent public contact, decision making, and concentration; frequent exposure to trauma, grief and death; occasional working overtime. BENEFITS Employees hired into this classification are members of a bargaining unit which is represented by SEIU Local 1021. Health Insurance: San Joaquin County provides employees with a choice of three health plans: a Kaiser Plan, a Select Plan, and a Premier Plan. Employees pay a portion of the cost of the premium. Dependent coverage is also available. Dental Insurance: The County provides employees with a choice of two dental plans: Delta Dental and United Health Care-Select Managed Care Direct Compensation Plan. There is no cost for employee only coverage in either plan; dependent coverage is available at the employee's expense. Vision Insurance: The County provides vision coverage through Vision Service Plan (VSP). There is no cost for employee only coverage; dependent coverage is available at the employee's expense. For more detailed information on the County's benefits program, visit our website at ************* under Human Resources/Employee Benefits. Life Insurance: The County provides eligible employees with life insurance coverage as follows: 1 but less than 3 years of continuous service: $1,000 3 but less than 5 years of continuous service: $3,000 5 but less than 10 years of continuous service: $5,000 10 years of continuous service or more: $10,000 Employee may purchase additional term life insurance at the group rate. 125 Flexible Benefits Plan: This is a voluntary program that allows employees to use pre-tax dollars to pay for health-related expenses that are not paid by a medical, dental or vision plan (Health Flexible Spending Account $2550 annual limit with a $500 carry over); and dependent care costs (Dependent Care Assistance Plan $5000 annual limit). Retirement Plan: Employees of the County are covered by the County Retirement Law of 1937. Please visit the San Joaquin County Employees' Retirement Association (SJCERA) at ************** for more information. NOTE: If you are receiving a retirement allowance from another California county covered by the County Employees' Retirement Act of 1937 or from any governmental agency covered by the California Public Employees' Retirement System (PERS), you are advised to contact the Retirement Officer of the Retirement Plan from which you retired to determine what effect employment in San Joaquin County would have on your retirement allowance. Deferred Compensation: The County maintains a deferred compensation plan under Section 457 of the IRS code. You may annually contribute $18,000 or 100% of your includible compensation, whichever is less. Individuals age 50 or older may contribute to their plan, up to $24,000. The Roth IRA (after tax) is also now available. Vacation: Maximum earned vacation is 10 days each year up to 3 years; 15 days after 3 years; 20 days after 10 years; and 23 days after 20 years. Holidays: Effective July 1, 2017, all civil service status employees earn 14 paid holidays each year. Please see the appopriate MOU for details regarding holidays, accruals, use, and cashability of accrued time. Sick Leave: 12 working days of sick leave annually with unlimited accumulation. Sick leave incentive: An employee is eligible to receive eight hours administrative leave if the leave balance equals at least one- half of the cumulative amount that the employee is eligible to accrue. The employee must also be on payroll during the entire calendar year. Bereavement Leave: 3 days of paid leave for the death of an immediate family member, 2 additional days of accrued leave for death of employee's spouse, domestic partner, parent or child. Merit Salary Increase: New employees will receive the starting salary, which is the first step of the salary range. After employees serve 52 weeks (2080 hours) on each step of the range, they are eligible for a merit increase to the next step. Job Sharing: Employees may agree to job-share a position, subject to approval by a Department Head and the Director of Human Resources. Educational Reimbursement Program: Eligible employees may be reimbursed for career-related course work up to a maximum of $850 per fiscal year. Eligible employees enrolled in an approved four (4) year College or University academic program may be reimbursed up to $800 per semester for a maximum of $1600 per fiscal year. Parking Supplemental Downtown Stockton: The County contributes up to $17 per pay period for employees who pay for parking and are assigned to work in the Downtown Core Area. School Activities: Employees may take up to 40 hours per year, but not more than eight (8) hours per month, to participate in their children's school activities. Selection Procedures Civil Service Rule 10 - Section 3 - Eligibility for Promotional Examinations To compete in a promotional examination, an employee must: A. Meet the minimum qualifications of the class on or before the final filing date for filing applications. B. Meet one of the following qualifying service requirements: 1. Have permanent status in the Classified Service. 2. Probationary, part-time, or temporary employees who have worked a minimum of 1040 hours in the previous 12 months or previous calendar year. 3. Exempt employees who have worked a minimum of 2,080 continuous and consecutive hours. C. Have a rating of satisfactory or better on the last performance evaluation. D. If a person whose name is on a promotional list is separated (except for layoff) the name shall be removed from the promotional list of the action. Employees who meet the minimum qualifications will go through one of the following examination process: * Written Exam: The civil service written exam is a multiple choice format. If the written exam is administered alone, it will be 100% of the overall score. Candidates must achieve a minimum rating of 70% in order to be placed on the eligible list. * Oral Exam: The oral exam is a structured interview process that will assess the candidate's education, training, and experience and may include a practical exercise. The oral exam selection process is not a hiring interview. A panel of up to four people will determine the candidate's score and rank for placement on the eligible list. Top candidates from the eligible list are referred for hiring interviews. If the oral exam is administered alone, it will be 100% of the overall score. Candidates must achieve a minimum rating of 70% in order to be placed on the eligible list. * Written & Oral Exam: If both a written exam and an oral exam is administered, the written exam is weighted at 60% and the oral exam is weighted at 40% unless otherwise indicated on the announcement. Candidates must achieve a minimum rating of 70% on each examination in order to be placed on the eligible list. * Rate-out: A rate-out is an examination that involves a paper rating of the candidate's application using the following criteria: education, training, and experience. Candidates will not be scheduled for the rate-out process. Online Written Exams: Written exams may be administered in-person, online. Candidates will be notified of the examination date and will be responsible to complete the written exam per notice instructions. Candidates are required to read the Online Exam Guide for Test Takers prior to taking an online written exam. The link to the guide is here: Online Exam Guide For Test Takers Note: The rating of 70 referred to may be the same or other than an arithmetic 70% of the total possible points. Testing Accommodation: Candidates who require testing accommodation under the Americans with Disabilities Act (ADA) must call Human Resources Division at ************** prior to the examination date. Eligible Lists: Candidates who pass the examination will be placed on an eligible list for that classification. Eligible lists are effective for nine months, but may be extended by the Human Resources Director for a longer period which shall not exceed a total of three years for the date esblished. Certification/Referral: Names from the eligible list will be referred to the hiring department by the following methods. * Rule of Five: The top five names will be referred for hiring interviews. This applies only to department or countywide promotional examination. Physical Exam: Some classifications require physical examinations. Final appointment cannot be made until the eligible has passed the physical examination. The County pays for physical examinations administered in its medical facilities. Employment of Relatives: Applicants who are relatives of employees in a department within the 3rd degree of relationship, (parent, child, grand parent, grand child or sibling) either by blood or marriage, may not be appointed, promoted, transferred into or within the department when; * They are related to the Appointing Authority or * The employment would result in one of them supervising the work of the other. Department Head may establish additional limitations on the hiring of relatives by departmental rule. HOW TO APPLY Please be advised that Human Resources will only be accepting Online Application submittals for this recruitment. Paper application submittals will not be considered or accepted. Apply Online: *************/department/hr Office hours: Monday - Friday 8:00 am to 5:00 pm; excluding holidays. Phone: ************** Job Line: For current employment opportunities please call our 24-hour job line at **************. When a final filing date is indicated, applications must be submitted online to the Human Resources Division before the submission deadline. Resumes and paper applications will not be accepted in lieu of an online application. (The County assumes no responsibility for online applications which are not received by the Human Resources Division). San Joaquin County Substance Abuse Policy: San Joaquin County has adopted a Substance Abuse Policy in compliance with the Federal Drug Free Workplace Act of 1988. This policy is enforced by all San Joaquin County Departments and applies to all San Joaquin County employees. Equal Opportunity Employer: San Joaquin County is an Equal Employment Opportunity (EEO) Employer and is committed to providing equal employment to all without regard to age, ancestry, color, creed, marital status, medical condition, national origin, physical or mental disability, political affiliation or belief, pregnancy, race, religion, sex, or sexual orientation. For more information go to *************/department/hr/eeo. Click on a link below to apply for this position: