Claim specialist jobs in Arden-Arcade, CA - 73 jobs
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Claims Representative - Rancho Cordova, CA
Federated Mutual Insurance Company 4.2
Claim specialist job in Rancho Cordova, CA
Who is Federated Insurance? At Federated Insurance, we do life-changing work, focused on our clients' success. For our employees, we provide tremendous opportunities for growth. Over 95% of them believe our company has an outstanding future. We make lives better, and we're looking for employees who want to make a difference in others' lives, all while enhancing their own.
Federated's culture is grounded in our Four Cornerstones: Equity, Integrity, Teamwork, and Respect. We strive to create a work environment that embodies our values and commitment to diversity and inclusion. We value and respect individual differences, and we leverage those differences to achieve better results and outcomes for our clients, employees, and communities. Our top priority in recruitment and development of our next generation is to ensure we align ourselves with truly exceptional people who share these values.
What Will You Do?
Customer-focused, source of knowledge and comfort, desire to help, professional, self-motivated - Does that sound like you? We are seeking someone who possesses those skills to assist our clients through the claims process and to help them return to normalcy after a loss.
No previous insurance or claims experience needed! Federated provides an exceptional training program to teach you the fundamentals of claims and will prepare you to assist clients.
This is an in-office position that will work out of our Rancho Cordova, CA office, located at 10850 Gold Center Drive. A work from home option is not available.
Responsibilities
* Work with policyholders, attorneys, and others to ensure claims are resolved in a prompt, fair and courteous way.
* Explain policy coverage to policyholders and third parties.
* Complete thorough investigations and document facts relating to claims.
* Resolve claims, which may include paying, settling, or denying claims, defending policyholders in court, compromising or recovering outstanding dollars.
Minimum Qualifications
* Current pursuing, or have obtained a four-year degree
* Experience in a customer service role in industries such as retail, hospitality, logistics, banking, equipment dealerships, equipment rental, sales or similar fields
* Ability to make confident decisions based on available information
* Strong analytical, computer, and time management skills
* Excellent written and verbal communication skills
* Leadership experience is a plus
Salary Range: $63,800 - $78,000
Pay may vary depending on job-related factors and individual experience, skills, knowledge, etc. In addition, this position is eligible for a Geographic Differential Payment. Details of this benefits will be discussed in the interview process.)
What We Offer
We offer a wide variety of ways to support you as a whole, both professionally and personally. Our commitment to your growth includes opportunities for internal mobility and career development paths, inspiring excellence in performance and ensuring your professional journey thrives. Additionally, we offer exceptional benefits to nurture your personal life. We understand the importance of health and financial security, offering encompassing competitive compensation, enticing bonus programs, cost-effective health insurance, and robust pension and 401(k) offerings. To encourage community engagement, we provide paid volunteer time and offer opportunities for gift matching. Discover more about Federated and our comprehensive benefits package: Federated Benefits You.
Employment Practices
All candidates must be legally authorized to work in the United States for any employer. Federated will not sponsor candidates for employment visa status, such as an H1-B visa. Federated does not interview or hire students or recent graduates with J-1 or F-1 visas or similar temporary work authorization.
If California Resident, please review Federated's enhanced Privacy Policy.
$63.8k-78k yearly Auto-Apply 11d ago
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Trucking Claims Specialist
Berkshire Hathaway 4.8
Claim specialist job in Rancho Cordova, CA
Good things are happening at Berkshire Hathaway GUARD Insurance Companies. We provide Property & Casualty insurance products and services through a nationwide network of independent agents and brokers. Our companies are all rated A+ “Superior” by AM Best (the leading independent insurance rating organization) and ultimately owned by Warren Buffett's Berkshire Hathaway group - one of the financially strongest organizations in the world! Headquartered in Wilkes-Barre, PA, we employ over 1,000 individuals (and growing) and have offices across the country. Our vision is to be a leading small business insurance provider nationwide.
Founded upon an exceptional culture and led by a collaborative and inclusive management team, our company's success is grounded in our core values: accountability, service, integrity, empowerment, and diversity. We are always in search of talented individuals to join our team and embark on an exciting career path!
Benefits:
We are an equal opportunity employer that strives to maintain a work environment that is welcoming and enriching for all. You'll be surprised by all we have to offer!
Competitive compensation
Healthcare benefits package that begins on first day of employment
401K retirement plan with company match
Enjoy generous paid time off to support your work-life balance plus 9 ½ paid holidays
Up to 6 weeks of parental and bonding leave
Hybrid work schedule (3 days in the office, 2 days from home)
Longevity awards (every 5 years of employment, receive a generous monetary award to be used toward a vacation)
Tuition reimbursement after 6 months of employment
Numerous opportunities for continued training and career advancement
And much more!
Responsibilities
Berkshire Hathaway GUARD Insurance Companies is seeking a Trucking ClaimsSpecialist to join our P&C Claims Casualty team. This role will report to the AVP of Claims and is responsible for investigating and resolving commercial auto liability and physical damage claims, with a focus on trucking exposures. The ideal candidate will bring strong analytical skills, sound judgment, and a commitment to delivering high-quality claims service.
Key Responsibilities
Investigate and resolve commercial auto liability and physical damage claims involving trucking exposures.
Review and interpret policy language to determine coverage and consult with coverage counsel when needed.
Manage a caseload of moderate to high complexity and exposure, applying effective resolution strategies.
Communicate with insureds, claimants, attorneys, body shops, and law enforcement to gather relevant information.
Collaborate with defense counsel and vendors to support litigation strategy and recovery efforts.
Ensure claims are handled accurately, efficiently, and in alignment with service and regulatory standards.
Participate in file reviews, team meetings, and ongoing training to support continuous learning.
Salary Range
$95,000.00-$145,000.00 USD
The successful candidate is expected to work in one of our offices 3 days per week and also be available for travel as required. The annual base salary range posted represents a broad range of salaries around the U.S. and is subject to many factors including but not limited to credentials, education, experience, geographic location, job responsibilities, performance, skills and/or training.
Qualifications
Minimum of 3 years of trucking industry experience.
Experience with bodily injury and/or cargo exposures.
Familiarity with trucking operations, FMCSA/DOT regulations, and multi-jurisdictional claims practices.
Strong analytical and negotiation skills, with the ability to manage multiple priorities.
Proven ability to manage sensitive and high-stakes situations with accuracy and professionalism.
Possession of applicable state adjuster licenses.
Juris Doctor (JD) preferred; alternatively, a bachelor's degree or equivalent experience in insurance, risk management, or a related field.
**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**
$52,600.00 - $86,800.00
**Target Openings**
3
**What Is the Opportunity?**
Travelers' Claim Organization is at the heart of our business by providing assurance to our customers and their employees in their time of need. The Travelers Workers Compensation Claim team is committed to partnering with our business insurance customers to help their injured employees return to work as soon as medically appropriate. As an Associate Claim Rep, Workers Compensation, you will receive comprehensive training in claim handling, customer service, and policy interpretation while working alongside experienced claim professionals. This position focuses on developing your skills and knowledge to successfully manage workers compensation claims. This program can typically last up to 12 months and upon successful completion of this program you will have the skills needed to handle claims independently and progress toward full claims handling responsibility.
As part of the hiring process, this position will require the completion of an online pre-employment assessment. Further information regarding the assessment including an accommodation process, if needed, will be provided at such time as your candidacy is deemed appropriate for further consideration.
**What Will You Do?**
+ Actively participate in structured training classes covering insurance policies, specific claim processes, systems, and procedures, including virtual, classroom, and on-the-job training.
+ Assist in reviewing, investigating, and documenting Workers Compensation claims under close supervision.
+ Investigate, develop, and evaluate action plans for claim resolution. Assess coverage and determine if a claim is compensable under Workers Compensation including evaluating claims for potential fraud.
+ Participate in Telephonic and/or onsite File Reviews.
+ Learn how to determine coverage, compensability, and exposure based on policy terms and claim facts.
+ Gather information from policyholders, claimants, witnesses, and third-party providers.
+ Communicate and apprise all parties regarding claim status which may include our business customers, injured employees, medical providers, and legal counsel.
+ Maintain accurate records of claim activity in claim management systems.
+ Achieve a positive result by returning an injured party to work when appropriate. This may include coordinating medical treatment in collaboration with internal or external resources.
+ Demonstrate openness to continuous learning, particularly in AI and digital transformation.
+ Acquire and maintain relevant Insurance License(s) to comply with state and Travelers' requirements within three months of starting the job.
+ Perform other duties as assigned.
**What Will Our Ideal Candidate Have?**
+ Previous internship or work experience in insurance, finance, or customer service.
+ Strong attention to detail and organizational skills.
+ Ability to manage multiple tasks and prioritize effectively.
+ Exceptional customer service skills and a commitment to providing a positive experience for insureds and claimants.
+ Ability to exercise sound judgement and make effective decisions.
+ Strong verbal and written communication skills with the ability to convey information clearly and professionally.
**What is a Must Have?**
+ High School Diploma or GED.
+ One year of customer service experience OR Bachelor's Degree.
**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 ******************************************************** .
$52.6k-86.8k yearly 6d ago
Claims Examiner
BRMS
Claim specialist job in Folsom, CA
Full-time Description
Summary: The Claims Examiner I is responsible for ensuring claims are coded and processed correctly and for meeting production requirements. Processes claims by performing the following duties.
Essential Duties and Responsibilities include the following. Other duties may be assigned.
· Compares data on claim with internal policy and other company records to ascertain completeness and validity of claim.
· Comprehensive understanding of employee benefits for medical, dental and vision plans.
·
Adjudicates medical claims, applies coordination of benefits as outlined in plan guidelines and works with providers to gather the necessary documents to make final payment determination on claims
· Ensures all claims are coded properly.
· Examines Summary Plan Document, claim adjustors' reports or similar claims/precedents to determine extent of coverage and liability.
· Maintains high quality standards to avoid paying claim incorrectly.
· Maintains productivity standards set by Management.
· Refers most questionable claims for investigation to claim examiner II for review and processing.
· Research and resolve paid and denied claims escalations from internal sources and/or TIPS ticketing system when assigned.
· Works from the claims queue manager to process & releases claims for adjudication and payment within 3-5 days of receipt.
· Performs other duties and responsibilities as assigned by Management.
Supervisory Responsibilities: This job has no supervisory responsibilities.
Physical Demands: 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 regularly required to sit for extended periods in front of a computer. The employee is frequently required to reach with hands and arms and talk or hear. The employee is occasionally required to stand; walk and use hands to finger, handle, or feel. The employee may frequently lift and/or move up to 10 pounds. Specific vision abilities required by this job include close vision, distance vision, peripheral vision, depth perception and ability to adjust focus. This position requires the employee to work in the office.
Work Environment: The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. The noise level in the work environment is usually moderate.
Requirements
Knowledge, Skills, & Abilities:
Excellent written and verbal communication skills.
Strong analytical skills and problem-solving skills.
Must be dependable and maintain excellent attendance and punctuality
Must be able to perform data entry operations quickly and accurately.
Ability to grow with changing demands of the position and the company.
Strong computer skills, including Word, Excel, and Outlook.
Successful candidates must have experience processing medical claims for an insurance company or third party administrator
Must be highly proficient in ICD-10, CPT, and HCPCS codes.
Qualifications: To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
Education and/or Experience: Associate's degree (A. A.) or equivalent from two-year college or technical school;
Must
have 3-5 years employee benefits industry/processing claims experience
or equivalent combination of education and experience.
Language Skills: Ability to read, speak, and write effectively in English. Ability to interpret documents such as safety rules, operating and maintenance instructions, and procedure manuals. Ability to write routine reports, meeting notes, project documentation, and correspondence. Ability to speak effectively before customers or employees of organization. Ability to effectively address or resolve customer service issues within guidelines of the position.
Mathematical Skills: Ability to add, subtract, multiply, and divide in all units of measure, using whole numbers, common fractions, and decimals. Ability to compute rate, ratio, and percent and to draw and interpret bar graphs.
Reasoning Ability: Ability to apply common sense understanding to carry out instructions furnished in written, oral, or diagram form. Ability to deal with problems involving several concrete variables in standardized or non-standardized situations.
Certificates, Licenses, Registrations: Valid, class C license in state working with no adverse driving record.
Salary Description $21.00 - $26.00 DOE
$33k-54k yearly est. 60d+ ago
Claims Supervisor II - Commercial Auto - BI
Philadelphia Insurance Companies 4.8
Claim specialist job in Roseville, CA
Marketing Statement:
Philadelphia Insurance Companies, a member of the Tokio Marine Group, designs, markets and underwrites commercial property/casualty and professional liability insurance products for select industries. We have been in operation since 1962 and are nationally recognized as a member of Ward's Top 50 and rated A++ by A.M.Best.
We are looking for a Claims Supervisor II - Commercial Auto - BI to join our team.
Summary:
Supervises claims adjusters and technical support staff to manage the day-to-day handling and settlement of claims, the processing and tracking of documents, making payments, tracking trends and communicating with underwriting.
A typical day will include the following:
Supervises the day-to-day activities of a claims handling unit; oversees the investigation of insurance claims.
Assures that corporate claims handling procedures and priorities are followed and that budget and productivity requirements are met.
Assures that department targets for customer service quality and priorities are met.
Participates in the hiring, training, evaluation and development of the claims staff.
Qualifications:
High School Diploma; Bachelor's degree from a four-year college or university preferred.
10 plus years related experience and/or training; or equivalent combination of education and experience.
Associate in Claims, CPCU or other industry related studies.
Experience with Windows operating system.
Basic Word processing skills.
National Range : $112,165.00 - $125,360.00
Ultimate salary offered will be based on factors such as applicant experience and geographic location.
PHLY locations considered: Roseville, CA / Seattle, WA / West Linn, OR.
EEO Statement:
Tokio Marine Group of Companies (including, but not limited to the Philadelphia Insurance Companies, Tokio Marine America, Inc., TMNA Services, LLC, TM Claims Service, Inc. and First Insurance Company of Hawaii, Ltd.) is an Equal Opportunity Employer. In order to remain competitive we must attract, develop, motivate, and retain the most qualified employees regardless of age, color, race, religion, gender, disability, national or ethnic origin, family circumstances, life experiences, marital status, military status, sexual orientation and/or any other status protected by law.
Benefits:
We offer a comprehensive benefit package, which includes tuition reimbursement and a generous 401K match. Our rich history of outstanding results and growth allow us to focus our business plan on continued growth, new products, people development and internal career opportunities. If you enjoy working in a fast paced work environment with growth potential please apply online.
Additional information on Volunteer Benefits, Paid Vacation, Medical Benefits, Educational Incentives, Family Friendly Benefits and Investment Incentives can be found at *****************************************
$112.2k-125.4k yearly Auto-Apply 60d+ ago
Daily Claims Adjuster - Sacramento, CA
Cenco Claims 3.8
Claim specialist job in Sacramento, CA
CENCO is a trusted leader in property claims solutions, partnering with top insurance carriers to provide accurate, timely, and professional adjusting services. We're currently looking for experienced Daily Property Claims Adjusters to handle residential and commercial claims across Sacramento and the Northern California region. This opportunity is ideal for independent adjusters seeking consistent assignments and the flexibility of field-based work.
Key Responsibilities:
Conduct on-site inspections of property damage caused by wind, water, fire, and other covered perils.
Capture detailed documentation, including photos and written reports.
Prepare accurate repair estimates using Xactimate or Symbility.
Maintain professional communication with policyholders, contractors, and insurance carriers.
Manage each claim efficiently and submit all required documentation within deadlines.
What We're Looking For:
Licensing: Must hold an active California adjuster license.
Software: Proficiency in Xactimate or Symbility preferred.
Tools & Transportation: Reliable vehicle, ladder, laptop, and field inspection equipment.
Work Style: Organized, self-motivated, and able to work independently.
Responsiveness: Able to accept and complete assignments in a timely manner.
Why Join CENCO?
Steady claim volume in Sacramento and surrounding areas
Competitive pay and timely compensation
Strong internal support and efficient claim-handling processes
If you're an experienced adjuster looking for consistent work and the opportunity to grow with a trusted industry leader, we'd love to hear from you!
$55k-68k yearly est. Auto-Apply 60d+ ago
Field Claims Adjuster
EAC Claims Solutions 4.6
Claim specialist job in Sacramento, CA
At EAC Claims Solutions, we are dedicated to resolving claims with integrity and efficiency. Join us in delivering exceptional service while upholding the highest standards of professionalism and compliance. Explore more about our commitment to innovation and community impact at **********************
Overview:
Join EAC Claims Solutions as a Property Field Adjuster, where you will be managing insurance claims from inception to resolution.
Key Responsibilities:
- Planning and organizing daily workload to process claims and conduct inspections
- Investigating insurance claims, including interviewing claimants and witnesses
- Handling property claims involving damage to buildings, structures, contents and/or property damage
- Conducting thorough property damage assessments and verifying coverage
- Evaluating damages to determine appropriate settlement
- Negotiating settlements
- Uploading completed reports, photos, and documents using our specialized software systems
Requirements:
- Ability to perform physical tasks including standing for extended periods, climbing ladders, and navigating tight spaces
- Strong interpersonal communication, organizational, and analytical skills
- Proficiency in computer software programs such as Microsoft Office and claims management systems
- Self-motivated with the ability to work independently and prioritize tasks effectively
- High school diploma or equivalent required
- Previous experience in insurance claims or related field is a plus but not required
Next Steps:
If you're passionate about making a difference, thrive on challenges, and deeply value your work, we invite you to apply. Should your application progress, a recruiter will reach out to discuss the next steps.
Join us at EAC Claims Solutions, where your passion meets purpose, and where your contributions truly matter.
$54k-67k yearly est. Auto-Apply 33d ago
Independent Insurance Claims Adjuster in Sacramento, California
Milehigh Adjusters Houston
Claim specialist job in Sacramento, CA
IS IT TIME FOR A CAREER CHANGE? INDEPENDENT INSURANCE CLAIMS ADJUSTERS NEEDED NOW! Are you ready to embark on a dynamic and in-demand career as an Independent Insurance Claims Adjuster? This is your chance to join a thriving industry with endless opportunities for growth and advancement.
Why This Opportunity Matters:
With the current surge in storm-related events sweeping across the nation, there's an urgent need for new adjusters to meet the escalating demand.
As a Licensed Claims Adjuster, you'll play a crucial role in helping individuals and businesses recover from unforeseen disasters and rebuild their lives.
This is not just a job-it's a rewarding career path where you can make a real difference in people's lives while enjoying flexibility, autonomy, and competitive compensation.
Join Our Team:
Are you actively working as a Licensed Claims Adjuster with 100 claims or more under your belt?
If so, that's great! If not, no problem! Let us help you on your career path as a Licensed Claims Adjuster.
You're welcome to sign up on our jobs roster if you meet our guidelines.
How We Can Help You Succeed:
At MileHigh Adjusters Houston, we offer comprehensive training programs tailored to equip you with the essential skills and knowledge needed to excel in the field of claims adjusting.
Our expert instructor, with years of industry experience, will provide you with hands-on training, insider tips, and practical insights to prepare you for real-world challenges.
Whether you're a seasoned professional or a newcomer to the field, our training programs are designed to meet you where you are and help you reach your full potential as a claims adjuster.
Don't miss out on this opportunity-let us assist you in advancing your career in claims adjusting and achieving your professional goals. With our guidance and support, you'll have the opportunity to thrive in a dynamic and rewarding industry, making a positive impact on the lives of others while achieving your professional goals.
Seize the Opportunity Today!
Contact us now at ************ or [email protected] to learn more about our training programs and take the first step towards a fulfilling career as a Licensed Claims Adjuster. Visit our website at ******************************** to explore our offerings and view our 375+ Five-Star Google Reviews.
You can also find us on YouTube at: (*********************************************************
and Facebook at: (************************************************** for additional resources and updates.
APPLY HERE
#AdjustersNeeded #CareerOpportunity #ClaimsAdjusterTraining #MileHighAdjustersHouston
By applying to this position, you consent to receive informational and promotional messages from MileHigh Adjusters Houston about training opportunities and related career programs. You may opt out at any time.
$53k-67k yearly est. Auto-Apply 60d+ ago
Work Comp Claims Adjuster Temporary Assignment
Avonrisk
Claim specialist job in Rocklin, CA
Job DescriptionWorkers Compensation Claims Adjuster - Temporary Assignment MUST Reside in California & MUST have California Workers Compensation Claims Experience. Workers' Compensation Claims Adjuster - Assist a Dynamic Team in Rocklin We're seeking an experienced and motivated Workers' Compensation Claims Adjuster to assist our team in Rocklin. As a Claims Adjuster , you'll work within a team of 7, including 5 Claims Adjusters and 2 Claims to ensure exceptional claim handling and adherence to company standards and regulations.
Our Offer:
Competitive salary and benefits package, including medical, dental, vision, and 401(k)
Opportunity for professional growth and advancement in a dynamic organization
Collaborative work environment with a team dedicated to workers' compensation excellence
Our Mission:
To be the leading third party administrator offering professional and technological resources through pro-active and aggressive claims and managed care solutions in support of our clients' objectives.
Innovative processes and state-of-the-art technology support our people. Competent and experienced individuals provide the human element needed to deliver good service and drives good outcomes.
Our Goal:
To be recognized as the most trusted and innovative partner in providing Claims and Managed Care solutions that are tailored to the specific needs of our clients.
Your Impact:
Provide ongoing coaching, counseling, and feedback to team members to enhance skills and performance
Ensure all claims are handled in accordance with relevant statutes and company guidelines
Address personnel issues promptly and decisively, keeping management informed of corrective action
Foster a collaborative and productive team environment focused on excellence in claim resolution
Our Offer:
Competitive salary and benefits package, including medical, dental, vision, and 401(k)
Opportunity for professional growth and advancement in a dynamic organization
Collaborative work environment with a team dedicated to workers' compensation excellence
Interested? Get in Touch:
To learn more about this exciting opportunity and what Intercare has to offer, please do one of the following:
Apply to this posting
Call me directly at ************
Email ************************
We look forward to hearing from you!
“Pursuant to the Los Angeles and San Francisco Fair Chance Ordinance, we will consider for employment qualified applicants with arrest or conviction records.”
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$53k-66k yearly est. Easy Apply 21d ago
FCA Examiner
Military, Veterans and Diverse Job Seekers
Claim specialist job in Sacramento, CA
As an FCA Examiner, you will:
Serve as examiner-in-charge (EIC) of institutions, including large, complex, or high-risk institutions.
Develop and finalize the examination scope, approach, and allocation of Agency resources for identifying institutional risks, assessing safety and soundness, and determining corrective actions.
Establish proactive risk-based ongoing oversight programs to monitor emerging issues and assess impact on Financial Institution Rating System (FIRS) ratings.
Prepare written communications on issues of increased complexity, conveying oversight and examination results as well as matters requiring attention to institution boards of directors and management teams.
Develop, lead, and maintain ongoing communications with assigned institutions to timely exchange information, identify emerging risks and issues, and discuss oversight/examination findings and conclusions.
Develop and manage a program of ongoing oversight and examination activities to assess asset quality, financial condition, management capabilities, internal controls, general operations, and compliance with laws and regulations as well as sound business practices.
Requirements Conditions of Employment
Must be a U.S. citizen.
One year probationary period, unless previously served.
One year supervisory or managerial probationary period, unless previously served.
Suitability for Federal employment, as determined by a background investigation.
Submission of a financial disclosure report may be required.
Males born after 12-31-59 must be registered for Selective Service.
Complete the initial online assessment and USAHire Assessment, if required
Qualifications
You may qualify at the VH-38 (GS-12) band level if you have one year of specialized experience equivalent to the VH-37 (GS-11) band level in the Federal service that demonstrates your ability to examine or audit financial institutions for adherence to regulatory policy related to capital markets, credit risk, information technology risks and/or consumer compliance.
You may qualify at the VH-39 (GS-13) band level if you have one year of specialized experience equivalent to the VH-38 (GS-12) band in the Federal service that demonstrates your ability to examine or audit financial institutions for adherence to regulatory policy related to capital markets, credit risk, information technology risks and/or consumer compliance; or experience in the credit or lending operations (e.g., serving as a lending officer or credit decision maker) at a financial institution.
Proof of Commissioned examiner status or equivalent required.
Experience refers to paid and unpaid experience, including volunteer work done through National Service programs (e.g., Peace Corps, AmeriCorps) and other organizations (e.g., professional; philanthropic; religious; spiritual; community, student, social). Volunteer work helps build critical competencies, knowledge, and skills and can provide valuable training and experience that translates directly to paid employment. You will receive credit for all qualifying experience, including volunteer experience.
Education
You may not substitute education for experience at the VH-38 or VH-39 band level.
$45k-74k yearly est. 60d+ ago
Claim Representative III - Property
Capital Insurance Group 4.4
Claim specialist job in Stockton, CA
Why CIG? At Capital Insurance Group we offer our employees more than just a job. We foster career growth, provide opportunities to give back to our communities, and help you take the next step in your career! CIG was founded in 1898 by a group of earnest farmers in need of protection and today, we are the leading West Coast Property & Casualty insurer. CIG is certified as a Great Place to Work and provides a collaborative, inclusive, and fun work culture for all employees.
Why Choose CIGs Claims Team
CIG claims department is here to support our insureds throughout their claims process. We work directly with our agency partners and policyholders to accomplish successful claim resolutions. Join the claims operation and you can be part of a team who provides excellent service, build relationships, and achieves successful outcomes for our clients.
Learn what it means to be a Claim Representative III - Property at CIG
$39k-53k yearly est. 60d+ ago
SUPERVISING CORPORATION EXAMINER
State of California 4.5
Claim specialist job in Sacramento, CA
Under the general supervision of the Assistant Deputy Director, the Supervising Examiner is responsible for directing the provider solvency program within the Division of Provider Solvency. The provider solvency program is charged with overseeing the fiscal viability of medical groups and Independent Physician Associations that qualify as Risk-Bearing Organizations (RBOs), which includes financial solvency monitoring, review of all financial filings, addressing compliance issues, corrective action plans, and conducting financial and claims examinations. Occasional travel for meetings and/or conferences.
Please let us know how you heard about this position by taking a brief survey: DMHC Recruitment Survey.
Leave Program (PLP) 2025 agreement:
Effective July 1, 2025, the California Department of Human Resources (CalHR) implemented the temporary Personal Leave Program 2025 (PLP 2025). PLP 2025 directs that each employee receive a temporary reduction in pay in exchange for PLP 2025 leave credits. The temporary salary reduction percentage and the number of PLP 2025 leave credits are based on the position's associated bargaining unit. The salary range(s) included in this job advertisement do not include the temporary salary reduction.
You will find additional information about the job in the Duty Statement.
Working Conditions
The DMHC has locations in Downtown Sacramento and Rancho Cordova. Both locations are located close to light-rail with various amenities. The incumbent will work in a climate-controlled cubicle and/or office environment with artificial lighting.
This position may be eligible for hybrid telework. The telework schedule is permitted at the operational needs of the Department and is subject to change, consistent with the State Telework Policy and the DMHC's Telework Policy. All employees who telework are required to be California residents and maintain California residency in accordance with Government Code 14200.
Minimum Requirements
You will find the Minimum Requirements in the Class Specification.
* SUPERVISING CORPORATION EXAMINER
Additional Documents
* Job Application Package Checklist
* Duty Statement
Position Details
Job Code #:
JC-503149
Position #(s):
409-131-4440-008
Working Title:
Supervising Examiner
Classification:
SUPERVISING CORPORATION EXAMINER
$10,551.00 - $12,578.00
New to State candidates will be hired into the minimum salary of the classification or minimum of alternate range when applicable.
# of Positions:
1
Work Location:
Sacramento County
Telework:
Hybrid
Job Type:
Permanent, Full Time
Department Information
The mission of the Department of Managed Health Care (DMHC) is to is to ensure health plan members have access to equitable, high-quality, timely, and affordable health care within a stable health care delivery system. The DMHC accomplishes its mission by ensuring the health care system works for consumers. The Department protects the health care rights of 30.2 million Californians by regulating health care service plans, assisting consumers through a consumer Help Center, educating consumers on their rights and responsibilities and preserving the financial stability of the managed health care system.
DMHC values diversity at all levels of the organization and is committed to fostering an environment in which employees from a variety of backgrounds, cultures, and personal experiences are welcomed and can thrive. DMHC believes the diversity of our employees and their unique ideas inspire innovative solutions to further our mission. Join DMHC and help us improve the lives of all Californians.
If you are interested in learning about the Department of Managed Health Care (DMHC) culture from the perspective of someone like yourself, contact our Someone Like Me program (please check your Spam or Junk folders for our email replies). Within five business days of your request to participate in the Someone Like Me program, you will be matched with a DMHC employee with a similar background to discuss the DMHC's culture. This program is not part of, or in any way affiliated with the application or hiring process. Prospective employees must complete the application process on Cal Careers (e.g., submit your application within the specified timeframes on the job posting) to be considered for hire at the DMHC. None of the information you provide through the Someone Like Me program will be relayed to the Hiring Unit.
Department Website: **********************
Special Requirements
* The position(s) require(s) a Background Investigation be cleared prior to being hired.
All applicants not currently employed by the DMHC will be subject to a pre-employment background investigation. The investigation will consist of fingerprinting and an inquiry to the California Department of Justice to disclose criminal records.
Any documents you submit for a job vacancy such as your State application, resume, cover letter, educational transcripts, etc. SHOULD NOT include ANY confidential information. Confidential information that should be excluded or removed from these documents include, but is not limited to, your Social Security Number (SSN), birthday, driver's license number (unless required), basis of eligibility, examination results, LEAP status, marital status, and age. Confidential information on the first page of applications submitted electronically online, such as Easy ID number, SSN, examination related information, and driver's license number will automatically be redacted upon submission. Possession of Minimum Qualifications will be verified prior to interview and/or appointment.
If you are using education to meet the minimum qualifications for this position, you MUST submit a copy of your college transcripts.
Unofficial transcripts may be accepted during the application process; however, submission of official transcripts may be required prior to appointment.
Application Instructions
Completed applications and all required documents must be received or postmarked by the Final Filing Date in order to be considered. Dates printed on Mobile Bar Codes, such as the Quick Response (QR) Codes available at the USPS, are not considered Postmark dates for the purpose of determining timely filing of an application.
Final Filing Date: 1/23/2026
Who May Apply
Individuals who are currently in the classification, eligible for lateral transfer, eligible for reinstatement, have list or LEAP eligibility, are in the process of obtaining list eligibility, or have SROA and/or Surplus eligibility (please attach your letter, if available). SROA and Surplus candidates are given priority; therefore, individuals with other eligibility may be considered in the event no SROA or Surplus candidates apply.
Applications will be screened and only the most qualified applicants will be selected to move forward in the selection process. Applicants must meet the Minimum Qualifications stated in the Classification Specification(s).
How To Apply
Complete Application Packages (including your Examination/Employment Application (STD 678) and applicable or required documents) must be submitted to apply for this Job Posting. Application Packages may be submitted electronically through your CalCareer Account at ********************** When submitting your application in hard copy, a completed copy of the Application Package listing must be included. If you choose to not apply electronically, a hard copy application package may be submitted through an alternative method listed below:
Address for Mailing Application Packages
You may submit your application and any applicable or required documents to:
Department of Managed Health Care
DMHC Recruitment
Attn: Human Resource Office
980 9th Street, Suite 500
Sacramento, CA 95814
Address for Drop-Off Application Packages
You may drop off your application and any applicable or required documents at:
Department of Managed Health Care
DMHC Recruitment
Human Resource Office
980 9th Street, Suite 500
Sacramento, CA 95814
08:00 AM - 05:00 PM
Required Application Package Documents
The following items are required to be submitted with your application. Applicants who do not submit the required items timely may not be considered for this job:
* Current version of the State Examination/Employment Application STD Form 678 (when not applying electronically), or the Electronic State Employment Application through your Applicant Account at ********************** All Experience and Education relating to the Minimum Qualifications listed on the Classification Specification should be included to demonstrate how you meet the Minimum Qualifications for the position.
* Resume is required and must be included.
Applicants requiring reasonable accommodations for the hiring interview process must request the necessary accommodations if scheduled for a hiring interview. The request should be made at the time of contact to schedule the interview. Questions regarding reasonable accommodations may be directed to the EEO contact listed on this job posting.
Desirable Qualifications
In addition to evaluating each candidate's relative ability, as demonstrated by quality and breadth of experience, the following factors will provide the basis for competitively evaluating each candidate:
1. Experience and knowledge with general and specialized accounting and auditing principles and procedures; laws, policies, rules and regulations administered by the Department of Managed Health Care.
2. Knowledge and ability to apply the Generally Accepted Auditing Standards (GAAS), Generally Accepted Accounting Principles (GAAP), Audit and Accounting Guide for Health Care Organizations (AICPA), Generally Accepted Governmental Auditing Standards (GAGAS), and other accounting or auditing standards.
3. Knowledge of the Knox-Keene Act for licensure applications; notices of material modifications and amendments to application file.
4. Ability to direct senior examiners and examiner staff to ensure staff is properly trained to perform essential job.
5. Experience in developing, implementing and supervising training programs to ensure staff is properly trained / educated.
6. Ability to administer procedures and program activities; gather, organize, summarize and interpret financial data; analyze situations accurately and adopt an effective course of action; prepare reports.
7. Establish and maintain cooperative relations with internal and external stakeholders.
8. Possess strong oral and written communication skills.
9. Experience developing, planning, and overseeing examinations of programs such as audits, program review, and budget reviews.
10. Knowledge and expertise with the principles and practices of public and business administration, including personnel management.
11. Experience with Microsoft Access, Excel, Word and/or Audit Command Language (ACL).
12. Experience reviewing financial statements, such as income statements, balance sheets and/or cash flow statements.
13. Experience in analyzing financial projections and assumptions in a Corrective Action Plan.
14. Experience gathering, organizing, summarizing and interpreting financial data to prepare reports and/or recommendations.
15. Experience with examination protocols including the usage of workbooks or reference materials.
16. Preferred college level education with courses in accounting, auditing, business administration, public administration, business law, and/or corporate finance with verifiable transcripts.
17. Possess CPA license or CPA Candidate in the process to take CPA test are preferred, but not required.
18. Understanding of federal and state legislation, statutes and regulations related to health care.
19. Strong written and oral communication skills.
20. Strong organizational skills and a commitment to producing a quality work product.
21. Ability to use tact and good judgment.
22. Ability to be flexible in response to changing workload.
Benefits
Benefit information can be found on the CalHR website and the CalPERS website.
Contact Information
The Human Resources Contact is available to answer questions regarding the position or application process.
Department Website: **********************
Human Resources Contact:
DMHC Recruitment
**************
***********************
Please direct requests for Reasonable Accommodations to the interview scheduler at the time the interview is being scheduled. You may direct any additional questions regarding Reasonable Accommodations or Equal Employment Opportunity for this position(s) to the Department's EEO Office.
EEO Contact:
EEO Office
**************
***************
California Relay Service: ************** (TTY), ************** (Voice) TTY is a Telecommunications Device for the Deaf, and is reachable only from phones equipped with a TTY Device.
Additional Application Instructions
To be considered for this vacancy, please complete all applicable fields on the application form, including a list or description of previous/current occupational experience in the duties performed section.
Electronic applications through your CalCareer account are highly recommended.
If you are unable to apply electronically through your CalCareer account, please mail or drop off a hard copy of your application packet. Please notate RPA: 25-135 and Job Control: JC-503149 on your application.
All Experience and Education relating to the Minimum Qualifications listed on the Classification Specification should be included to clearly demonstrate how you meet the Minimum Qualifications for the position on your State Application (STD Form 678). The application should also clearly demonstrate the candidate's ability to meet the Desirable Qualifications identified in this job advertisement. The Classification Specification for Supervising Corporation Examiner is located at the top of this Job Announcement Posting under Minimum Requirements.
Foreign Degrees or Transcripts - Applicants with foreign degrees or transcripts who wish to apply that coursework toward meeting the minimum qualifications of the classification must provide a transcript evaluation that indicates the number of units to which his/her foreign coursework is equivalent. DMHC accepts foreign transcript evaluations that are completed by one of the agencies approved by the California Commission on Teacher Credentialing.
PLEASE NOTE: If you are mailing your application, it must be postmarked by the final filing date. Hand delivered applications must be submitted no later than 5:00 p.m. on the final filing date. Applications slipped under the door at the Human Resources Office will be time stamped the following business day.
Equal Opportunity Employer
The State of California is an equal opportunity employer to all, regardless of age, ancestry, color, disability (mental and physical), exercising the right to family care and medical leave, gender, gender expression, gender identity, genetic information, marital status, medical condition, military or veteran status, national origin, political affiliation, race, religious creed, sex (includes pregnancy, childbirth, breastfeeding and related medical conditions), and sexual orientation.
It is an objective of the State of California to achieve a drug-free work place. Any applicant for state employment will be expected to behave in accordance with this objective because the use of illegal drugs is inconsistent with the law of the State, the rules governing Civil Service, and the special trust placed in public servants.
$43k-67k yearly est. 13d ago
Claims Service Specialist
Pacific Staffing
Claim specialist job in Sacramento, CA
We are recruiting for a Claims Service Specialist to join a healthcare company based in Sacramento. This role is responsible for customer service calls from providers to assist callers as it relates to claims. Ideal candidates will be comfortable answering high volume calls and researching eligibility claim issues. This is a contract position (6 months) Monday-Friday, 8am-5pm onsite (with potential for hybrid after training and probationary period).
Pay: $20/hour
PRIMARY RESPONSIBILITIES:
Provide a full range of assistance to providers via telephone or correspondence concerning claims.
Answer telephone in a prompt, professional, courteous, and helpful manner; respond to questions regarding claims status and eligibility inquiries.
Maintain accurate phone calls in the Customer Service Module log.
Demonstrate a comprehensive knowledge of Health Plan Benefits and the various departmental functions.
Analyze and identify concerns/issues and refer to appropriate department as needed.
Evaluate and process claims and claim adjustments in accordance with company policies and procedures according to productivity and quality standards.
Interpret and process routine to moderate claims inquiries.
Check for erroneous items or codes and missing information and correct errors according to established procedures.
Research, update and/or adds eligibility to previously entered claims.
Consistently maintain production standards based on transactions/units per hour.
Perform other related duties consistent with the scope and intent of the position.
SKILLS & QUALIFICATIONS:
High School diploma or equivalent required; Associate degree preferred.
One (1) year experience in a healthcare Customer Service Call Center required.
Medical claims experience in managed care claims processing required.
Familiarity with ICD-10, HCPCS, CPT coding, modifiers, DMHC regulations, facility, and professional claim billing practices.
Ability to maintain production level and quality goals.
Excellent communication skills, including both oral and written.
Ability to demonstrate self-motivation, multi-task, exercise excellent time management, follow through on commitments and meet multiple deadlines.
Excellent active listening and critical thinking skills.
Ability to solve entry to mid-level problems with supervision.
Ability to maintain confidentiality and appropriately share information on a need-to-know basis.
Able to pass a drug screen and background check.
$20 hourly 4d ago
Claims Service Specialist
Pacific Temporary Services
Claim specialist job in Sacramento, CA
Contract
We are recruiting for a Claims Service Specialist to join a healthcare company based in Sacramento. This role is responsible for customer service calls from providers to assist callers as it relates to claims. Ideal candidates will be comfortable answering high volume calls and researching eligibility claim issues. This is a contract position (6 months) Monday-Friday, 8am-5pm onsite (with potential for hybrid after training and probationary period).
Pay: $20/hour
PRIMARY RESPONSIBILITIES:
Provide a full range of assistance to providers via telephone or correspondence concerning claims.
Answer telephone in a prompt, professional, courteous, and helpful manner; respond to questions regarding claims status and eligibility inquiries.
Maintain accurate phone calls in the Customer Service Module log.
Demonstrate a comprehensive knowledge of Health Plan Benefits and the various departmental functions.
Analyze and identify concerns/issues and refer to appropriate department as needed.
Evaluate and process claims and claim adjustments in accordance with company policies and procedures according to productivity and quality standards.
Interpret and process routine to moderate claims inquiries.
Check for erroneous items or codes and missing information and correct errors according to established procedures.
Research, update and/or adds eligibility to previously entered claims.
Consistently maintain production standards based on transactions/units per hour.
Perform other related duties consistent with the scope and intent of the position.
SKILLS & QUALIFICATIONS:
High School diploma or equivalent required; Associate degree preferred.
One (1) year experience in a healthcare Customer Service Call Center required.
Medical claims experience in managed care claims processing required.
Familiarity with ICD-10, HCPCS, CPT coding, modifiers, DMHC regulations, facility, and professional claim billing practices.
Ability to maintain production level and quality goals.
Excellent communication skills, including both oral and written.
Ability to demonstrate self-motivation, multi-task, exercise excellent time management, follow through on commitments and meet multiple deadlines.
Excellent active listening and critical thinking skills.
Ability to solve entry to mid-level problems with supervision.
Ability to maintain confidentiality and appropriately share information on a need-to-know basis.
Able to pass a drug screen and background check.
$20 hourly 2d ago
Verifications Specialist
Assurehire
Claim specialist job in Rocklin, CA
JOB DESCRIPTION About Us:
In 1997, our founders built the first web-based employment screening solution. Today, AssureHire is creating next generation solutions to help companies onboard and protect human capital with first class candidate experiences.
Responsibilities:
Verify employment and education history information using telephone, web, email and fax.
Provide professional service to third party verifiers and applicants.
Handle Personal Identifying Information confidentially and responsibly.
Employ knowledge and ingenuity to process verifications.
Log clear and detailed notes documenting research steps and actions taken on screening.
Analyze collected data and personal documents and evaluate their relevance and applicability.
Prepare accurate and grammatically correct reports.
Maintain a personal performance level that meets or exceeds the established production and quality goals of the department
Requirements:
Expert computer skills (Internet Searches, Database Lookups)
Outstanding verbal and written communication skills, excellent problem-solving skills
Ability to work independently and problem-solve
Energetic, self-motivated, and detail-oriented
Ability to manage multiple priorities using time management and organization skills
Team player with the ability to work with a wide variety of people
Bilingual (Spanish) a plus
High School Diploma or GED required
Entry level position with room for growth
Perks:
We are located in Rocklin, CA minutes from both Highway 80 and Highway 65.
We are a growing, thriving company with a progressive culture focused on a healthy, fun and fulfilling workplace.
Medical, Dental, Vision.
Stock Options.
Paid Training, Vacation and Sick Leave.
Food, Fun Fridays, Fitness Stipends, Device Stipends and more.
$12-$17 per hour
$12-17 hourly 60d+ ago
ELPAC (English Language Proficiency Assessments for California) Examiner (Temporary), one.Program, Venture, Special Education (one or more positions)
San Joaquin County Office of Education 4.3
Claim specialist job in Stockton, CA
Educate, Innovate and Inspire! San Joaquin County Office of Education located in Stockton, CA is a regional agency that provides educational leadership, resources, and customized services to assist school districts. San Joaquin County Office of Education (SJCOE) employs over 2,100 classified and certificated employees. SJCOE promotes student achievement and accountability, serves San Joaquin County's most at-risk students, and strives to create an environment in which every student, regardless of circumstances, has an opportunity for a quality education.
See attachment on original job posting
Equivalent of the completion of the twelfth grade.
Please be advised that your application will be considered incomplete if a formal letter of introduction, resume and three letters of recommendation are not attached to your on-line application by the closing date. If you need assistance attaching your documents please call **************.
Equivalent of the completion of the twelfth grade.
Please be advised that your application will be considered incomplete if a formal letter of introduction, resume and three letters of recommendation are not attached to your on-line application by the closing date. If you need assistance attaching your documents please call **************.
* Letter of Introduction (COVER LETTER)
* Letter(s) of Recommendation (3 Letters of Recommendation-MUST BE SIGNED BY AUTHOR)
* Resume
Comments and Other Information
Nondiscrimination in Employment & Sexual Harassment The Superintendent prohibits discrimination and/or harassment of San Joaquin County Office of Education (SJCOE) employees and job applicants on the basis of actual or perceived race, religious creed, color, national origin, ancestry, age, marital status, pregnancy, physical or mental disability, medical condition, genetic information, veteran status, gender, gender identity, gender expression, sex or sexual orientation at any SJCOE site and/or activity. The Superintendent prohibits sexual harassment of San Joaquin County Office of Education (SJCOE) employees and job applicants, as well as retaliatory behavior or action against employees or other persons who complain, testify, or otherwise participate in the complaint process established pursuant to this policy and administrative regulation. Contact the Title IX Coordinator/Coordinator for Nondiscrimination in Employment listed below for information on Nondiscrimination in Employment/Harassment (including Sexual harassment). Name: HR Title IX Investigations E-mail: ********************************* School District: San Joaquin County Office of Education Telephone: ************
$35k-44k yearly est. Easy Apply 60d+ ago
Complex Commercial Construction Defect Claim Representative
Travelers Insurance Company 4.4
Claim specialist job in Rancho Cordova, CA
**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 ******************************************************** .
$42k-55k yearly est. 32d ago
Work Comp Claims Adjuster Temporary Assignment
Avonrisk
Claim specialist job in Rocklin, CA
Workers Compensation Claims Adjuster - Temporary Assignment MUST Reside in California & MUST have California Workers Compensation Claims Experience. Workers' Compensation Claims Adjuster - Assist a Dynamic Team in Rocklin We're seeking an experienced and motivated Workers' Compensation Claims Adjuster to assist our team in Rocklin. As a Claims Adjuster , you'll work within a team of 7, including 5 Claims Adjusters and 2 Claims to ensure exceptional claim handling and adherence to company standards and regulations.
Our Offer:
Competitive salary and benefits package, including medical, dental, vision, and 401(k)
Opportunity for professional growth and advancement in a dynamic organization
Collaborative work environment with a team dedicated to workers' compensation excellence
Our Mission:
To be the leading third party administrator offering professional and technological resources through pro-active and aggressive claims and managed care solutions in support of our clients' objectives.
Innovative processes and state-of-the-art technology support our people. Competent and experienced individuals provide the human element needed to deliver good service and drives good outcomes.
Our Goal:
To be recognized as the most trusted and innovative partner in providing Claims and Managed Care solutions that are tailored to the specific needs of our clients.
Your Impact:
Provide ongoing coaching, counseling, and feedback to team members to enhance skills and performance
Ensure all claims are handled in accordance with relevant statutes and company guidelines
Address personnel issues promptly and decisively, keeping management informed of corrective action
Foster a collaborative and productive team environment focused on excellence in claim resolution
Our Offer:
Competitive salary and benefits package, including medical, dental, vision, and 401(k)
Opportunity for professional growth and advancement in a dynamic organization
Collaborative work environment with a team dedicated to workers' compensation excellence
Interested? Get in Touch:
To learn more about this exciting opportunity and what Intercare has to offer, please do one of the following:
Apply to this posting
Call me directly at ************
Email [email protected]
We look forward to hearing from you!
“Pursuant to the Los Angeles and San Francisco Fair Chance Ordinance, we will consider for employment qualified applicants with arrest or conviction records.”
$53k-66k yearly est. Auto-Apply 60d+ ago
Independent Insurance Claims Adjuster in Stockton, California
Milehigh Adjusters Houston
Claim specialist job in Stockton, CA
IS IT TIME FOR A CAREER CHANGE? INDEPENDENT INSURANCE CLAIMS ADJUSTERS NEEDED NOW! Are you ready to embark on a dynamic and in-demand career as an Independent Insurance Claims Adjuster? This is your chance to join a thriving industry with endless opportunities for growth and advancement.
Why This Opportunity Matters:
With the current surge in storm-related events sweeping across the nation, there's an urgent need for new adjusters to meet the escalating demand.
As a Licensed Claims Adjuster, you'll play a crucial role in helping individuals and businesses recover from unforeseen disasters and rebuild their lives.
This is not just a job-it's a rewarding career path where you can make a real difference in people's lives while enjoying flexibility, autonomy, and competitive compensation.
Join Our Team:
Are you actively working as a Licensed Claims Adjuster with 100 claims or more under your belt?
If so, that's great! If not, no problem! Let us help you on your career path as a Licensed Claims Adjuster.
You're welcome to sign up on our jobs roster if you meet our guidelines.
How We Can Help You Succeed:
At MileHigh Adjusters Houston, we offer comprehensive training programs tailored to equip you with the essential skills and knowledge needed to excel in the field of claims adjusting.
Our expert instructor, with years of industry experience, will provide you with hands-on training, insider tips, and practical insights to prepare you for real-world challenges.
Whether you're a seasoned professional or a newcomer to the field, our training programs are designed to meet you where you are and help you reach your full potential as a claims adjuster.
Don't miss out on this opportunity-let us assist you in advancing your career in claims adjusting and achieving your professional goals. With our guidance and support, you'll have the opportunity to thrive in a dynamic and rewarding industry, making a positive impact on the lives of others while achieving your professional goals.
Seize the Opportunity Today!
Contact us now at ************ or [email protected] to learn more about our training programs and take the first step towards a fulfilling career as a Licensed Claims Adjuster. Visit our website at ******************************** to explore our offerings and view our 375+ Five-Star Google Reviews.
You can also find us on YouTube at: (*********************************************************
and Facebook at: (************************************************** for additional resources and updates.
APPLY HERE
#AdjustersNeeded #CareerOpportunity #ClaimsAdjusterTraining #MileHighAdjustersHouston
By applying to this position, you consent to receive informational and promotional messages from MileHigh Adjusters Houston about training opportunities and related career programs. You may opt out at any time.
$53k-67k yearly est. Auto-Apply 60d+ ago
Field Claims Adjuster
EAC Claims Solutions 4.6
Claim specialist job in Fairfield, CA
At EAC Claims Solutions, we are dedicated to resolving claims with integrity and efficiency. Join us in delivering exceptional service while upholding the highest standards of professionalism and compliance. Explore more about our commitment to innovation and community impact at **********************
Overview:
Join EAC Claims Solutions as a Property Field Adjuster, where you will be managing insurance claims from inception to resolution.
Key Responsibilities:
- Planning and organizing daily workload to process claims and conduct inspections
- Investigating insurance claims, including interviewing claimants and witnesses
- Handling property claims involving damage to buildings, structures, contents and/or property damage
- Conducting thorough property damage assessments and verifying coverage
- Evaluating damages to determine appropriate settlement
- Negotiating settlements
- Uploading completed reports, photos, and documents using our specialized software systems
Requirements:
- Ability to perform physical tasks including standing for extended periods, climbing ladders, and navigating tight spaces
- Strong interpersonal communication, organizational, and analytical skills
- Proficiency in computer software programs such as Microsoft Office and claims management systems
- Self-motivated with the ability to work independently and prioritize tasks effectively
- High school diploma or equivalent required
- Previous experience in insurance claims or related field is a plus but not required
Next Steps:
If you're passionate about making a difference, thrive on challenges, and deeply value your work, we invite you to apply. Should your application progress, a recruiter will reach out to discuss the next steps.
Join us at EAC Claims Solutions, where your passion meets purpose, and where your contributions truly matter.
How much does a claim specialist earn in Arden-Arcade, CA?
The average claim specialist in Arden-Arcade, CA earns between $30,000 and $81,000 annually. This compares to the national average claim specialist range of $27,000 to $67,000.
Average claim specialist salary in Arden-Arcade, CA
$49,000
What are the biggest employers of Claim Specialists in Arden-Arcade, CA?
The biggest employers of Claim Specialists in Arden-Arcade, CA are: