Claim processor jobs in Lancaster, CA - 58 jobs

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.

Grow Healthy If you are as passionate about helping those in need as you are about growing your career, consider AltaMed. At AltaMed, your passion for helping others isn't just welcomed - it's nurtured, celebrated, and promoted, allowing you to grow while making a meaningful difference. We don't just serve our communities; we are an integral part of them. By raising the expectations of what a community clinic can deliver, we demonstrate our belief that quality care is for everyone. Our commitment to providing exceptional care, despite any challenges, goes beyond just a job; it's a calling that drives us forward every day. Job Overview The Claims Examiner II is responsible for analyzing and adjudication of medical claims as it relates to managed care. Performs payment reconciliations and/or adjustments related to retroactive contract rate and fee schedule changes. May resolve claims payment issues as presented through the Provider Dispute Resolution (PDR) process or from claims incidents/inquiries. Identifies root causes of claims payment errors and reports to Management. Responds to provider inquiries/calls related to claims payment. Collaborates with other departments and/or providers in the successful resolution of claims-related issues. Minimum Requirements HS Diploma or GED Minimum of 3 years of Claims Processing experience in a managed care environment. Experience in reading and interpreting DOFRs and Contracts is required. Experience in reading CMS-1500 and UB-04 forms is required. Compensation $26.91 - $33.53 hourly Compensation Disclaimer Actual salary offers are considered by various factors, including budget, experience, skills, education, licensure and certifications, and other business considerations. The range is subject to change. AltaMed is committed to ensuring a fair and competitive compensation package that reflects the candidate's value and the role's strategic importance within the organization. This role may also qualify for discretionary bonuses or incentives. Benefits & Career Development Medical, Dental and Vision insurance 403(b) Retirement savings plans with employer matching contributions Flexible Spending Accounts Commuter Flexible Spending Career Advancement & Development opportunities Paid Time Off & Holidays Paid CME Days Malpractice insurance and tail coverage Tuition Reimbursement Program Corporate Employee Discounts Employee Referral Bonus Program Pet Care Insurance Job Advertisement & Application Compliance Statement AltaMed Health Services Corp. will consider qualified applicants with criminal history pursuant to the California Fair Chance Act and City of Los Angeles Fair Chance Ordinance for Employers. You do not need to disclose your criminal history or participate in a background check until a conditional job offer is made to you. After making a conditional offer and running a background check, if AltaMed Health Service Corp. is concerned about a conviction directly related to the job, you will be given a chance to explain the circumstances surrounding the conviction, provide mitigating evidence, or challenge the accuracy of the background report.

The Claims Examiner will be responsible for researching and resolving pending claims, reviewing claim denials requiring manual review, and ensuring timely processing in compliance with policies, procedures, and regulatory guidelines. The role involves determining claim payments, maintaining correspondence for procedural and medical coding, and adhering to all regulatory standards. Duties and Responsibilities Review, price, and release paper and electronic claims for assigned claim types. Analyze Manual Review and Master Denial reports for all company health programs. Audit claims from specialized reports (e.g., ER, Family Planning, Mental Health). Identify and propose process improvements or automation in collaboration with the Supervisor. Contribute ideas for System Change Forms (SCFs) as needed. Stay updated on company health policies and support departmental improvement initiatives. Ensure compliance with all regulatory guidelines. Maintain a daily activity log. Assist in claims processing and report billing/error trends identified during reviews. Adhere to AB1455 Claims Settlement Practices and DHCS Regulations timelines. Perform additional duties and projects as assigned. Skills/Knowledge/Abilities Familiarity with the Medi-Cal program. Experience in a high-volume production environment. Strong oral and written communication skills. High attention to detail. Knowledge of medical terminology and/or coding is highly preferred. Education and Experience High school diploma or equivalent. Prior experience as a claims examiner.

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! Company Job Description/Day to Day Duties: -Reports to the Director of Claims -Responsible for the accurate and timely adjudication of all claims in accordance with applicable contracts, state and federal regulations, health plan requirements -Examiners are expected to produce a minimum of 30 claims per hour. -Examiners are expected to maintain 98 percent coding and financial accuracy. -Examiners must meet timeliness requirements for the product line(s) they are responsible for processing. This can be achieved by effectively managing pended items/claims on a daily basis (working them at least two times a day) and by meeting daily production goals. A. Medicare- 30 calendar days regardless of provider contract status. B. Medi-Cal- 30 calendar days regardless of provider contract status. C. Commercial- 60 calendar days regardless of provider contract status. Qualifications Minimum Education/Licensures/Qualifications: -HS/Diploma or GED/equivalent -1-3+ years of processing of managed care health claims -Strong knowledge of medical terminology -Strong Ten Key by touch -Ability to type at least 40- 45 wpm (if they are unsure of typing skills, please send prove it!) -Proficient with Microsoft Office/General office equipment experience (i.e. photocopier, fax, calculator, ability to operate a PC) -Strong working knowledge of ICD.9.CM, CPT, HCPCS, RBRVS coding schemes -Experience with different software and hardware systems for claims adjudication -Must have an excellent understanding of health and managed care concepts and their application in the adjudication of claims. -Must be able to accurately assess financial responsibility and liability for claims submitted by both members and providers. -Accurate input of data is required for claims adjudication including: diagnostic and procedural coding, pricing schedules, member and provider identification, and all other related information as required. Best Candidate: 3+ years of experience working on Managed Care claims 2nd Best: 1+ year experience as a Claims Examiner Additional Information Location: 15821 Ventura Blvd suite 600 Encino, CA 91436 If Contract, Length of Assignment: RTH Shift: Monday-Friday, 8am-5pm (There is a night shift, but as of now they are not looking to fill any night spots- if you have a candidate seeking a later shift, I am happy to present them) Start Date: As soon as all HR is back and clear Times/Interviewer: Phone interviews with hiring manager- Laura Saez, Claims Supervisor- possible for same day scheduling if not as soon as next day

Job Description The Insurance Claims Examiner is responsible for overseeing insurance claims and ensuring the company maintains adequate insurance coverage for all multi-family housing communities. This role combines claims management with insurance coordination, including policy review, compliance oversight, and vendor/insurer communication. The ideal candidate will safeguard the company's properties through proactive risk management and efficient handling of insurance claims. This position is on-site at our corporate office in Arcadia, CA. Responsibilities and Duties: Review, analyze, and process insurance claims for property damage, liability, and habitability issues. Examine insurance policies and coverage to ensure adequate protection for all properties within the portfolio. Coordinate with insurance brokers, carriers, and adjusters regarding claims, renewals, and policy updates. Maintain accurate records of claims, settlements, and policy documents. Monitor policy expirations and ensure timely renewals. Assist with filing new insurance claims and track them through resolution. Ensure compliance with insurance requirements, industry standards, and local/state regulations. Evaluate insurance certificates from vendors and contractors for accuracy and coverage compliance. Provide support in risk assessments and recommend coverage adjustments as needed. Prepare reports for leadership regarding claims trends, costs, and insurance adequacy. Collaborate with property management teams to educate staff on insurance protocols and risk management practices. Qualifications: Bachelor's degree in Business, Finance, Risk Management, or related field preferred. Prior experience in insurance claims, risk management, or insurance coordination (property management or multi-family housing experience preferred). Knowledge of insurance policies, coverages (including habitability insurance), and claims handling procedures. Strong analytical and organizational skills. Excellent communication and negotiation abilities. Proficiency with Microsoft Office Suite and claims management systems. Ability to manage multiple priorities in a fast-paced environment. Work Environment: Full-time, Monday-Friday schedule. Based at corporate office with occasional property site visits as needed. Proficiency in Microsoft Office Suite; experience with insurance or Yardi software is a plus.

DescriptionJob Title: Claims Examiner III Department: Ops - Claims Ops What You'll Do Analyze, process, research, adjust and adjudicate claims with the use of accurate procedure/revenue and ICD-10 codes, under the correct provider and member benefits Review and process facility (UB-04) and professional claims (CMS-1500) Process claims based on contractual agreements, health plan division of financial responsibility, applicable regulatory legislature, claims processing guidelines and client groups' and company policies and procedures Process Medicare member claims based on DMHC and DHS regulatory legislature Respond to and resolve provider and health plan claims inquiries and give resolution in a timely manner Review services for appropriateness of charges and apply authorization guidelines during claims processing Monitor and track age, pended, and open reports to maintain timeliness in claims processing based on individual work allocation reports Maintain quality and productivity standards, teamwork, and comply with company/administrative guidelines Participate in special projects, complete tasks assigned by management and attend meetings/conference calls as necessary Loading and entering claims Other duties as assigned Qualifications Must have at least 3 years of applicable healthcare claims adjudication experience within the managed care industry for a level I or II and at least 4 years for Senior level claims Candidates with multi-product line claims adjustment experience, preferred Must be familiar with ICD-10, HCPCS, CPT coding, APC, ASC and DRG pricing, CMS, DMHC regulations, facility and professional claim billing practices Must possess proficient filing, general clerical, verbal and written communication and presentations skills Must be able to problem-solve, follow guidelines, multi-task, and work comfortably within a team-oriented environment Computer literacy required, including proficient use of Microsoft Word, Excel, Outlook, and Ez-cap Claims adjudication software, preferred Ability to type with accuracy and speed of at least 35 wpm Associate's degree (A. A.) or equivalent from two-year college or technical school; some college courses, or six months to one year related experience and/or training; or equivalent combination of education and experience Environmental Job Requirements and Working Conditions Our organization follows a hybrid work structure where the expectation is to work both in office and at home on a weekly basis. The office is located at 1600 Corporate Center Dr., Monterey Park, CA 91754. The national target pay range for this role is: $28.00 - $32.00 per hour. Actual compensation will be determined based on geographic location (current or future), experience, and other job-related factors. Astrana Health is proud to be an Equal Employment Opportunity and Affirmative Action employer. We do not discriminate based on race, religion, color, national origin, gender (including pregnancy, childbirth, or related medical conditions), sexual orientation, gender identity, gender expression, age, status as a protected veteran, status as an individual with a disability, or other applicable legally protected characteristics. All employment is decided based on qualifications, merit, and business need. If you require assistance in applying for open positions due to a disability, please email us at ************************************ to request an accommodation. Additional Information:The job description does not constitute an employment agreement between the employer and employee and is subject to change by the employer as the needs of the employer and requirements of the job change.

We are seeking a Claims Processor to join a well-established sales and marketing firm that represents an international partner and serves as the liaison between overseas operations and customers across North America. This role is ideal for someone with strong analytical skills, attention to detail, and the ability to manage claims processes while maintaining excellent communication with multiple stakeholders. Essential Duties and Responsibilities Process all product claims, reviewing and analyzing new claims for accuracy and disseminating them to the appropriate insurance carrier. Act as a liaison with intercompany parties, insurance adjusters, and customers to resolve product claims. Evaluate claims submitted to insurance companies to determine eligibility standards. Research and resolve issues within the scope of the job. Maintain communication between corporate and field offices to gather information for timely responses to legal documents and claim losses. Draft written and oral correspondence related to claims processing. Report exposures, pending claims, and litigations that may impact company assets or goals. Perform additional office duties as assigned by the immediate supervisor. Competencies Strong attention to detail, organization, and thoroughness. Familiarity with general merchandise manufacturing processes, product parts, and plumbing industry standards. Knowledge of commercial insurance and claims processing. Excellent research, analytical, and problem-solving skills. Professionalism, collaboration, and strong communication skills (oral and written). Proficiency in Microsoft Office (Outlook, Excel, Word, PowerPoint) and Adobe. Travel Requirements Up to 25% travel required for offsite product inspections. Education and Experience Associate degree in business or related field. Minimum of two years of relevant work experience and/or training, or equivalent combination of education and experience. Language Skills Ability to read, analyze, interpret, and respond to general business correspondence. This will be a full-time, Non-exempt position with a salary of $22.00/hour. Monday to Friday from 8:00am to 5:00pm.

PENNYMAC Pennymac (NYSE: PFSI) is a specialty financial services firm with a comprehensive mortgage platform and integrated business focused on the production and servicing of U. S. mortgage loans and the management of investments related to the U. S. mortgage market. At Pennymac, our people are the foundation of our success and at the heart of our dynamic work culture. Together, we work towards a unified goal of helping millions of Americans achieve aspirations of homeownership through the complete mortgage journey. A Typical Day The Quality Assurance (QA) Claims Processor will perform QA reviews in accordance with established procedures and complying with investor requirements and federal and state regulations. As the QA Processor, you will be responsible for reviewing the default timeline to verify that reported actions occurred as required by the applicable investor and insurer servicing guidelines. The QA Claims Processor will: Reconcile servicing expenses/corporate advances as required by MI, investor, insurer and internal guidelines including: foreclosure fees and costs, eviction requirements, property inspections and preservation, HOAs, taxes, hazard insurance and expenses during the default process Ensure reviews are performed in a timely manner in accordance with established procedures and investor guidelines Maintain and update various databases to meet departmental and QA requirements Assist in identifying error trends noted during the QA evaluation Achieve key metrics associated with the process and meet departmental monthly goals Perform other related duties as required and assigned Demonstrate behaviors which are aligned with the organization's desired culture and values What You'll Bring Mortgage default-related experience preferred Demonstrated aptitude for data, reporting, data reconciliation desired Familiarity with FHA, VA, USDA, MI and GSE Insurer servicing guidelines Must have experience with auditing and/or filing claims for FHA, VA and/or USDA adhering to the Investor/Insurer's guidelines Must be highly proficient in Excel and Word Why You Should Join As one of the top mortgage lenders in the country, Pennymac has helped over 4 million lifetime homeowners achieve and sustain their aspirations of home. Our vision is to be the most trusted partner for home. Together, 4,000 Pennymac team members across the country are guided by our core values: to be Accountable, Reliable and Ethical in all that we do. Pennymac is committed to conducting a business that makes positive contributions and promotes long-term sustainable growth and to fostering an equitable and inclusive environment, where all employees and customers feel valued, respected and supported. Benefits That Bring It Home: Whether you're looking for flexible benefits for today, setting up short-term goals for tomorrow, or planning for long-term success and retirement, Pennymac's benefits have you covered. Some key benefits include: Comprehensive Medical, Dental, and Vision Paid Time Off Programs including vacation, holidays, illness, and parental leave Wellness Programs, Employee Recognition Programs, and onsite gyms and cafe style dining (select locations) Retirement benefits, life insurance, 401k match, and tuition reimbursement Philanthropy Programs including matching gifts, volunteer grants, charitable grants and corporate sponsorships To learn more about our benefits visit: ********************* page. link/benefits For residents with state required benefit information, additional information can be found at: ************ pennymac. com/additional-benefits-information Compensation: Individual salary may vary based on multiple factors including specific role, geographic location / market data, and skills and experience as defined below: Lower in range - Building skills and experience in the role Mid-range - Experience and skills align with proficiency in the role Higher in range - Experience and skills add value above typical requirements of the role Some roles may be eligible for performance-based compensation and/or stock-based incentives awarded to employees based on company and individual performance. Salary $39,000 - $55,000 Work Model OFFICE

Under limited supervision and established practices, responsible for the investigation, evaluation, and disposition of Complex Workers Compensation cases of high exposure and severity. Applies established medical management strategies on high dollar complex claims. Has developed high level of knowledge of Workers Compensation claims handling techniques, a full knowledge of LMG claims procedures and is cognizant of new industry trends and claim handling techniques Uses available data to track claims trends and other claim related metrics. Candidates should be based in California with California Self-Insured Certification or based in West Region with experience in handling Alaska Workers Compensation claims. The salary range posted reflects the range for the varying pay scale that encompasses each of the Liberty Mutual regions and the overall cost of living for that region. Responsibilities * Investigates claims to determine whether coverage is provided, establish compensability and verify exposure. * Resolves claims within authority and makes recommendations regarding case value and resolution strategy to Branch Office Management and HO Examining on cases which exceed authority. * Participates in pricing, reserving and strategy discussions with HO Examining and Examining Management. * Works closely with staff and outside defense counsel in managing litigated files according to established litigation management protocols. * Identifies and appropriately handles suspicious claims and claims with the potential to develop adversely. * Identifies and appropriately handles claims with third party subrogation potential, SIF (Self-Insured Fund) and MSA (Medicare Set Aside) exposure. * Establishes and maintains accurate reserves on all assigned files. * Makes timely reserve recommendations to Branch Office Management and HO Examining on cases which exceed authority. * Prepares for and attends mediation sessions and/or settlement conferences and negotiates on behalf of LMG and LMG Insureds. * Demonstrates the ability to understand new and unique exposures and coverages. * Demonstrates the ability to understand key data elements and claims related data analysis. * Confers directly with policyholders on coverage and resolution strategy issues. * Coordinates and participates in training sessions for less experienced staff, including both Complex Non-Complex staff. Qualifications * A bachelor's degree or equivalent business experience is required * In addition, the candidate will generally possess 5-7 years of related claims experience with 1-2 years of experience in complex claims * Demonstrated proficiency in Excel, PowerPoint as well as excellent written and verbal communication skills required About Us Pay Philosophy: The typical starting salary range for this role is determined by a number of factors including skills, experience, education, certifications and location. The full salary range for this role reflects the competitive labor market value for all employees in these positions across the national market and provides an opportunity to progress as employees grow and develop within the role. Some roles at Liberty Mutual have a corresponding compensation plan which may include commission and/or bonus earnings at rates that vary based on multiple factors set forth in the compensation plan for the role. At Liberty Mutual, our goal is to create a workplace where everyone feels valued, supported, and can thrive. We build an environment that welcomes a wide range of perspectives and experiences, with inclusion embedded in every aspect of our culture and reflected in everyday interactions. This comes to life through comprehensive benefits, workplace flexibility, professional development opportunities, and a host of opportunities provided through our Employee Resource Groups. Each employee plays a role in creating our inclusive culture, which supports every individual to do their best work. Together, we cultivate a community where everyone can make a meaningful impact for our business, our customers, and the communities we serve. We value your hard work, integrity and commitment to make things better, and we put people first by offering you benefits that support your life and well-being. To learn more about our benefit offerings please visit: *********************** Liberty Mutual is an equal opportunity employer. We will not tolerate discrimination on the basis of race, color, national origin, sex, sexual orientation, gender identity, religion, age, disability, veteran's status, pregnancy, genetic information or on any basis prohibited by federal, state or local law. Fair Chance Notices * California * Los Angeles Incorporated * Los Angeles Unincorporated * Philadelphia * San Francisco

Job Description- National Insurance Carrier is looking for an experienced EPL Claims Manager that is currently managing a team. Prior experience in EPLI & professional liability claims is preferred but not mandatory. Will need a minimum of 5 to 7 years experience in EPL and or professional liability claims. JD preferred with good interpersonal skills. Call for additional details.

Job Type: Permanent Build a brilliant future with Hiscox Put your claims skills to the test and join one of the top Professional Liability Insurers in the Industry as a Complex Claims Specialist! Please note that this position is hybrid and requires working in office two (2) days per week. Position can be based near the following office locations: * West Hartford, CT (preferred) * Atlanta, GA * Boston, MA * Chicago, IL * Los Angeles, CA * Manhattan, NY About the Hiscox Claims team: The US Claims team at Hiscox is a growing group of professionals with experience across private practice and in-house roles, working together to provide the ultimate product we offer to the market. Complex Claims Specialists are empowered to manage their claims with high levels of authority to provide fair and fast resolution of claims for our insured and broker partners. The Role: The primary role of a Complex Claims Specialist is to analyze liability claim submissions for potential coverage, set adequate case reserves, promptly and professionally respond to inquiries from our customers and their brokers, and to proactively drive early resolution of claims arising from our commercial lines of insurance. This particular role is open to Atlanta and will be focused on servicing claims and potential claims arising from our book of Cyber, Tech PL, Media and/or Crime professional liability lines of business. This is a fantastic opportunity to join Hiscox USA, a growing business where you will be able to make a real impact. Together, we aim to be the best people producing the best insurance solutions and delivering the best service possible. What you'll be doing as the Complex Claims Specialist: Key Responsibilities: To perform all core aspects of in-house claims management, including but not limited to: * Reviewing and analyzing claim documentation and legal filings * Drafting coverage analyses for tech E&O, first and third party cyber claims * Strategizing and maximizing early resolution opportunities * Monitoring litigation and managing local defense and breach counsel * Attending mediations and/or settlement conferences, either in person or by phone as appropriate * Smartly managing and tracking third-party vendor and service provider spend * Continually assessing exposures and adequacy of claim reserves, and escalating high exposure and/or volatile claims to line manager * Liaising directly on daily basis with insureds and brokers * Maintaining timely and accurate file documentation/information in our claims management system Our Must-Haves: * 5+ years of professional lines claims handling experience * A JD from an ABA-accredited law school and bar admission in good standing may be considered as a supplement to claims handing experience * A minimum of 2-3 years professional experience in the area of Cyber and Technology coverage experience required * Proven ability to positively affect complex claims outcomes through investigation, negotiation and effectively leading litigation * Advanced knowledge of coverage within the team's specialty or focus * Advanced knowledge of litigation process and negotiation skills * Excellent verbal and written communication skills * Advanced analytical skills * B.A./B.S degree from an accredited College or University, JD degree from an ABA accredited law school is preferred What Hiscox USA Offers: * Competitive salary and bonus (based on personal & company performance) * Comprehensive health insurance, Vision, Dental and FSA (medical, limited purpose, and dependent care) * Company paid group term life, short-term disability and long-term disability coverage * 401(k) with competitive company matching * 24 Paid time off days with 2 Hiscox Days * 10 Paid Holidays plus 1 paid floating holiday * Ability to purchase 5 additional PTO days * Paid parental leave * 4 week paid sabbatical after every 5 years of service * Financial Adoption Assistance and Medical Travel Reimbursement Programs * Annual reimbursement up to $600 for health club membership or fees associated with any fitness program * Company paid subscription to Headspace to support employees' mental health and wellbeing * Recipient of 2024 Cigna's Well-Being Award for having a best-in-class health and wellness program * Dynamic, creative and values-driven culture * Modern and open office spaces, complimentary drinks * Spirit of volunteerism, social responsibility and community involvement, including matching charitable donations for qualifying non-profits via our sister non-profit company, the Hiscox USA Foundation About Hiscox USA: Hiscox USA was established in 2006 to focus primarily on the needs of small and middle market commercial clients, via both the broker and direct distribution channels and is today the fastest-growing business unit within the Hiscox Group. Today, Hiscox USA has a talent force of about 420 employees mostly operating out of 6 major cities - New York, Atlanta, Dallas, Chicago, Los Angeles and San Francisco. Hiscox USA offers a broad portfolio of commercial products, including technology, cyber & data risk, multiple professional liability lines, media, entertainment, management liability, crime, kidnap & ransom, commercial property and terrorism. You can follow Hiscox on LinkedIn, Glassdoor and Instagram (@HiscoxInsurance) Salary Range: $125,000- $160,000 The actual salary for this position will be determined by a number of factors, including the scope, complexity and location of the role; the skills, education, training, credentials and experience of the candidate; and other conditions of employment. We are an Equal Opportunity Employer and do not discriminate against any employee or applicant for employment because of race, color, sex, age, national origin, religion, sexual orientation, gender identity, status as a veteran, and basis of disability or any other federal, state or local protected class. #LI-RM1 Work with amazing people and be part of a unique culture

Job Description 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.

Grow Healthy If you are as passionate about helping those in need as you are about growing your career, consider AltaMed. At AltaMed, your passion for helping others isn't just welcomed - it's nurtured, celebrated, and promoted, allowing you to grow while making a meaningful difference. We don't just serve our communities; we are an integral part of them. By raising the expectations of what a community clinic can deliver, we demonstrate our belief that quality care is for everyone. Our commitment to providing exceptional care, despite any challenges, goes beyond just a job; it's a calling that drives us forward every day. Job Overview The Claims Examiner II is responsible for analyzing and adjudication of medical claims as it relates to managed care. Performs payment reconciliations and/or adjustments related to retroactive contract rate and fee schedule changes. May resolve claims payment issues as presented through the Provider Dispute Resolution (PDR) process or from claims incidents/inquiries. Identifies root causes of claims payment errors and reports to Management. Responds to provider inquiries/calls related to claims payment. Collaborates with other departments and/or providers in the successful resolution of claims-related issues. Minimum Requirements HS Diploma or GED Minimum of 3 years of Claims Processing experience in a managed care environment. Experience in reading and interpreting DOFRs and Contracts is required. Experience in reading CMS-1500 and UB-04 forms is required. Compensation $26.91 - $33.53 hourly Compensation Disclaimer Actual salary offers are considered by various factors, including budget, experience, skills, education, licensure and certifications, and other business considerations. The range is subject to change. AltaMed is committed to ensuring a fair and competitive compensation package that reflects the candidate's value and the role's strategic importance within the organization. This role may also qualify for discretionary bonuses or incentives. Benefits & Career Development Medical, Dental and Vision insurance 403(b) Retirement savings plans with employer matching contributions Flexible Spending Accounts Commuter Flexible Spending Career Advancement & Development opportunities Paid Time Off & Holidays Paid CME Days Malpractice insurance and tail coverage Tuition Reimbursement Program Corporate Employee Discounts Employee Referral Bonus Program Pet Care Insurance Job Advertisement & Application Compliance Statement AltaMed Health Services Corp. will consider qualified applicants with criminal history pursuant to the California Fair Chance Act and City of Los Angeles Fair Chance Ordinance for Employers. You do not need to disclose your criminal history or participate in a background check until a conditional job offer is made to you. After making a conditional offer and running a background check, if AltaMed Health Service Corp. is concerned about a conviction directly related to the job, you will be given a chance to explain the circumstances surrounding the conviction, provide mitigating evidence, or challenge the accuracy of the background report.

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! Job Description Intro: Are you an experienced Claims Examiner looking for a new opportunity with a prestigious healthcare company? Do you have claims adjudication or facility claims experience in healthcare? 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! Daily Responsibilities: Conducts claims payment analyses to identify root cause of claims issues/deficiencies. Adjudicates medical claims Verifies patient account, eligibility, benefits and authorizations. Prioritizes assigned claims according to regulatory timelines. Requests additional information for incomplete or unclean claims; follows up with provider as necessary. Runs claims report to adjudicate adjustments due to retroactive effective date of contract or fee schedule changes. Corresponds with IPAs/Medical Groups regarding misdirected claims. Qualifications Requirements: 2-5 years medical claims examining experience, Minimum typing speed of 45 WPM and use of Ten-Key by touch Knowledge of ICD9-CM, HCPCS level II and III, CPT, and revenue Codes, DRG and APC coding a plus Knowledge of different payment methodologies such as Medi-Cal, RBRVS, DRG and other Medicare reimbursements Additional Information If you are interested, PLEASE CONTACT Tyler AT 407-478-0332 EXT 117

Under limited supervision and established practices, responsible for the investigation, evaluation, and disposition of Complex Workers Compensation cases of high exposure and severity. Applies established medical management strategies on high dollar complex claims. Has developed high level of knowledge of Workers Compensation claims handling techniques, a full knowledge of LMG claims procedures and is cognizant of new industry trends and claim handling techniques Uses available data to track claims trends and other claim related metrics. Candidates should be based in California with California Self-Insured Certification or based in West Region with experience in handling Alaska Workers Compensation claims. The salary range posted reflects the range for the varying pay scale that encompasses each of the Liberty Mutual regions and the overall cost of living for that region. Responsibilities Investigates claims to determine whether coverage is provided, establish compensability and verify exposure. Resolves claims within authority and makes recommendations regarding case value and resolution strategy to Branch Office Management and HO Examining on cases which exceed authority. Participates in pricing, reserving and strategy discussions with HO Examining and Examining Management. Works closely with staff and outside defense counsel in managing litigated files according to established litigation management protocols. Identifies and appropriately handles suspicious claims and claims with the potential to develop adversely. Identifies and appropriately handles claims with third party subrogation potential, SIF (Self-Insured Fund) and MSA (Medicare Set Aside) exposure. Establishes and maintains accurate reserves on all assigned files. Makes timely reserve recommendations to Branch Office Management and HO Examining on cases which exceed authority. Prepares for and attends mediation sessions and/or settlement conferences and negotiates on behalf of LMG and LMG Insureds. Demonstrates the ability to understand new and unique exposures and coverages. Demonstrates the ability to understand key data elements and claims related data analysis. Confers directly with policyholders on coverage and resolution strategy issues. Coordinates and participates in training sessions for less experienced staff, including both Complex Non-Complex staff. Qualifications A bachelor's degree or equivalent business experience is required In addition, the candidate will generally possess 5-7 years of related claims experience with 1-2 years of experience in complex claims Demonstrated proficiency in Excel, PowerPoint as well as excellent written and verbal communication skills required About Us Pay Philosophy: The typical starting salary range for this role is determined by a number of factors including skills, experience, education, certifications and location. The full salary range for this role reflects the competitive labor market value for all employees in these positions across the national market and provides an opportunity to progress as employees grow and develop within the role. Some roles at Liberty Mutual have a corresponding compensation plan which may include commission and/or bonus earnings at rates that vary based on multiple factors set forth in the compensation plan for the role. At Liberty Mutual, our goal is to create a workplace where everyone feels valued, supported, and can thrive. We build an environment that welcomes a wide range of perspectives and experiences, with inclusion embedded in every aspect of our culture and reflected in everyday interactions. This comes to life through comprehensive benefits, workplace flexibility, professional development opportunities, and a host of opportunities provided through our Employee Resource Groups. Each employee plays a role in creating our inclusive culture, which supports every individual to do their best work. Together, we cultivate a community where everyone can make a meaningful impact for our business, our customers, and the communities we serve. We value your hard work, integrity and commitment to make things better, and we put people first by offering you benefits that support your life and well-being. To learn more about our benefit offerings please visit: *********************** Liberty Mutual is an equal opportunity employer. We will not tolerate discrimination on the basis of race, color, national origin, sex, sexual orientation, gender identity, religion, age, disability, veteran's status, pregnancy, genetic information or on any basis prohibited by federal, state or local law. Fair Chance Notices California Los Angeles Incorporated Los Angeles Unincorporated Philadelphia San Francisco We can recommend jobs specifically for you! Click here to get started.

Job Type: Permanent Build a brilliant future with Hiscox Put your claims skills to the test and join one of the top Professional Liability Insurers in the Industry as a Complex Claims Specialist! Please note that this position is hybrid and requires working in office two (2) days per week. Position can be based near the following office locations: West Hartford, CT (preferred) Atlanta, GA Boston, MA Chicago, IL Los Angeles, CA Manhattan, NY About the Hiscox Claims team: The US Claims team at Hiscox is a growing group of professionals with experience across private practice and in-house roles, working together to provide the ultimate product we offer to the market. Complex Claims Specialists are empowered to manage their claims with high levels of authority to provide fair and fast resolution of claims for our insured and broker partners. The Role: The primary role of a Complex Claims Specialist is to analyze liability claim submissions for potential coverage, set adequate case reserves, promptly and professionally respond to inquiries from our customers and their brokers, and to proactively drive early resolution of claims arising from our commercial lines of insurance. This particular role is open to Atlanta and will be focused on servicing claims and potential claims arising from our book of Cyber, Tech PL, Media and/or Crime professional liability lines of business. This is a fantastic opportunity to join Hiscox USA, a growing business where you will be able to make a real impact. Together, we aim to be the best people producing the best insurance solutions and delivering the best service possible. What you'll be doing as the Complex Claims Specialist: Key Responsibilities: To perform all core aspects of in-house claims management, including but not limited to: Reviewing and analyzing claim documentation and legal filings Drafting coverage analyses for tech E&O, first and third party cyber claims Strategizing and maximizing early resolution opportunities Monitoring litigation and managing local defense and breach counsel Attending mediations and/or settlement conferences, either in person or by phone as appropriate Smartly managing and tracking third-party vendor and service provider spend Continually assessing exposures and adequacy of claim reserves, and escalating high exposure and/or volatile claims to line manager Liaising directly on daily basis with insureds and brokers Maintaining timely and accurate file documentation/information in our claims management system Our Must-Haves: 5+ years of professional lines claims handling experience A JD from an ABA-accredited law school and bar admission in good standing may be considered as a supplement to claims handing experience A minimum of 2-3 years professional experience in the area of Cyber and Technology coverage experience required Proven ability to positively affect complex claims outcomes through investigation, negotiation and effectively leading litigation Advanced knowledge of coverage within the team's specialty or focus Advanced knowledge of litigation process and negotiation skills Excellent verbal and written communication skills Advanced analytical skills B.A./B.S degree from an accredited College or University, JD degree from an ABA accredited law school is preferred What Hiscox USA Offers: Competitive salary and bonus (based on personal & company performance) Comprehensive health insurance, Vision, Dental and FSA (medical, limited purpose, and dependent care) Company paid group term life, short-term disability and long-term disability coverage 401(k) with competitive company matching 24 Paid time off days with 2 Hiscox Days 10 Paid Holidays plus 1 paid floating holiday Ability to purchase 5 additional PTO days Paid parental leave 4 week paid sabbatical after every 5 years of service Financial Adoption Assistance and Medical Travel Reimbursement Programs Annual reimbursement up to $600 for health club membership or fees associated with any fitness program Company paid subscription to Headspace to support employees' mental health and wellbeing Recipient of 2024 Cigna's Well-Being Award for having a best-in-class health and wellness program Dynamic, creative and values-driven culture Modern and open office spaces, complimentary drinks Spirit of volunteerism, social responsibility and community involvement, including matching charitable donations for qualifying non-profits via our sister non-profit company, the Hiscox USA Foundation About Hiscox USA: Hiscox USA was established in 2006 to focus primarily on the needs of small and middle market commercial clients, via both the broker and direct distribution channels and is today the fastest-growing business unit within the Hiscox Group. Today, Hiscox USA has a talent force of about 420 employees mostly operating out of 6 major cities - New York, Atlanta, Dallas, Chicago, Los Angeles and San Francisco. Hiscox USA offers a broad portfolio of commercial products, including technology, cyber & data risk, multiple professional liability lines, media, entertainment, management liability, crime, kidnap & ransom, commercial property and terrorism. You can follow Hiscox on LinkedIn, Glassdoor and Instagram (@HiscoxInsurance) Salary Range: $125,000- $160,000 The actual salary for this position will be determined by a number of factors, including the scope, complexity and location of the role; the skills, education, training, credentials and experience of the candidate; and other conditions of employment. We are an Equal Opportunity Employer and do not discriminate against any employee or applicant for employment because of race, color, sex, age, national origin, religion, sexual orientation, gender identity, status as a veteran, and basis of disability or any other federal, state or local protected class. #LI-RM1 Work with amazing people and be part of a unique culture

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.

Grow Healthy If you are as passionate about helping those in need as you are about growing your career, consider AltaMed. At AltaMed, your passion for helping others isn't just welcomed - it's nurtured, celebrated, and promoted, allowing you to grow while making a meaningful difference. We don't just serve our communities; we are an integral part of them. By raising the expectations of what a community clinic can deliver, we demonstrate our belief that quality care is for everyone. Our commitment to providing exceptional care, despite any challenges, goes beyond just a job; it's a calling that drives us forward every day. Job Overview A Claims Examiner is responsible for analyzing and adjudication of medical claims as it relates to managed care. Performs payment reconciliations and/or adjustments related to retroactive contract rate and fee schedule changes. Resolve claims payment issues as presented through the Provider Dispute Resolution (PDR) process or from claims incidents/inquiries. Identifies root causes of claims payment errors and reports to Management. Responds to provider inquiries/calls related to claims payments. Collaborates with other departments and/or providers in the successful resolution of claims-related issues. Minimum Requirements HS Diploma or GED. Must have some knowledge of Medi-Cal regulations. Must have some Knowledge of medical terminology. Must understand to read and interpret DOFRs and Contracts. Preferred knowledge of Medicare and Commercial rules and regulations. Must have an understanding of how to read a CMS-1500 and UB-04 form. Must have strong organizational and mathematical skills. Must be able to multi-task Compensation $25.00 - $29.32 hourly Compensation Disclaimer Actual salary offers are considered by various factors, including budget, experience, skills, education, licensure and certifications, and other business considerations. The range is subject to change. AltaMed is committed to ensuring a fair and competitive compensation package that reflects the candidate's value and the role's strategic importance within the organization. This role may also qualify for discretionary bonuses or incentives. Benefits & Career Development Medical, Dental and Vision insurance 403(b) Retirement savings plans with employer matching contributions Flexible Spending Accounts Commuter Flexible Spending Career Advancement & Development opportunities Paid Time Off & Holidays Paid CME Days Malpractice insurance and tail coverage Tuition Reimbursement Program Corporate Employee Discounts Employee Referral Bonus Program Pet Care Insurance Job Advertisement & Application Compliance Statement AltaMed Health Services Corp. will consider qualified applicants with criminal history pursuant to the California Fair Chance Act and City of Los Angeles Fair Chance Ordinance for Employers. You do not need to disclose your criminal history or participate in a background check until a conditional job offer is made to you. After making a conditional offer and running a background check, if AltaMed Health Service Corp. is concerned about a conviction directly related to the job, you will be given a chance to explain the circumstances surrounding the conviction, provide mitigating evidence, or challenge the accuracy of the background report.

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! Job Description Are you an experienced Claims Examiner looking for a new opportunity with a prestigious healthcare company in the San Fernando, CA area? 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! The ideal person for this position would have 1+ year of Managed Care claims experience. In this role you will be responsible for the accurate & timely adjudication of all claims in accordance with applicable contracts, state & federal regulations, health plan requirements, policies & procedures. Key Responsibilities: Analyzes professional &/or hospital claims for accuracy according to set dollar thresholds, meets & maintains production & quality standards Reviews authorization &/or provider's contract & adjudicates claims accordingly Accurate input of data is requried for claims adjudication including: diagnostic & procedural coding, pricing schedules, member & provider identification & all other related information is required Performs any correspondence, follow up & any projects delegated by claims supervisor Knowledge, Skills & Abilities: Understanding of health & managed care concepts & their application in the adjudication of claims Strong working knowledge of ICD9 CM, CPT, HCPCS, RBRVS coding schemes & medical terminology Minimum Qualifications: Monday - Friday schedule & competitive pay! Qualifications 1-3+ year experience processing of managed care health claims Ability to type 40-45 wpm Understanding of medical terminology Must have excellent understanding of health & managed care concepts & their application in the adjudication of claims Must be able to accurately assess financial responsibility & liability for claims submitted by both members & providers High School diploma/GED required Additional Information Interested in being considered? If you are interested in applying to this position, please contact Blake Anderson at 407-478-0332 ext. 115 and/or click the Green I'm Interested Button to email your resume