Claim processor jobs in Oceanside, CA - 60 jobs

Energy: Forget about blending in. That's not our style. We're the risk-takers, the trailblazers, the game-changers. We're not perfect, and we don't pretend to be. We're raw, unfiltered, and a bit unconventional. But our drive is unrivaled, just like our athletes. The power is in your hands to define what success looks like and where you want to take your career. It's not just about what we do, but about who we become along the way. We are much more than a brand here. We are a way of life, a mindset. Join us. A day in the life: As a Bottler Claims Representative at Monster Energy, you'll be at the heart of the action, processing, validating, and coding promotional invoices with the precision of a high-speed racer! Get ready to rev up your data-entry skills and keep the promotions engine running smoothly. Your role is all about ensuring everything flows seamlessly, just like the thrilling rush of a Monster Energy drink! The impact you'll make: Review, validate, and process distributor invoices in accordance with company policies and procedures. Requires frequent communication with distributors and the Sales Team to obtain necessary supporting documentation and approvals. Verify invoice program details, ensure accuracy, compliance, and adherence to promotional execution or contractual agreements. -->> Collect, organize, and maintain supporting documents required for invoice validation and/or support in SAP, Vistex, Sales Force and or other source locations. Accurately code and enter invoice details into SAP, Vistex, Sales Force, and or other source locations, to ensure proper GL coding and reporting. Identify discrepancies or errors in claims and work with relevant teams to resolve issues efficiently. Ensure all claims adhere to company policies, industry regulations, and audit requirements. Maintain accurate and up-to-date records of processed claims for tracking and audit purposes. Identify opportunities to enhance efficiency and accuracy in claims processing workflows. Work closely with internal teams, including Finance and Sales and Chain Claims, to support business objectives and streamline operations alongside any additional ad hoc duties. Who you are: Prefer a Bachelor's Degree in the field of --Accounting, Math, Business Administration, or other related field of study Additional Experience Desired: Minimum 1 year of experience in Accounts Payable position Additional Experience Desired: Minimum 1 year of experience in processing vendor invoices, data entry, account reconciliation Computer Skills Desired: Proficiency with Microsoft's office desktop solutions (Intermediate Excel a must - Test Scores required), Teams, Outlook, SharePoint, SAP or other accounting technology a plus. Preferred Certifications: N/A Additional Knowledge or Skills to be Successful in this role: Typing, 10 Key desired Monster Energy provides a competitive total compensation. This position has an estimated hourly rate of $17.00 - $23.00 per hour. The actual pay may vary depending on your skills, qualifications, experience, and work location.

Workers' Compensation Claim Supervisor Schedule: Monday-Friday, 8:00 AM-4:30 PM PST Salary Range: $98,000-$110,000 annually Direct Reports: 2-6 adjusters Build Your Career With Purpose at CCMSI At CCMSI, we partner with global clients to solve their most complex risk management challenges, delivering measurable results through advanced technology, collaborative problem-solving, and an unwavering commitment to their success. We don't just process claims-we support people. As the largest privately-owned Third Party Administrator (TPA), CCMSI delivers customized claim solutions that help our clients protect their employees, assets, and reputations. We are a certified Great Place to Work , and our employee-owners are empowered to grow, collaborate, and make meaningful contributions every day. Job Summary We are seeking a Workers' Compensation Claim Supervisor with California jurisdiction expertise to remotely lead a team of adjusters out of our Las Vegas, NV branch. This role is critical in ensuring claims are handled accurately, efficiently, and in compliance with client and regulatory requirements. You'll provide clear guidance and direction throughout the lifecycle of each claim, while mentoring and developing your team for long-term success. Responsibilities • Oversee proper handling of WC claims to protect the interests of the adjuster, client, and carrier • Review claim files regularly and provide direction on complex or litigated matters • Assist with reserve accuracy and compliance with client handling instructions • Participate in claim reviews and ensure adherence to jurisdictional laws and best practices • Recruit, train, and mentor staff; conduct performance reviews and manage PIPs • Address personnel issues and manage administrative responsibilities • Ensure compliance with carrier/state reporting requirements Qualifications What You'll Bring Required: • 10+ years of WC claims experience (California jurisdiction) • Prior experience adjusting WC claims from start to resolution • CA SIP designation or CA Claims Certificate (or ability to obtain within 60 days) • Strong leadership, communication, and organizational skills Preferred: • 3+ years of supervisory experience • Bilingual (English/Spanish) communications skills ) - This role may involve communicating with injured workers, employers, or vendors where Spanish-language skills are beneficial but not required. • Proficiency in Microsoft Office and claims systems Why You'll Love Working Here 4 weeks PTO + 10 paid holidays in your first year Comprehensive benefits: Medical, Dental, Vision, Life, and Disability Insurance Retirement plans: 401(k) and Employee Stock Ownership Plan (ESOP) Career growth: Internal training and advancement opportunities Culture: A supportive, team-based work environment How We Measure Success At CCMSI, great adjusters stand out through ownership, accuracy, and impact. We measure success by: • Quality claim handling - thorough investigations, strong documentation, well-supported decisions • Compliance & audit performance - adherence to jurisdictional and client standards • Timeliness & accuracy - purposeful file movement and dependable execution • Client partnership - proactive communication and strong follow-through • Professional judgment - owning outcomes and solving problems with integrity • Cultural alignment - believing every claim represents a real person and acting accordingly This is where we shine, and we hire adjusters who want to shine with us Compensation & Compliance The posted salary reflects CCMSI's good-faith estimate in accordance with applicable pay transparency laws. Actual compensation will be based on qualifications, experience, geographic location, and internal equity. This role may also qualify for bonuses or additional forms of pay. Visa Sponsorship: CCMSI does not provide visa sponsorship for this position. ADA Accommodations: CCMSI is committed to providing reasonable accommodations throughout the application and hiring process. Equal Opportunity Employer: CCMSI complies with all applicable employment laws, including pay transparency and fair chance hiring regulations. Our Core Values At CCMSI, we believe in doing what's right-for our clients, our coworkers, and ourselves. We look for team members who: Lead with transparency We build trust by being open and listening intently in every interaction. Perform with integrity We choose the right path, even when it is hard. Chase excellence We set the bar high and measure our success. What gets measured gets done. Own the outcome Every employee is an owner, treating every claim, every decision, and every result as our own. Win together Our greatest victories come when our clients succeed. We don't just work together-we grow together. If that sounds like your kind of workplace, we'd love to meet you. #NowHiring #ClaimsLeadership #WorkersCompensationJobs #InsuranceCareers #HybridWork #RemoteJobs #CaliforniaJobs #EmployeeOwned #GreatPlaceToWork #CareerWithPurpose #JoinOurTeam #TPACareers #CCMSICareers #WorkersCompensation #WCSupervisor #ClaimsSupervisor #ClaimsLeadership #ClaimsManagement #RemoteJobs #RemoteLeadership #CaliforniaWorkersComp #CAClaims #CAAdjusters #WorkersCompSupervisor #LI-Hybrid #LI-Remote We can recommend jobs specifically for you! Click here to get started.

Job DescriptionDescription: Verda Health Plan of Texas has a contract with the Center of Medicaid and Medicare Services (CMS) and a state license with the Texas Department of Insurance for a Medicare Advantage Prescription Drug (MAPD) plan. We are committed to the idea that healthcare should be easily and equitably accessed by all. Our mission is to ensure that underserved communities have access to health and wellness services, and receive the support needed to live a healthy life that is free of worry and full of joy. We are looking for a Claims Examiner III to join our growing company with many internal opportunities. Are you ready to join a company that is changing the face of health care across the nation? Verda Healthcare health plan is looking for people like you who value excellence, integrity, care and innovation. As an employee, you'll join a team dedicated to improving the lives of our Medicare members. Our vision incorporates value-based health care that works. We value diversity. Align your career goals with Verda Healthcare, Inc. and we will support you all the way. Position Overview The Claims Examiner III performs advanced administrative, operational, and customer support duties that require independent initiative and sound judgment. This position is responsible for the analysis and adjudication of medical claims within a managed care environment. The role includes processing payment reconciliations and adjustments related to retroactive contract rates and fee schedule changes, as well as identifying root causes of claims payment errors and reporting them to management. The Claims Examiner III also manages provider inquiries and supports resolution efforts across departments. This position reports to: Claims Operations Manager. Responsibilities: · Analyze and adjudicate complex medical claims in compliance with CMS guidelines and health plan policies. · Review and apply appropriate fee schedules, contracts, and benefit plans. · Perform claim payment reconciliations and retroactive adjustments. · Identify patterns and root causes of payment discrepancies and escalate issues as needed. · Respond to provider inquiries and coordinate with internal teams for resolution. · Maintain documentation and track resolution outcomes. · Ensure compliance with regulatory, contractual, and internal policies. · Recommend process improvements based on claim trends and data analysis. · Support training initiatives for new staff and peers as subject matter experts. Requirements: Minimum Qualifications · High school diploma or GED required. Associate or bachelor's degree preferred. · Minimum of 3-5 years of experience in claims processing and adjudication, preferably within Medicare Advantage or managed care settings. · Knowledge of CPT, HCPCS, ICD-10 coding, and CMS regulations. · Strong analytical and problem-solving skills. · Proficient in claims systems (e.g., Plexis, Facets) and Microsoft Office tools. · Ability to handle confidential information in compliance with HIPAA. Professional Competencies · Strong attention to detail and accuracy · Excellent verbal and written communication · Customer service-oriented with a collaborative mindset · Ability to work independently and prioritize tasks · Commitment to continuous learning and quality improvement Verda cares deeply about the future, growth, and well-being of its employees. Join our team today! Job Type: Full-time Benefits: 401(k) Paid time off (vacation, holiday, sick leave) Health insurance Dental Insurance Vision insurance Life insurance Schedule: Full-time onsite (100% in-office) Hours of operations: 9am - 6pm Standard business hours Monday to Friday/weekends as needed Occasional travel may be required for meetings and training sessions. Ability to commute/relocate: Reliably commute or planning to relocate before starting work (Required) PHYSICAL DEMANDS Regularly sit/walk at a workstation in an office or cubicle setting. Must occasionally lift and/or move up to 25-50 pounds. * Other duties may be assigned in support of departmental goals.

Job DescriptionJob ProfileJob TitleWorkers Compensation Claims Examiner (1360552) LocationRemote/Hybrid in San Diego CAHire TypeContingentHourlyopenWork ModelMonday - FridayContact Phone(443)-345-3305 Contact Emailsean@marykraft.com Nature & Scope:Positional Overview Mary Kraft is seeking an experienced Workers Compensation Claims Examiner to analyze complex or technically difficult workers' compensation claims. The role involves managing high-exposure claims, including those with litigation and rehabilitation, ensuring adherence to industry best practices, service expectations, and specific client requirements. The examiner will also identify subrogation opportunities and negotiate settlements to achieve cost-effective resolutions.Role & Responsibility:Tasks That Will Lead To Your Success Analyze and process complex workers' compensation claims by investigating and gathering information to determine the exposure on the claim. Manage claims through well-developed action plans, ensuring timely and appropriate resolutions. Negotiate settlement of claims within designated authority limits. Calculate and assign timely and appropriate reserves to claims; manage reserve adequacy throughout the life of the claim. Approve and process claim payments, adjustments, and benefits, ensuring accuracy and timeliness. Prepare necessary state filings within statutory limits. Oversee the litigation process to ensure timely and cost-effective resolution of claims. Coordinate vendor referrals for additional investigation or litigation management. Implement cost-containment strategies, including partnerships with vendors, to reduce overall claim costs. Manage claim recoveries, including subrogation, Second Injury Fund recoveries, and Social Security and Medicare offsets. Report claims to excess carriers and respond to their inquiries in a timely and professional manner. Maintain communication with claimants and clients, fostering professional relationships. Ensure claims files are properly documented, with accurate coding. Refer complex cases to supervisors or management as needed. Skills & Experience:Qualifications That Will Help You Thrive Bachelor's degree from an accredited college or university preferred. Professional certifications relevant to workers' compensation claims are preferred. Five (5) years of claims management experience or an equivalent combination of education and experience required. Minimum of 3 years of California workers' compensation claims handling experience is mandatory. Self-Insurance Plan (SIP) certification is preferred but not mandatory. Expertise in insurance principles and laws, claim and disability duration, and medical management practices. Strong knowledge of Social Security, Medicare application procedures, and recovery processes. Excellent communication skills, both oral and written, including presentation abilities. Proficiency in Microsoft Office and general PC literacy. Strong analytical, interpretive, and problem-solving skills. Strong organizational skills and the ability to manage multiple priorities effectively. Excellent negotiation skills. Ability to work collaboratively in a team environment and meet or exceed service expectations.

Company Cox Automotive - USA Job Family Group Vehicle Operations Job Profile Arbitrator I Management Level Individual Contributor Flexible Work Option No remote option; must work at a specified Cox location Travel % No Work Shift Day Compensation Hourly base pay rate is $19.90 - $29.81/hour. The hourly base rate may vary within the anticipated range based on factors such as the ultimate location of the position and the selected candidate's knowledge, skills, and abilities. Position may be eligible for additional compensation that may include commission (annual, monthly, etc.) and/or an incentive program. Job Description At Manheim (a Cox Automotive company), we strive to make sure every customer is completely satisfied when they do business with us. On the off-chance we fall short, we do our best to make things right, pronto. That's where you come in. We're looking for an Auto Claims Specialist I to learn the ropes of resolving customer complaints and ensuring we don't make the same mistake again. Do you have the skills we're looking for? Keep reading for more details! Benefits We all have lives and responsibilities outside of work. We have an exceptional work/life balance at Cox, with accommodating work schedules and flexible time-off policies. We show our appreciation for our talent with a competitive salary package and top-notch bonus & incentive plans. How does a great healthcare benefits package from day one sound? Multiple options are available for individuals and families. One employee-only plan could be FREE, if you participate in our health screening program. 10 days of free child or senior care through your complimentary Care.com membership. Generous 401(k) retirement plans with up to 6% company match. Employee discounts on hundreds of items, from cars to computers to continuing education. Looking to grow your family? You'll have access to our inclusive parental leave policies, plus comprehensive fertility coverage and adoption assistance. Want to volunteer in your community? We encourage that, and even offer paid hours for you to do so. We all love our pets-whether they walk, crawl, fly, swim or slither-and we're happy to supply insurance for them as well. At Cox, we believe in being transparent - please click on this link (Cox Benefits Overview) to learn more about our amazing benefits. What You'll Do From your very first day on the job, you'll receive guidance and coaching so you can learn the ropes. You'll work with everyone from buyers to sellers to dealers in coordinating and validating customer returns and claims. With Guidance, responsibilities include: Reviews customer claims to verify that they meet Manheim's National Arbitration policies and any account-specific guidelines. Investigates basic, less complex cases (e.g., late title claims, basic condition report claims, vehicle availability, post-sale inspection fails, mechanical/structural/undisclosed vehicle damage, etc.) or those requiring more prescriptive decision-making. Interfaces with all departments involved in the complaint (i.e., reconditioning, front office, dealer services, vehicle entry, etc.), including during the fact finding and investigative phases. Uses appropriate resources to investigate and facilitate relevant inspection, documentation, and communication to ensure appropriate actions are completed to move cases forward or to resolution. Uses appropriate levels/limits of financial approval authority to resolve cases. Evaluate claims by obtaining, comparing, evaluating, and validating various forms of information. Prepares and facilitates communication for resolution via telephone, email, and in-person discussion. Mediates disputes and negotiates repair and/or pricing of disputed vehicles to arrive at a mutually acceptable solution and to keep vehicles sold. Monitors and maintains accurate files for each arbitration case, verifying the accuracy of all required documentation, including invoices and settlement agreements. Engages with supervisor/manager to determine if escalation is required. Performs other duties as assigned. Who You Are You've got a knack for negotiation. You're ethical, dependable, and trustworthy. You're eager to learn. You also have the following qualifications: Minimum A high school diploma or GED and less than 2 years of related experience. Accuracy and attention to detail. Organizational and time management skills. The ability to adapt in a fluid and changing environment. Preferred 1+ years of automotive or body shop experience. Claims adjuster experience. Cox is a great place to be, wouldn't you agree? Apply today! Drug Testing To be employed in this role, you'll need to clear a pre-employment drug test. Cox Automotive does not currently administer a pre-employment drug test for marijuana for this position. However, we are a drug-free workplace, so the possession, use or being under the influence of drugs illegal under federal or state law during work hours, on company property and/or in company vehicles is prohibited. Benefits Employees are eligible to receive a minimum of sixteen hours of paid time off every month and seven paid holidays throughout the calendar year. Employees are also eligible for additional paid time off in the form of bereavement leave, time off to vote, jury duty leave, volunteer time off, military leave, and parental leave. About Us Through groundbreaking technology and a commitment to stellar experiences for drivers and dealers alike, Cox Automotive employees are transforming the way the world buys, owns, sells - or simply uses - cars. Cox Automotive employees get to work on iconic consumer brands like Autotrader and Kelley Blue Book and industry-leading dealer-facing companies like vAuto and Manheim, all while enjoying the people-centered atmosphere that is central to our life at Cox. Benefits of working at Cox may include health care insurance (medical, dental, vision), retirement planning (401(k)), and paid days off (sick leave, parental leave, flexible vacation/wellness days, and/or PTO). For more details on what benefits you may be offered, visit our benefits page. Cox is an Equal Employment Opportunity employer - All qualified applicants/employees will receive consideration for employment without regard to that individual's age, race, color, religion or creed, national origin or ancestry, sex (including pregnancy), sexual orientation, gender, gender identity, physical or mental disability, veteran status, genetic information, ethnicity, citizenship, or any other characteristic protected by law. Cox provides reasonable accommodations when requested by a qualified applicant or employee with disability, unless such accommodations would cause an undue hardship.Applicants must currently be authorized to work in the United States for any employer without current or future sponsorship. No OPT, CPT, STEM/OPT or visa sponsorship now or in future.

Company Cox Automotive - USA Job Family Group Vehicle Operations Job Profile Arbitrator I Management Level Individual Contributor Flexible Work Option No remote option; must work at a specified Cox location Travel % No Work Shift Day Compensation Hourly base pay rate is $19.90 - $29.81/hour. The hourly base rate may vary within the anticipated range based on factors such as the ultimate location of the position and the selected candidate's knowledge, skills, and abilities. Position may be eligible for additional compensation that may include commission (annual, monthly, etc.) and/or an incentive program. Job Description At Manheim (a Cox Automotive company), we strive to make sure every customer is completely satisfied when they do business with us. On the off-chance we fall short, we do our best to make things right, pronto. That's where you come in. We're looking for an Auto Claims Specialist I to learn the ropes of resolving customer complaints and ensuring we don't make the same mistake again. Do you have the skills we're looking for? Keep reading for more details! Benefits * We all have lives and responsibilities outside of work. We have an exceptional work/life balance at Cox, with accommodating work schedules and flexible time-off policies. * We show our appreciation for our talent with a competitive salary package and top-notch bonus & incentive plans. * How does a great healthcare benefits package from day one sound? Multiple options are available for individuals and families. One employee-only plan could be FREE, if you participate in our health screening program. * 10 days of free child or senior care through your complimentary Care.com membership. * Generous 401(k) retirement plans with up to 6% company match. * Employee discounts on hundreds of items, from cars to computers to continuing education. * Looking to grow your family? You'll have access to our inclusive parental leave policies, plus comprehensive fertility coverage and adoption assistance. * Want to volunteer in your community? We encourage that, and even offer paid hours for you to do so. * We all love our pets-whether they walk, crawl, fly, swim or slither-and we're happy to supply insurance for them as well. At Cox, we believe in being transparent - please click on this link (Cox Benefits Overview) to learn more about our amazing benefits. What You'll Do From your very first day on the job, you'll receive guidance and coaching so you can learn the ropes. You'll work with everyone from buyers to sellers to dealers in coordinating and validating customer returns and claims. With Guidance, responsibilities include: * Reviews customer claims to verify that they meet Manheim's National Arbitration policies and any account-specific guidelines. * Investigates basic, less complex cases (e.g., late title claims, basic condition report claims, vehicle availability, post-sale inspection fails, mechanical/structural/undisclosed vehicle damage, etc.) or those requiring more prescriptive decision-making. * Interfaces with all departments involved in the complaint (i.e., reconditioning, front office, dealer services, vehicle entry, etc.), including during the fact finding and investigative phases. * Uses appropriate resources to investigate and facilitate relevant inspection, documentation, and communication to ensure appropriate actions are completed to move cases forward or to resolution. * Uses appropriate levels/limits of financial approval authority to resolve cases. * Evaluate claims by obtaining, comparing, evaluating, and validating various forms of information. * Prepares and facilitates communication for resolution via telephone, email, and in-person discussion. * Mediates disputes and negotiates repair and/or pricing of disputed vehicles to arrive at a mutually acceptable solution and to keep vehicles sold. * Monitors and maintains accurate files for each arbitration case, verifying the accuracy of all required documentation, including invoices and settlement agreements. * Engages with supervisor/manager to determine if escalation is required. * Performs other duties as assigned. Who You Are You've got a knack for negotiation. You're ethical, dependable, and trustworthy. You're eager to learn. You also have the following qualifications: Minimum * A high school diploma or GED and less than 2 years of related experience. * Accuracy and attention to detail. * Organizational and time management skills. * The ability to adapt in a fluid and changing environment. Preferred * 1+ years of automotive or body shop experience. * Claims adjuster experience. Cox is a great place to be, wouldn't you agree? Apply today! Drug Testing To be employed in this role, you'll need to clear a pre-employment drug test. Cox Automotive does not currently administer a pre-employment drug test for marijuana for this position. However, we are a drug-free workplace, so the possession, use or being under the influence of drugs illegal under federal or state law during work hours, on company property and/or in company vehicles is prohibited. Benefits Employees are eligible to receive a minimum of sixteen hours of paid time off every month and seven paid holidays throughout the calendar year. Employees are also eligible for additional paid time off in the form of bereavement leave, time off to vote, jury duty leave, volunteer time off, military leave, and parental leave. About Us Through groundbreaking technology and a commitment to stellar experiences for drivers and dealers alike, Cox Automotive employees are transforming the way the world buys, owns, sells - or simply uses - cars. Cox Automotive employees get to work on iconic consumer brands like Autotrader and Kelley Blue Book and industry-leading dealer-facing companies like vAuto and Manheim, all while enjoying the people-centered atmosphere that is central to our life at Cox. Benefits of working at Cox may include health care insurance (medical, dental, vision), retirement planning (401(k)), and paid days off (sick leave, parental leave, flexible vacation/wellness days, and/or PTO). For more details on what benefits you may be offered, visit our benefits page. Cox is an Equal Employment Opportunity employer - All qualified applicants/employees will receive consideration for employment without regard to that individual's age, race, color, religion or creed, national origin or ancestry, sex (including pregnancy), sexual orientation, gender, gender identity, physical or mental disability, veteran status, genetic information, ethnicity, citizenship, or any other characteristic protected by law. Cox provides reasonable accommodations when requested by a qualified applicant or employee with disability, unless such accommodations would cause an undue hardship. Applicants must currently be authorized to work in the United States for any employer without current or future sponsorship. No OPT, CPT, STEM/OPT or visa sponsorship now or in future.

Job DescriptionSalary: $28-$32 Hourly, DOE AmeriPharma is a rapidly growing healthcare company where you will have the opportunity to contribute to our joint success on a daily basis. We value new ideas, creativity, and productivity. We like people who are passionate about their roles and people who like to grow and change as the company evolves. AmeriPharmas Benefits Full benefits package including medical, dental, vision, life that fits your lifestyle and goals Great pay and general compensation structures Employee assistance program to assist with mental health, legal questions, financial counseling etc. Comprehensive PTO and sick leave options 401k program Plenty of opportunities for growth and advancement Company sponsored outings and team-building events Casual Fridays Job Summary The Claims Adjudicator is responsible for overseeing the claims adjudication process through effective management of claims. This role ensures the accuracy and timely processing of claims, coordinates bill payments, and collaborates with the Copay Assistance Department as needed to resolve issues. Schedule Details Location: On-Site (Laguna Hills, CA) Hours: Monday-Friday, 9:00 AM - 5:30 PM Duties and Responsibilities Collaborate closely with pharmacists and other departments to ensure seamless claims processing. Perform thorough reconciliation of daily batch postings to ensure all transactions are accurately recorded and balanced. Manage both automated and manual batch posting processes, including the accurate input and verification of claims and payment Stay informed on current billing issues and implement necessary changes to existing billing practices. Maintain comprehensive knowledge of prescription plans and their intricacies. Analyze claims, considering factors such as the cost of goods, allowed amounts, insurance coverage, and patient copays. Troubleshoot and resolve claim rejections and overrides as necessary. Use decision trees to assess whether a case will be serviced or transferred to another department. Process claims for both primary and secondary payers. Review patient coverage for primary and secondary payers and determine eligibility for copay assistance or enrollment in FHP. Coordinate with the Financial Assistance Department to secure additional funding when copay assistance is exhausted. Work with the Patient Care Coordinator Supervisor to address delays in claim scheduling and order statuses. Update insurance information and add new payors when patients experience insurance changes. Ensure accuracy in NCPDP claim submissions. Review order profitability and manage the 3 & 5 queues to complete margin reviews and update last events. Oversee the B queue, test claim refill orders, and update last events. Manage the 541 queue, confirming delivery tickets and resolving rejected claims. Accurately document patient medication coverage in progress notes. Adhere to the 14-day adjudication and scheduled delivery window. Promptly report underpaid claims, reimbursement changes, pricing issues, or billing/cost assistance issues to the supervisor. Perform other duties as assigned. Required Qualifications Previous pharmacy experience Strong interpersonal skills with the ability to collaborate effectively Excellent verbal and written communication skills Ability to work independently and manage multiple deadlines in a fast-paced environment Strong organizational skills and keen attention to detail Proficient typing and keyboarding skills Fluency in reading, writing, speaking, and understanding English Preferred Qualifications Experience with prior authorization/override processing Familiarity with CPR+ software AmeriPharmas Mission Statement Our goal is to achieve superior clinical and economic outcomes while maintaining the utmost compassion and care for our patients. It is our joint and individual responsibility daily to demonstrate to outpatients, prescribers, colleagues, and others that We Care! Physical Requirements The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. While performing the duties of this job, the employee is continuously required to sit and talk or hear. The employee is occasionally required to stand; walk; use hands to finger, handle, or feel objects, tools, or controls; reach with hands and arms; and stoop, kneel, crouch or crawl. The employee must regularly lift and/or move up to 20 pounds and occasionally lift/or move up to 30 pounds. Specific vision abilities required by this job include close vision, peripheral vision, depth perception and the ability to adjust focus. EEO Statement The above statements are intended to describe the work being performed by people assigned to this job. They are not intended to be anexhaustive list of all responsibilities, duties and skills required. The duties and responsibilities of this position are subject to change and otherduties may be assigned or removed at any time. AmeriPharma values diversity in its workforce and is proud to be an AAP/EEO employer.All qualified applicants will receive consideration for employment without regard to race, sex, color, religion, sexual orientation, gender identity, national origin, age, protected veteran status, or on the basis of disability or any other legally protected class.

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

Company Cox Automotive - USA Job Family Group Vehicle Operations Job Profile Arbitrator I Management Level Individual Contributor Flexible Work Option No remote option; must work at a specified Cox location Travel % No Work Shift Day Compensation Hourly base pay rate is $19.90 - $29.81/hour. The hourly base rate may vary within the anticipated range based on factors such as the ultimate location of the position and the selected candidate's knowledge, skills, and abilities. Position may be eligible for additional compensation that may include commission (annual, monthly, etc.) and/or an incentive program. Job Description At Manheim (a Cox Automotive company), we strive to make sure every customer is completely satisfied when they do business with us. On the off-chance we fall short, we do our best to make things right, pronto. That's where you come in. We're looking for an Auto Claims Specialist I to learn the ropes of resolving customer complaints and ensuring we don't make the same mistake again. Do you have the skills we're looking for? Keep reading for more details! Benefits We all have lives and responsibilities outside of work. We have an exceptional work/life balance at Cox, with accommodating work schedules and flexible time-off policies. We show our appreciation for our talent with a competitive salary package and top-notch bonus & incentive plans. How does a great healthcare benefits package from day one sound? Multiple options are available for individuals and families. One employee-only plan could be FREE, if you participate in our health screening program. 10 days of free child or senior care through your complimentary Care.com membership. Generous 401(k) retirement plans with up to 6% company match. Employee discounts on hundreds of items, from cars to computers to continuing education. Looking to grow your family? You'll have access to our inclusive parental leave policies, plus comprehensive fertility coverage and adoption assistance. Want to volunteer in your community? We encourage that, and even offer paid hours for you to do so. We all love our pets-whether they walk, crawl, fly, swim or slither-and we're happy to supply insurance for them as well. At Cox, we believe in being transparent - please click on this link (Cox Benefits Overview) to learn more about our amazing benefits. What You'll Do From your very first day on the job, you'll receive guidance and coaching so you can learn the ropes. You'll work with everyone from buyers to sellers to dealers in coordinating and validating customer returns and claims. With Guidance, responsibilities include: Reviews customer claims to verify that they meet Manheim's National Arbitration policies and any account-specific guidelines. Investigates basic, less complex cases (e.g., late title claims, basic condition report claims, vehicle availability, post-sale inspection fails, mechanical/structural/undisclosed vehicle damage, etc.) or those requiring more prescriptive decision-making. Interfaces with all departments involved in the complaint (i.e., reconditioning, front office, dealer services, vehicle entry, etc.), including during the fact finding and investigative phases. Uses appropriate resources to investigate and facilitate relevant inspection, documentation, and communication to ensure appropriate actions are completed to move cases forward or to resolution. Uses appropriate levels/limits of financial approval authority to resolve cases. Evaluate claims by obtaining, comparing, evaluating, and validating various forms of information. Prepares and facilitates communication for resolution via telephone, email, and in-person discussion. Mediates disputes and negotiates repair and/or pricing of disputed vehicles to arrive at a mutually acceptable solution and to keep vehicles sold. Monitors and maintains accurate files for each arbitration case, verifying the accuracy of all required documentation, including invoices and settlement agreements. Engages with supervisor/manager to determine if escalation is required. Performs other duties as assigned. Who You Are You've got a knack for negotiation. You're ethical, dependable, and trustworthy. You're eager to learn. You also have the following qualifications: Minimum A high school diploma or GED and less than 2 years of related experience. Accuracy and attention to detail. Organizational and time management skills. The ability to adapt in a fluid and changing environment. Preferred 1+ years of automotive or body shop experience. Claims adjuster experience. Cox is a great place to be, wouldn't you agree? Apply today! Drug Testing To be employed in this role, you'll need to clear a pre-employment drug test. Cox Automotive does not currently administer a pre-employment drug test for marijuana for this position. However, we are a drug-free workplace, so the possession, use or being under the influence of drugs illegal under federal or state law during work hours, on company property and/or in company vehicles is prohibited. Benefits Employees are eligible to receive a minimum of sixteen hours of paid time off every month and seven paid holidays throughout the calendar year. Employees are also eligible for additional paid time off in the form of bereavement leave, time off to vote, jury duty leave, volunteer time off, military leave, and parental leave. About Us Through groundbreaking technology and a commitment to stellar experiences for drivers and dealers alike, Cox Automotive employees are transforming the way the world buys, owns, sells - or simply uses - cars. Cox Automotive employees get to work on iconic consumer brands like Autotrader and Kelley Blue Book and industry-leading dealer-facing companies like vAuto and Manheim, all while enjoying the people-centered atmosphere that is central to our life at Cox. Benefits of working at Cox may include health care insurance (medical, dental, vision), retirement planning (401(k)), and paid days off (sick leave, parental leave, flexible vacation/wellness days, and/or PTO). For more details on what benefits you may be offered, visit our benefits page. Cox is an Equal Employment Opportunity employer - All qualified applicants/employees will receive consideration for employment without regard to that individual's age, race, color, religion or creed, national origin or ancestry, sex (including pregnancy), sexual orientation, gender, gender identity, physical or mental disability, veteran status, genetic information, ethnicity, citizenship, or any other characteristic protected by law. Cox provides reasonable accommodations when requested by a qualified applicant or employee with disability, unless such accommodations would cause an undue hardship.Applicants must currently be authorized to work in the United States for any employer without current or future sponsorship. No OPT, CPT, STEM/OPT or visa sponsorship now or in future.

**Who Are We?** Taking care of our customers, our communities and each other. That's the Travelers Promise. By honoring this commitment, we have maintained our reputation as one of the best property casualty insurers in the industry for over 170 years. Join us to discover a culture that is rooted in innovation and thrives on collaboration. Imagine loving what you do and where you do it. **Job Category** Claim **Compensation Overview** The annual base salary range provided for this position is a nationwide market range and represents a broad range of salaries for this role across the country. 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. As part of our comprehensive compensation and benefits program, employees are also eligible for performance-based cash incentive awards. **Salary Range** $94,400.00 - $155,800.00 **Target Openings** 1 **What Is the Opportunity?** This role is eligible for a sign-on bonus of up to $20,000. This position is hybrid (3 days in office, 2 days remote). Under general supervision, this position is responsible for investigating, evaluating, reserving, negotiating and resolving assigned Specialty Liability Bodily Injury and Property Damage claims. Provides quality claim handling throughout the claim life cycle (customer contacts, coverage, investigation, evaluation, reserving, litigation management, negotiation and resolution) including maintaining full compliance with internal and external quality standards and state specific regulations. Provides consulting and training resources, and serves as a contact and technical resource to the field and our business partners. This job does not manage staff. **What Will You Do?** + Directly handles assigned severity claims. + Provides quality customer service and ensures quality and timely coverage analysis and communication with insured based on application of policy information to facts or allegations of each case. + Consults with Manager on use of Claim Coverage Counsel as needed. + Directly investigates each claim through prompt and strategically-appropriate contact with appropriate parties such as policyholders, accounts, claimants, law enforcement agencies, witnesses, agents, medical providers and technical experts to determine the extent of liability, damages, and contribution potential. Interview witnesses and stakeholders; take necessary statements, as strategically appropriate. + Actively engages in the identification, selection and direction of appropriate internal and/or external resources for specific activities required to effectively evaluate claims, such as Subrogation, Risk Control, nurse consultants, and fire or fraud investigators, and other experts. + Verifies the nature and extent of injury or property damage by obtaining and reviewing appropriate records and damage documentation. + Maintains claim files and documents claim file activities in accordance with established procedures. + Utilizes evaluation documentation tools in accordance with department guidelines. + Proactively creates Claim File Analysis (CFA) by adhering to quality standards. + Utilizes diary management system to ensure that all claims are handled timely. + At required time intervals, evaluate liability & damages exposure. + Establishes and maintains proper indemnity and expense reserves. + Recommends appropriate cases for discussion at roundtable. + Attends and/or present at roundtables/ authority discussions for collaboration of technical expertise resulting in improved payout on indemnity and expense. + Actively and enthusiastically shares experience and knowledge of creative resolution techniques to improve the claim results of others. + Applies the Company's claim quality management protocols and Best Practices to all claims; documents the rationale for any departure from applicable protocols with or without assistance. + Develops and employ creative resolution strategies. + Responsible for prompt and proper disposition of all claims within delegated authority. + Negotiates disposition of claims with insureds and claimants or their legal representatives. + Recognizes and implements alternate means of resolution. + Manages litigated claims. Develops litigation plan with staff or panel counsel, including discovery and legal expenses, to assure effective resolution and to satisfy customers. + Applies litigation management through the selection of counsel, evaluation and direction of claim and litigation strategy, + Tracks and controls legal expenses to assure cost-effective resolution. + Effectively and efficiently manage both allocated and unallocated loss adjustment expenses. + Perform other duties as assigned. **What Will Our Ideal Candidate Have?** + Bachelor's Degree. + 5 years equivalent business experience. + Advanced level knowledge and skill in claim and litigation. + Basic working level knowledge and skill in various business line products. + Strong negotiation and customer service skills. + Skilled in coverage, liability and damages analysis and has a thorough understanding of the litigation process, relevant case and statutory law and expert litigation management skills. + Extensive claim and/or legal experience and technical expertise to evaluate severe and complex claims. + Able to make independent decisions on most assigned cases without involvement of supervisor. + Openness to the ideas and expertise of others actively solicits input and shares ideas. + Thorough understanding of commercial lines products, policy language, exclusions, ISO forms, and effective claims handling practices. + Demonstrated coaching, influence and persuasion skills. + Advanced written and verbal communication skills are required so as to understand, synthesize, interpret and convey, in a simplified manner, complex data and information to audiences with varying levels of expertise. + Can adapt to and support cultural change. + Strong technology aptitude; ability to use business technology tools to effectively research, track, and communicate information. + Analytical Thinking - Advanced. + Judgment/Decision Making - Advanced. + Communication - Advanced. + Negotiation - Advanced. + Insurance Contract. + Knowledge - Advanced. + Principles of Investigation - Advanced. + Value Determination - Advanced. + Settlement Techniques - Advanced. + Legal Knowledge - Advanced. + Medical Knowledge - Intermediate. **What is a Must Have?** + High School Degree or GED. + 3 years of liability claim handling experience and/or comparable litigation claim experience. + In order to perform the essential job functions of this job, acquisition and maintenance of Insurance License(s) may be required to comply with state and Travelers requirements. + Generally, license(s) are required to be obtained within three months of starting the job. **What Is in It for You?** + **Health Insurance** : Employees and their eligible family members - including spouses, domestic partners, and children - are eligible for coverage from the first day of employment. + **Retirement:** Travelers matches your 401(k) contributions dollar-for-dollar up to your first 5% of eligible pay, subject to an annual maximum. If you have student loan debt, you can enroll in the Paying it Forward Savings Program. When you make a payment toward your student loan, Travelers will make an annual contribution into your 401(k) account. You are also eligible for a Pension Plan that is 100% funded by Travelers. + **Paid Time Off:** Start your career at Travelers with a minimum of 20 days Paid Time Off annually, plus nine paid company Holidays. + **Wellness Program:** The Travelers wellness program is comprised of tools, discounts and resources that empower you to achieve your wellness goals and caregiving needs. In addition, our mental health program provides access to free professional counseling services, health coaching and other resources to support your daily life needs. + **Volunteer Encouragement:** We have a deep commitment to the communities we serve and encourage our employees to get involved. Travelers has a Matching Gift and Volunteer Rewards program that enables you to give back to the charity of your choice. **Employment Practices** Travelers is an equal opportunity employer. We value the unique abilities and talents each individual brings to our organization and recognize that we benefit in numerous ways from our differences. In accordance with local law, candidates seeking employment in Colorado are not required to disclose dates of attendance at or graduation from educational institutions. If you are a candidate and have specific questions regarding the physical requirements of this role, please send us an email (*******************) so we may assist you. Travelers reserves the right to fill this position at a level above or below the level included in this posting. To learn more about our comprehensive benefit programs please visit ******************************************************** .

The Role We are seeking an experienced Claims Specialist - Liability & Damages to join our Pre-Litigation team in Costa Mesa, CA. This role is ideal for candidates with a background in insurance claims or personal injury who excel at evaluating liability, coverage, and damages. You will play a critical part in investigating claims, determining case value, and supporting negotiations that drive successful outcomes for our clients. Closing Statement We're excited to grow our team and are handling all hiring in-house. To be considered for this position, please apply directly through Indeed, LinkedIn, or our official company website. All updates, contact, or communication should come straight from our internal recruiting team. What You Will Do Investigate and evaluate liability and damages on personal injury claims Review police reports, witness statements, and client testimony to establish liability Analyze medical records and bills to assess injury-related damages Work closely with attorneys to prepare case strategy and determine claim value Support negotiations with insurance carriers to reach fair settlements Maintain accurate, detailed case documentation in a paperless environment Communicate with clients, providers, and carriers to ensure claims move efficiently Stay up to date on California insurance laws, coverage standards, and best practices Role may include other relevant duties as assigned. Required Qualifications: 2+ years of experience as an auto claims adjuster, bodily injury adjuster, or in California personal injury law Strong knowledge of insurance coverage, liability assessment, and damages evaluation Proficient in Microsoft Office Suite and case management systems Excellent time management, organizational, and analytical skills Strong written and verbal communication skills Must be able to type at least 40 WPM Comfortable working in large teams and fast-paced environments Preferred Qualifications: Bilingual in Spanish or Korean Experience negotiating settlements with insurance carriers Background in pre-litigation claims or personal injury law firm environment Familiarity with reviewing and summarizing medical records Experience using Filevine, Clio, Litify, or other legal case management systems

Job Description Seeking experienced investigators with commercial or personal lines experience, with multi-lines preferred to include AOE/COE, Auto, and Homeowners. SIU experience is highly desired, but not required. We are seeking individuals who possess proven investigative skill sets within the industry, as well as honesty, integrity, self-reliance, resourcefulness, independence, and discipline. Good time management skills are a must. Must have reliable transportation, digital recorder and digital camera. Job duties include, but are not limited to, taking in-person recorded statements, scene photos, writing a detailed, comprehensive report, client communications, as well as meeting strict due dates on all assignments. If you have the desire to operate at your highest professional level within an organization that values and rewards excellence, please submit your resume. Only the finest individuals are considered for hire. Visit our website and find out why at ****************** The Claims Investigator should demonstrate proficiency in the following areas: AOE/COE, Auto, or Homeowners Investigations. Writing accurate, detailed reports Strong initiative, integrity, and work ethic Securing written/recorded statements Accident scene investigations Possession of a valid driver's license Ability to prioritize and organize multiple tasks Computer literacy to include Microsoft Word and Microsoft Outlook (email) Full-Time benefits Include: Medical, dental and vision insurance 401K Extensive performance bonus program Dynamic and fast paced work environment We are an equal opportunity employer. Powered by JazzHR gRTudgCzv8

At Stout, we're dedicated to exceeding expectations in all we do - we call it Relentless Excellence . Both our client service and culture are second to none, stemming from our firmwide embrace of our core values: Positive and Team-Oriented, Accountable, Committed, Relationship-Focused, Super-Responsive, and being Great communicators. Sound like a place you can grow and succeed? Read on to learn more about an exciting opportunity to join our team. About Stout's Forensics and Compliance GroupStout's Forensics and Compliance group supports organizations in addressing complex compliance, investigative, and regulatory challenges. Our professionals bring strong technical capabilities and healthcare industry experience to identify fraud, waste, abuse, and operational inefficiencies, while promoting a culture of integrity and accountability. We work closely with clients, legal counsel, and internal stakeholders to support investigations, regulatory inquiries, litigation, and the implementation of sustainable compliance and revenue cycle improvements.What You'll DoAs an Analyst, you will play a hands-on role in client engagements, contributing independently while collaborating closely with senior team members. Responsibilities include: Support and execute client engagements related to healthcare billing, coding, reimbursement, and revenue cycle operations. Perform detailed forensic analyses and compliance reviews to identify potential fraud, waste, abuse, and process inefficiencies. Analyze and document EMR/EHR hospital billing workflows (e.g., Epic Resolute), including charge capture, claims processing, and reimbursement logic. Assist in audits, investigations, and litigation support engagements, including evidence gathering, issue identification, and corrective action planning. Collaborate with Stout engagement teams, client compliance functions, legal counsel, and leadership to support project objectives. Support EMR/EHR implementations and optimization initiatives, including system testing, data validation, workflow review, and post-go-live support. Prepare clear, well-structured analyses, reports, and client-ready presentations summarizing findings, risks, and recommendations. Communicate proactively with managers and project teams to ensure alignment, quality, and timely delivery. Continue developing technical, analytical, and consulting skills while building credibility with clients. Stay current on healthcare regulations, payer rules, EMR/EHR enhancements, and industry trends impacting compliance and reimbursement. Contribute to internal knowledge sharing, thought leadership, and practice development initiatives within Stout's Healthcare Consulting team. What You Bring Bachelor's degree in Healthcare Administration, Information Technology, Computer Science, Accounting, or a related field required; Master's degree preferred. Two (2)+ years of experience in healthcare revenue cycle operations, EMR/EHR implementations, compliance, or related healthcare consulting roles. Experience supporting consulting engagements, audits, or investigations related to billing, coding, reimbursement, or compliance. Epic Resolute or other hospital billing system experience preferred; Epic certification a plus. Nationally recognized coding credential (e.g., CCS, CPC, RHIA, RHIT) required. Additional certifications such as CHC, CFE, or AHFI preferred. Working knowledge of EMR/EHR system configuration, workflows, issue resolution, and optimization. Proficiency in Microsoft Office (Excel, PowerPoint, Word); experience with Visio, SharePoint, Tableau, or Power BI preferred. Understanding of key healthcare regulatory and compliance frameworks, including CMS regulations, HIPAA, and the False Claims Act. Willingness to travel up to 25%, based on client and project needs. How You'll Thrive Analytical and Detail-Oriented: You are comfortable working with complex data and systems, identifying risks, and drawing well-supported conclusions. Collaborative and Client-Focused: You communicate clearly, work well in team-based environments, and contribute to positive client relationships. Accountable and Proactive: You take ownership of your work, manage priorities effectively, and deliver high-quality results on time. Adaptable and Curious: You are eager to learn new systems, regulations, and methodologies in a fast-paced consulting environment. Growth-Oriented: You seek feedback, develop your technical and professional skills, and build toward increased responsibility. Aligned with Stout Values: You demonstrate integrity, professionalism, and a commitment to excellence in all client and team interactions. Why Stout? At Stout, we offer a comprehensive Total Rewards program with competitive compensation, benefits, and wellness options tailored to support employees at every stage of life. We foster a culture of inclusion and respect, embracing diverse perspectives and experiences to drive innovation and success. Our leadership is committed to inclusion and belonging across the organization and in the communities we serve. We invest in professional growth through ongoing training, mentorship, employee resource groups, and clear performance feedback, ensuring our employees are supported in achieving their career goals. Stout provides flexible work schedules and a discretionary time off policy to promote work-life balance and help employees lead fulfilling lives. Learn more about our benefits and commitment to your success. en/careers/benefits The specific statements shown in each section of this description are not intended to be all-inclusive. They represent typical elements and criteria necessary to successfully perform the job. Stout is an Equal Employment Opportunity. All qualified applicants will receive consideration for employment on the basis of valid job requirements, qualifications and merit without regard to race, color, religion, sex, national origin, disability, age, protected veteran status or any other characteristic protected by applicable local, state or federal law. Stout is required by applicable state and local laws to include a reasonable estimate of the compensation range for this role. The range for this role considers several factors including but not limited to prior work and industry experience, education level, and unique skills. The disclosed range estimate has not been adjusted for any applicable geographic differential associated with the location at which the position may be filled. It is not typical for an individual to be hired at or near the top of the range for their role and compensation decisions are dependent on the facts and circumstances of each case. A reasonable estimate of the current range is $60,000.00 - $130,000.00 Annual. This role is also anticipated to be eligible to participate in an annual bonus plan. Information about benefits can be found here - en/careers/benefits.

Workers' Compensation Claim Supervisor Schedule: Monday-Friday, 8:00 AM-4:30 PM PST Salary Range: $98,000-$110,000 annually Direct Reports: 2-6 Build Your Career With Purpose at CCMSI At CCMSI, we partner with global clients to solve their most complex risk management challenges, delivering measurable results through advanced technology, collaborative problem-solving, and an unwavering commitment to their success. We don't just process claims-we support people. As the largest privately-owned Third Party Administrator (TPA), CCMSI delivers customized claim solutions that help our clients protect their employees, assets, and reputations. We are a certified Great Place to Work , and our employee-owners are empowered to grow, collaborate, and make meaningful contributions every day. Job Summary We are seeking an experienced Workers' Compensation Claim Supervisor with deep California jurisdiction expertise to lead a team of 3-6 adjusters supporting a PEO/Staffing account. This role may be remote or hybrid, reporting to our Irvine, CA branch. This is a hands-on leadership role for a supervisor who understands the full California workers' compensation lifecycle-from intake through resolution-and can coach adjusters through complex, fast-paced claims while ensuring strict compliance with regulatory and client-specific requirements. You'll guide claim strategy, mentor your team, and partner closely with clients to deliver consistent, high-quality outcomes. Responsibilities When we hire claim supervisors at CCMSI, we look for leaders who believe strong teams create strong outcomes-leaders who own results, develop people, and treat every claim with purpose and care. Supervise and guide a team of 3-6 California Workers' Compensation adjusters handling cradle-to-grave claims Ensure claims are investigated, evaluated, and resolved accurately, timely, and in compliance with California WC laws Review claim files regularly, providing direction on complex, litigated, or high-exposure matters Oversee reserve accuracy and compliance with client handling instructions Participate in claim reviews, audits, and quality initiatives Partner with internal teams, clients, and vendors to resolve issues and maintain service standards Recruit, onboard, train, and mentor staff; conduct performance evaluations and manage development plans Address personnel and administrative matters with professionalism and consistency Ensure compliance with carrier/state reporting requirements Qualifications What You'll Bring Required: • 10+ years of WC claims experience (California jurisdiction) • Proven experience adjusting CA WC claims from intake through resolution • CA SIP designation or CA Claims Certificate (or ability to obtain within 60 days) • Demonstrated leadership, coaching, and communication skills Preferred: • 3+ years of supervisory experience • Bilingual (English/Spanish) communications skills ) - This role may involve communicating with injured workers, employers, or vendors where Spanish-language skills are beneficial but not required. • Experience supporting PEO and/or staffing accounts • Proficiency in Microsoft Office and claims systems Why You'll Love Working Here 4 weeks PTO + 10 paid holidays in your first year Comprehensive benefits: Medical, Dental, Vision, Life, and Disability Insurance Retirement plans: 401(k) and Employee Stock Ownership Plan (ESOP) Career growth: Internal training and advancement opportunities Culture: A supportive, team-based work environment How We Measure Success At CCMSI, great adjusters stand out through ownership, accuracy, and impact. We measure success by: • Quality claim handling - thorough investigations, strong documentation, well-supported decisions • Compliance & audit performance - adherence to jurisdictional and client standards • Timeliness & accuracy - purposeful file movement and dependable execution • Client partnership - proactive communication and strong follow-through • Professional judgment - owning outcomes and solving problems with integrity • Cultural alignment - believing every claim represents a real person and acting accordingly This is where we shine, and we hire adjusters who want to shine with us Compensation & Compliance The posted salary reflects CCMSI's good-faith estimate in accordance with applicable pay transparency laws. Actual compensation will be based on qualifications, experience, geographic location, and internal equity. This role may also qualify for bonuses or additional forms of pay. Visa Sponsorship: CCMSI does not provide visa sponsorship for this position. ADA Accommodations: CCMSI is committed to providing reasonable accommodations throughout the application and hiring process. Equal Opportunity Employer: CCMSI complies with all applicable employment laws, including pay transparency and fair chance hiring regulations. Our Core Values At CCMSI, we believe in doing what's right-for our clients, our coworkers, and ourselves. We look for team members who: Lead with transparency We build trust by being open and listening intently in every interaction. Perform with integrity We choose the right path, even when it is hard. Chase excellence We set the bar high and measure our success. What gets measured gets done. Own the outcome Every employee is an owner, treating every claim, every decision, and every result as our own. Win together Our greatest victories come when our clients succeed. We don't just work together-we grow together. If that sounds like your kind of workplace, we'd love to meet you. #NowHiring #ClaimsLeadership #WorkersCompensationJobs #InsuranceCareers #HybridWork #RemoteJobs #CaliforniaJobs #EmployeeOwned #GreatPlaceToWork #CareerWithPurpose #JoinOurTeam #TPACareers #CCMSICareers #WorkersCompensation #WCSupervisor #ClaimsSupervisor #ClaimsLeadership #ClaimsManagement #RemoteJobs #RemoteLeadership #CaliforniaWorkersComp #CAClaims #CAAdjusters #WorkersCompSupervisor #LI-Hybrid #LI-Remote We can recommend jobs specifically for you! Click here to get started.

AmeriPharma is a rapidly growing healthcare company where you will have the opportunity to contribute to our joint success on a daily basis. We value new ideas, creativity, and productivity. We like people who are passionate about their roles and people who like to grow and change as the company evolves. AmeriPharma's Benefits Full benefits package including medical, dental, vision, life that fits your lifestyle and goals Great pay and general compensation structures Employee assistance program to assist with mental health, legal questions, financial counseling etc. Comprehensive PTO and sick leave options 401k program Plenty of opportunities for growth and advancement Company sponsored outings and team-building events Casual Fridays Job Summary The Claims Adjudicator is responsible for overseeing the claims adjudication process through effective management of claims. This role ensures the accuracy and timely processing of claims, coordinates bill payments, and collaborates with the Copay Assistance Department as needed to resolve issues. Schedule Details Location: On-Site (Laguna Hills, CA) Hours: Monday-Friday, 9:00 AM - 5:30 PM Duties and Responsibilities Collaborate closely with pharmacists and other departments to ensure seamless claims processing. Perform thorough reconciliation of daily batch postings to ensure all transactions are accurately recorded and balanced. Manage both automated and manual batch posting processes, including the accurate input and verification of claims and payment Stay informed on current billing issues and implement necessary changes to existing billing practices. Maintain comprehensive knowledge of prescription plans and their intricacies. Analyze claims, considering factors such as the cost of goods, allowed amounts, insurance coverage, and patient copays. Troubleshoot and resolve claim rejections and overrides as necessary. Use decision trees to assess whether a case will be serviced or transferred to another department. Process claims for both primary and secondary payers. Review patient coverage for primary and secondary payers and determine eligibility for copay assistance or enrollment in FHP. Coordinate with the Financial Assistance Department to secure additional funding when copay assistance is exhausted. Work with the Patient Care Coordinator Supervisor to address delays in claim scheduling and order statuses. Update insurance information and add new payors when patients experience insurance changes. Ensure accuracy in NCPDP claim submissions. Review order profitability and manage the 3 & 5 queues to complete margin reviews and update last events. Oversee the B queue, test claim refill orders, and update last events. Manage the 541 queue, confirming delivery tickets and resolving rejected claims. Accurately document patient medication coverage in progress notes. Adhere to the 14-day adjudication and scheduled delivery window. Promptly report underpaid claims, reimbursement changes, pricing issues, or billing/cost assistance issues to the supervisor. Perform other duties as assigned. Required Qualifications Previous pharmacy experience Strong interpersonal skills with the ability to collaborate effectively Excellent verbal and written communication skills Ability to work independently and manage multiple deadlines in a fast-paced environment Strong organizational skills and keen attention to detail Proficient typing and keyboarding skills Fluency in reading, writing, speaking, and understanding English Preferred Qualifications Experience with prior authorization/override processing Familiarity with CPR+ software AmeriPharma's Mission Statement Our goal is to achieve superior clinical and economic outcomes while maintaining the utmost compassion and care for our patients. It is our joint and individual responsibility daily to demonstrate to outpatients, prescribers, colleagues, and others that We Care! Physical Requirements The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. While performing the duties of this job, the employee is continuously required to sit and talk or hear. The employee is occasionally required to stand; walk; use hands to finger, handle, or feel objects, tools, or controls; reach with hands and arms; and stoop, kneel, crouch or crawl. The employee must regularly lift and/or move up to 20 pounds and occasionally lift/or move up to 30 pounds. Specific vision abilities required by this job include close vision, peripheral vision, depth perception and the ability to adjust focus. EEO Statement The above statements are intended to describe the work being performed by people assigned to this job. They are not intended to be an exhaustive list of all responsibilities, duties and skills required. The duties and responsibilities of this position are subject to change and other duties may be assigned or removed at any time. AmeriPharma values diversity in its workforce and is proud to be an AAP/EEO employer. All qualified applicants will receive consideration for employment without regard to race, sex, color, religion, sexual orientation, gender identity, national origin, age, protected veteran status, or on the basis of disability or any other legally protected class.

Who Are We? Taking care of our customers, our communities and each other. That's the Travelers Promise. By honoring this commitment, we have maintained our reputation as one of the best property casualty insurers in the industry for over 170 years. Join us to discover a culture that is rooted in innovation and thrives on collaboration. Imagine loving what you do and where you do it. Job Category Claim Compensation Overview The annual base salary range provided for this position is a nationwide market range and represents a broad range of salaries for this role across the country. 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. As part of our comprehensive compensation and benefits program, employees are also eligible for performance-based cash incentive awards. Salary Range $94,400.00 - $155,800.00 Target Openings 1 What Is the Opportunity? This role is eligible for a sign-on bonus of up to $20,000. This position is hybrid (3 days in office, 2 days remote). Under general supervision, this position is responsible for investigating, evaluating, reserving, negotiating and resolving assigned Specialty Liability Bodily Injury and Property Damage claims. Provides quality claim handling throughout the claim life cycle (customer contacts, coverage, investigation, evaluation, reserving, litigation management, negotiation and resolution) including maintaining full compliance with internal and external quality standards and state specific regulations. Provides consulting and training resources, and serves as a contact and technical resource to the field and our business partners. This job does not manage staff. What Will You Do? * Directly handles assigned severity claims. * Provides quality customer service and ensures quality and timely coverage analysis and communication with insured based on application of policy information to facts or allegations of each case. * Consults with Manager on use of Claim Coverage Counsel as needed. * Directly investigates each claim through prompt and strategically-appropriate contact with appropriate parties such as policyholders, accounts, claimants, law enforcement agencies, witnesses, agents, medical providers and technical experts to determine the extent of liability, damages, and contribution potential. Interview witnesses and stakeholders; take necessary statements, as strategically appropriate. * Actively engages in the identification, selection and direction of appropriate internal and/or external resources for specific activities required to effectively evaluate claims, such as Subrogation, Risk Control, nurse consultants, and fire or fraud investigators, and other experts. * Verifies the nature and extent of injury or property damage by obtaining and reviewing appropriate records and damage documentation. * Maintains claim files and documents claim file activities in accordance with established procedures. * Utilizes evaluation documentation tools in accordance with department guidelines. * Proactively creates Claim File Analysis (CFA) by adhering to quality standards. * Utilizes diary management system to ensure that all claims are handled timely. * At required time intervals, evaluate liability & damages exposure. * Establishes and maintains proper indemnity and expense reserves. * Recommends appropriate cases for discussion at roundtable. * Attends and/or present at roundtables/ authority discussions for collaboration of technical expertise resulting in improved payout on indemnity and expense. * Actively and enthusiastically shares experience and knowledge of creative resolution techniques to improve the claim results of others. * Applies the Company's claim quality management protocols and Best Practices to all claims; documents the rationale for any departure from applicable protocols with or without assistance. * Develops and employ creative resolution strategies. * Responsible for prompt and proper disposition of all claims within delegated authority. * Negotiates disposition of claims with insureds and claimants or their legal representatives. * Recognizes and implements alternate means of resolution. * Manages litigated claims. Develops litigation plan with staff or panel counsel, including discovery and legal expenses, to assure effective resolution and to satisfy customers. * Applies litigation management through the selection of counsel, evaluation and direction of claim and litigation strategy, * Tracks and controls legal expenses to assure cost-effective resolution. * Effectively and efficiently manage both allocated and unallocated loss adjustment expenses. * Perform other duties as assigned. What Will Our Ideal Candidate Have? * Bachelor's Degree. * 5 years equivalent business experience. * Advanced level knowledge and skill in claim and litigation. * Basic working level knowledge and skill in various business line products. * Strong negotiation and customer service skills. * Skilled in coverage, liability and damages analysis and has a thorough understanding of the litigation process, relevant case and statutory law and expert litigation management skills. * Extensive claim and/or legal experience and technical expertise to evaluate severe and complex claims. * Able to make independent decisions on most assigned cases without involvement of supervisor. * Openness to the ideas and expertise of others actively solicits input and shares ideas. * Thorough understanding of commercial lines products, policy language, exclusions, ISO forms, and effective claims handling practices. * Demonstrated coaching, influence and persuasion skills. * Advanced written and verbal communication skills are required so as to understand, synthesize, interpret and convey, in a simplified manner, complex data and information to audiences with varying levels of expertise. * Can adapt to and support cultural change. * Strong technology aptitude; ability to use business technology tools to effectively research, track, and communicate information. * Analytical Thinking - Advanced. * Judgment/Decision Making - Advanced. * Communication - Advanced. * Negotiation - Advanced. * Insurance Contract. * Knowledge - Advanced. * Principles of Investigation - Advanced. * Value Determination - Advanced. * Settlement Techniques - Advanced. * Legal Knowledge - Advanced. * Medical Knowledge - Intermediate. What is a Must Have? * High School Degree or GED. * 3 years of liability claim handling experience and/or comparable litigation claim experience. * In order to perform the essential job functions of this job, acquisition and maintenance of Insurance License(s) may be required to comply with state and Travelers requirements. * Generally, license(s) are required to be obtained within three months of starting the job. What Is in It for You? * Health Insurance: Employees and their eligible family members - including spouses, domestic partners, and children - are eligible for coverage from the first day of employment. * Retirement: Travelers matches your 401(k) contributions dollar-for-dollar up to your first 5% of eligible pay, subject to an annual maximum. If you have student loan debt, you can enroll in the Paying it Forward Savings Program. When you make a payment toward your student loan, Travelers will make an annual contribution into your 401(k) account. You are also eligible for a Pension Plan that is 100% funded by Travelers. * Paid Time Off: Start your career at Travelers with a minimum of 20 days Paid Time Off annually, plus nine paid company Holidays. * Wellness Program: The Travelers wellness program is comprised of tools, discounts and resources that empower you to achieve your wellness goals and caregiving needs. In addition, our mental health program provides access to free professional counseling services, health coaching and other resources to support your daily life needs. * Volunteer Encouragement: We have a deep commitment to the communities we serve and encourage our employees to get involved. Travelers has a Matching Gift and Volunteer Rewards program that enables you to give back to the charity of your choice. Employment Practices Travelers is an equal opportunity employer. We value the unique abilities and talents each individual brings to our organization and recognize that we benefit in numerous ways from our differences. In accordance with local law, candidates seeking employment in Colorado are not required to disclose dates of attendance at or graduation from educational institutions. If you are a candidate and have specific questions regarding the physical requirements of this role, please send us an email so we may assist you. Travelers reserves the right to fill this position at a level above or below the level included in this posting. To learn more about our comprehensive benefit programs please visit *********************************************************

Job DescriptionCLAIMS INVESTIGATOR Seeking an experienced investigator with multi-lines investigations to include W/C and P&C experience. SIU experience is also highly desired, but not required. We are seeking individuals who possess proven investigative skill sets within the industry, as well as honesty, integrity, self-reliance, resourcefulness, independence, and discipline. Good time management skills are highly needed. Must have reliable transportation, along with own digital recorder and camera. Job duties include, but are not limited to, taking in-person recorded statements, scene photos, writing a detailed, comprehensive report, client communications, as well as meeting strict due dates on all assignments. If you have the desire to operate at your highest professional level within an organization that values and rewards excellence, please submit your resume. Only the finest individuals are considered for hire. Visit our website and find out why at ****************** The Claims Investigator should demonstrate proficiency in the following areas: W/C and P&C investigations Writing accurate, detailed reports Strong initiative, integrity, and work ethic Securing written/recorded statements Accident scene investigations Possession of a valid driver's license Ability to prioritize and organize multiple tasks Computer literacy to include Microsoft Word and Microsoft Outlook (email) Powered by JazzHR ae8MYMuvvL

Overview Workers' Compensation Claim Specialist (California Jurisdiction - Remote) Schedule: Monday-Friday, 8:00 AM - 4:30 PM PST Compensation Range: $87,000 - $97,000 annually (based on experience) Work Type: Full-Time | Employee-Owned Company Build Your Career With Purpose at CCMSI At CCMSI, we partner with global clients to solve their most complex risk management challenges, delivering measurable results through advanced technology, collaborative problem-solving, and an unwavering commitment to their success. We don't just process claims-we support people. As the largest privately owned Third Party Administrator (TPA), CCMSI delivers customized claim solutions that help our clients protect their employees, assets, and reputations. We are a certified Great Place to Work , and our employee-owners are empowered to grow, collaborate, and make meaningful contributions every day. Job Summary As a Workers' Compensation Claim Specialist, you'll manage a caseload of mostly litigated and complex claims from start to finish (“cradle to grave”). You'll ensure timely benefit payments, coordinate medical treatment through MMI, evaluate reserves, and pursue fair settlements and closure. You'll also work closely with our client to provide exceptional claim outcomes and uphold CCMSI's commitment to quality and compliance. ⚠️ Please Note: This is an experienced insurance adjusting position. It is not an HR, consultant, or risk management role. We're seeking a skilled California workers' compensation adjuster experienced in litigated and complex claims. Applicants without hands-on adjusting experience will not be considered. Responsibilities When we hire adjusters at CCMSI, we look for professionals who understand that every claim represents a real person's livelihood, take ownership of outcomes, and see challenges as opportunities to solve problems. Investigate, evaluate, and adjust California workers' compensation claims in accordance with CCMSI standards and state laws. Manage medical treatment plans and ensure benefits are paid timely and accurately. Evaluate claim reserves and settlement potential; negotiate settlements within authority and client guidelines. Collaborate effectively with clients, attorneys, medical providers, and internal partners. Maintain accurate and timely claim documentation and diary management. Participate in regular file reviews and provide thoughtful updates to the client. Contribute to a supportive, high-performing team culture rooted in employee ownership. Qualifications Required: Proven experience handling California jurisdiction workers' compensation claims (litigated and/or complex). Strong communication, organization, and time management skills. Analytical mindset with sound judgment and decision-making. Proficiency in Microsoft Word and Excel. Preferred: SIP designation (or willingness to obtain). AIC, ARM, or CPCU certification a plus. Bilingual (Spanish) proficiency - highly valued for communicating with claimants, employers, or vendors, but not required. Candidates with less experience may be considered at a lower range within the posted salary band. Why You'll Love Working Here 4 weeks PTO + 10 paid holidays in your first year Comprehensive benefits: Medical, Dental, Vision, Life, and Disability Insurance Retirement plans: 401(k) and Employee Stock Ownership Plan (ESOP) Career growth: Internal training and advancement opportunities Culture: A supportive, team-based work environment How We Measure Success At CCMSI, great adjusters stand out through ownership, accuracy, and impact. We measure success by: Quality claim handling - thorough investigations, strong documentation, well-supported decisions • Compliance & audit performance - adherence to jurisdictional and client standards • Timeliness & accuracy - purposeful file movement and dependable execution • Client partnership - proactive communication and strong follow-through • Professional judgment - owning outcomes and solving problems with integrity • Cultural alignment - believing every claim represents a real person and acting accordingly This is where we shine, and we hire adjusters who want to shine with us. Compensation & Compliance The posted salary reflects CCMSI's good-faith estimate in accordance with applicable pay transparency laws. Actual compensation will be based on qualifications, experience, geographic location, and internal equity. Visa Sponsorship: CCMSI does not provide visa sponsorship for this position. ADA Accommodations: CCMSI is committed to providing reasonable accommodations throughout the application and hiring process. Equal Opportunity Employer: CCMSI complies with all applicable employment laws, including pay transparency and fair chance hiring regulations. Our Core Values At CCMSI, we believe in doing what's right-for our clients, our coworkers, and ourselves. We look for team members who: Lead with transparency We build trust by being open and listening intently in every interaction. Perform with integrity We choose the right path, even when it is hard. Chase excellence We set the bar high and measure our success. What gets measured gets done. Own the outcome Every employee is an owner, treating every claim, every decision, and every result as our own. Win together Our greatest victories come when our clients succeed. We don't just work together-we grow together. If that sounds like your kind of workplace, we'd love to meet you. #EmployeeOwned #GreatPlaceToWorkCertified #CCMSICareers #WorkersCompensation #ClaimsAdjuster #CaliforniaJobs #RemoteWork #LI-Remote We can recommend jobs specifically for you! Click here to get started.

**Who Are We?** Taking care of our customers, our communities and each other. That's the Travelers Promise. By honoring this commitment, we have maintained our reputation as one of the best property casualty insurers in the industry for over 170 years. Join us to discover a culture that is rooted in innovation and thrives on collaboration. Imagine loving what you do and where you do it. **Job Category** Claim **Compensation Overview** The annual base salary range provided for this position is a nationwide market range and represents a broad range of salaries for this role across the country. 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. As part of our comprehensive compensation and benefits program, employees are also eligible for performance-based cash incentive awards. **Salary Range** $94,400.00 - $155,800.00 **Target Openings** 1 **What Is the Opportunity?** This role is eligible for a sign-on bonus of up to $20,000. This position is hybrid (3 days in office, 2 days remote). Under general supervision, this position is responsible for investigating, evaluating, reserving, negotiating and resolving assigned Specialty Liability Bodily Injury and Property Damage claims. Provides quality claim handling throughout the claim life cycle (customer contacts, coverage, investigation, evaluation, reserving, litigation management, negotiation and resolution) including maintaining full compliance with internal and external quality standards and state specific regulations. Provides consulting and training resources, and serves as a contact and technical resource to the field and our business partners. This job does not manage staff. **What Will You Do?** + Directly handles assigned severity claims. + Provides quality customer service and ensures quality and timely coverage analysis and communication with insured based on application of policy information to facts or allegations of each case. + Consults with Manager on use of Claim Coverage Counsel as needed. + Directly investigates each claim through prompt and strategically-appropriate contact with appropriate parties such as policyholders, accounts, claimants, law enforcement agencies, witnesses, agents, medical providers and technical experts to determine the extent of liability, damages, and contribution potential. Interview witnesses and stakeholders; take necessary statements, as strategically appropriate. + Actively engages in the identification, selection and direction of appropriate internal and/or external resources for specific activities required to effectively evaluate claims, such as Subrogation, Risk Control, nurse consultants, and fire or fraud investigators, and other experts. + Verifies the nature and extent of injury or property damage by obtaining and reviewing appropriate records and damage documentation. + Maintains claim files and documents claim file activities in accordance with established procedures. + Utilizes evaluation documentation tools in accordance with department guidelines. + Proactively creates Claim File Analysis (CFA) by adhering to quality standards. + Utilizes diary management system to ensure that all claims are handled timely. + At required time intervals, evaluate liability & damages exposure. + Establishes and maintains proper indemnity and expense reserves. + Recommends appropriate cases for discussion at roundtable. + Attends and/or present at roundtables/ authority discussions for collaboration of technical expertise resulting in improved payout on indemnity and expense. + Actively and enthusiastically shares experience and knowledge of creative resolution techniques to improve the claim results of others. + Applies the Company's claim quality management protocols and Best Practices to all claims; documents the rationale for any departure from applicable protocols with or without assistance. + Develops and employ creative resolution strategies. + Responsible for prompt and proper disposition of all claims within delegated authority. + Negotiates disposition of claims with insureds and claimants or their legal representatives. + Recognizes and implements alternate means of resolution. + Manages litigated claims. Develops litigation plan with staff or panel counsel, including discovery and legal expenses, to assure effective resolution and to satisfy customers. + Applies litigation management through the selection of counsel, evaluation and direction of claim and litigation strategy, + Tracks and controls legal expenses to assure cost-effective resolution. + Effectively and efficiently manage both allocated and unallocated loss adjustment expenses. + Perform other duties as assigned. **What Will Our Ideal Candidate Have?** + Bachelor's Degree. + 5 years equivalent business experience. + Advanced level knowledge and skill in claim and litigation. + Basic working level knowledge and skill in various business line products. + Strong negotiation and customer service skills. + Skilled in coverage, liability and damages analysis and has a thorough understanding of the litigation process, relevant case and statutory law and expert litigation management skills. + Extensive claim and/or legal experience and technical expertise to evaluate severe and complex claims. + Able to make independent decisions on most assigned cases without involvement of supervisor. + Openness to the ideas and expertise of others actively solicits input and shares ideas. + Thorough understanding of commercial lines products, policy language, exclusions, ISO forms, and effective claims handling practices. + Demonstrated coaching, influence and persuasion skills. + Advanced written and verbal communication skills are required so as to understand, synthesize, interpret and convey, in a simplified manner, complex data and information to audiences with varying levels of expertise. + Can adapt to and support cultural change. + Strong technology aptitude; ability to use business technology tools to effectively research, track, and communicate information. + Analytical Thinking - Advanced. + Judgment/Decision Making - Advanced. + Communication - Advanced. + Negotiation - Advanced. + Insurance Contract. + Knowledge - Advanced. + Principles of Investigation - Advanced. + Value Determination - Advanced. + Settlement Techniques - Advanced. + Legal Knowledge - Advanced. + Medical Knowledge - Intermediate. **What is a Must Have?** + High School Degree or GED. + 3 years of liability claim handling experience and/or comparable litigation claim experience. + In order to perform the essential job functions of this job, acquisition and maintenance of Insurance License(s) may be required to comply with state and Travelers requirements. + Generally, license(s) are required to be obtained within three months of starting the job. **What Is in It for You?** + **Health Insurance** : Employees and their eligible family members - including spouses, domestic partners, and children - are eligible for coverage from the first day of employment. + **Retirement:** Travelers matches your 401(k) contributions dollar-for-dollar up to your first 5% of eligible pay, subject to an annual maximum. If you have student loan debt, you can enroll in the Paying it Forward Savings Program. When you make a payment toward your student loan, Travelers will make an annual contribution into your 401(k) account. You are also eligible for a Pension Plan that is 100% funded by Travelers. + **Paid Time Off:** Start your career at Travelers with a minimum of 20 days Paid Time Off annually, plus nine paid company Holidays. + **Wellness Program:** The Travelers wellness program is comprised of tools, discounts and resources that empower you to achieve your wellness goals and caregiving needs. In addition, our mental health program provides access to free professional counseling services, health coaching and other resources to support your daily life needs. + **Volunteer Encouragement:** We have a deep commitment to the communities we serve and encourage our employees to get involved. Travelers has a Matching Gift and Volunteer Rewards program that enables you to give back to the charity of your choice. **Employment Practices** Travelers is an equal opportunity employer. We value the unique abilities and talents each individual brings to our organization and recognize that we benefit in numerous ways from our differences. In accordance with local law, candidates seeking employment in Colorado are not required to disclose dates of attendance at or graduation from educational institutions. If you are a candidate and have specific questions regarding the physical requirements of this role, please send us an email (*******************) so we may assist you. Travelers reserves the right to fill this position at a level above or below the level included in this posting. To learn more about our comprehensive benefit programs please visit ******************************************************** .