Claims adjuster jobs in Alameda, CA

DETAILS Senior Claims Examiner Department: Workers' Compensation California Reports To: Claims Supervisor FLSA Status: Non-Exempt Job Grade: 12 Career Ladder: Next step in progression could include Lead Senior Claims Examiner or Claims Supervisor ATHENS ADMINISTRATORS Explore the Athens Administrators difference: We have been dynamic, innovative leaders in claims administration since our founding in 1976. We foster an environment where employees not only thrive but consistently recognize Athens as a “Best Place to Work.” Immerse yourself in our engaging, supportive, and inclusive culture, offering opportunities for continuous professional growth. Join our nationwide family-owned company in Workers' Compensation, Property & Casualty, Program Business, and Managed Care. Embrace a change and come make an impact with the Athens Administrators family today! POSITION SUMMARY Athens Administrators has an immediate need for a full-time Senior Claims Examiner to support our workers compensation offices. This position requires residing in the Bay Area, in order to attend meetings in Concord and San Mateo as needed. Additionally, employees who live less than 26 miles from the Concord, CA office are required to work once a week in the office on a day determined by their supervisor between Tuesday - Thursday. The remaining days can be worked remotely if technical requirements are met. Athens offices are open for business Monday-Friday from 7:30 a.m. to 5:30 p.m. local time. The schedule for this position is Monday-Friday at 37.5 hours a week with the option of a flex schedule. The Senior Claims Examiner will adjust workers' compensation claims from inception through settlement and closure, ensuring timely processing of claims and payment of benefits, managing, and directing medical treatment, setting reserves, and negotiating settlements. The Senior Claims Examiner will adjust workers' compensation claims from inception through settlement and closure, ensuring timely processing of claims and payment of benefits, managing, and directing medical treatment, setting reserves, and negotiating settlements. PRIMARY RESPONSIBILITIES Our new hire should have the skills, ability, and judgment to perform the following essential job duties and responsibilities with or without reasonable accommodation. Additional duties may be assigned: Establish contact with employer to review issues Respond to inquiries from the employer, employee, doctors, and attorneys Establish and maintain appropriate reserves Review legal correspondence and medical reports Evaluate and approve medical procedures and treatment Administer benefits and ensure appropriateness of all payments Investigate coverage, liability, and monetary value of claim Review medical and legal bills for appropriateness Discuss appropriateness of medical treatment with medical case manager Determine compensability Monitor and assist litigation Negotiate settlement of claim, liens, rehabilitation plans, etc. Prepare and present reports to clients Appropriately close claims Help resolve client billing and payment inquiries Investigate complaints from injured workers Document and code the claim files and claims system with all relevant information Maintain and update action plans within specified time frames Provide direction to Claims Assistants and Claims Technicians and assist with training, coaching, and mentoring as needed for them to support daily claims tasks Contact with employers, employees, attorneys, doctors, vendors, and other parties Provide customer service and support to clients and claimants Work collaboratively with attorneys to draft settlements and assist with litigation strategies Negotiate settlements Authorize and negotiate cost of medical treatment and supplies Internal communication with staff Prepare professional, well written correspondence and other communications ESSENTIAL POSITION REQUIREMENTS The requirements listed below are representative of the knowledge, skill, and/or ability required. While it does not encompass all job requirements, it is meant to give you a solid understanding of expectations. High School Diploma or equivalent (GED) required for all positions AA/AS or BA/BS preferred but not required Administrators Certificate from Self-Insurance Plans will be required within one year of employment if not already obtained Must possess a current Experienced Indemnity Claims Adjuster Designation, provided by an insurer, as defined in California Code of Regulations, Title 10, Chapter 5, Subchapter 3, Section 2592.01(f) 3+ years recent workers compensation claims handling experience required At least 5 years of workers compensation claims experience preferred Solid knowledge of workers compensation laws, policies, and procedures' Completion of IEA or equivalent courses Proficiency in determining case value and negotiating settlements Understanding of medical and legal terminology Mathematical calculating skills Well-developed verbal and written communication skills with strong attention to detail Excellent organizational skills and ability to multi-task Ability to type quickly, accurately and for prolonged periods Proficient in Microsoft Office Suite Ability to learn additional computer programs Reasoning ability, including problem-solving and analytical skills, i.e., proven ability to research and analyze facts, identify issues, and make appropriate recommendations and solutions for resolution Ability to be trustworthy, dependable, and team-oriented for fellow employees and the organization Seeks to include innovative strategies and methods to provide a high level of commitment to service and results Ability to demonstrate care and concern for fellow team members and clients in a professional and friendly manner Acts with integrity in difficult or challenging situations and is a trustworthy, dependable contributor. Ability to attend occasional in office meetings or file reviews APPLY WITH US We look forward to learning about YOU! If you believe in our core values of honesty and integrity, a commitment to service and results, and a caring family culture, we invite you to apply with us. Please submit your resume and application directly through our website at *********************************************** Feel free to include a cover letter if you'd like to share any other details. All applications received are reviewed by our in-house Corporate Recruitment team. This description portrays in general terms the type and levels of work performed and is not intended to be all-inclusive or represent specific duties of any one incumbent. The knowledge, skills, and abilities may be acquired through a combination of formal schooling, self-education, prior experience, or on-the-job training. Athens Administrators is an Equal Opportunity/ Affirmative Action employer. We provide equal employment opportunities to all qualified employees and applicants for employment without regard to race, religion, sex, age, marital status, national origin, sexual orientation, citizenship status, veteran status, disability, or any other legally protected status. We prohibit discrimination in decisions concerning recruitment, hiring, compensation, benefits, training, termination, promotions, or any other condition of employment or career development. THANK YOU! We look forward to reviewing your information. We understand that applying for jobs may not be the most enjoyable task, so we genuinely appreciate the time you've dedicated. Don't forget to check out our website at ******************* as well as our LinkedIn, Glassdoor, and Facebook pages! Athens Administrators is dedicated to fair and equitable compensation for our employees that is both competitive and reflective of the market. The estimated rate of pay can vary depending on skills, knowledge, abilities, location, labor market trends, experience, education including applicable licenses & certifications, etc. Our ranges may be modified at any time. In addition, eligible employees may be considered annually for discretionary salary adjustments and/or incentive payments. Further information about our comprehensive benefits package may be found on our website at https://*******************/careers/why-work-here

About Us: The Greenspan Co./Adjusters International is the leading Public Insurance Adjusting firm with locations in California, Nevada, and Arizona. We advocate for the insured during times of crisis, navigating them through the complex and tedious insurance claims process. We aim to be the gold standard in customer service, and we've helped thousands of residential and commercial clients with their claims for over 70 years. Job Summary: We are seeking a Senior Claims Adjuster for our San Jose office. This role is a full time position with base salary plus commission. The Senior Claims Adjuster role will have the following responsibilities but not limited to: will investigate commercial and residential property claims, evaluate damages, determine coverage, set accurate cost estimates, control the insured's exposures and losses, manage consultants, and achieve a prompt, fair and equitable settlement according to fair claims handling requirements. Additionally, negotiate settlement of claims with varying complexity and perils. If you're an independent adjuster or a staff adjuster who wants to do the right thing for the policy holder and work to help homeowners and business owners rebuild after a catastrophe, we are the right team to join! The Senior Claims Adjuster will have the following duties & responsibilities but not limited to: Conducts a prompt, thorough and fair investigation by obtaining relevant facts to determine coverage, origin, and extent of loss losses. Reviews & utilizes financial statements to adjust complex residential and/or business interruption losses. Conduct on-site appraisal or direct independent adjuster to determine facts relevant causation, damages and exposures Engages and manages team members as required to assist in determining facts, causation, damages and exposure; monitors the costs to ensure they are reasonable and necessary. Establishes and maintains accurate loss cost estimates and reserves for each claim for reporting, financial records, and other purposes. Keeps the clients and others informed about the claim's status with clear, timely and accurate written/oral communications. Effectively communicates in writing on moderately complex coverage issues with minimal review and coaching. Determines depreciate of claim. Meet time requirements of the policy and fair claims handling practices. Effectively negotiate settlement of claims of varying complexity and perils. Achieves a prompt, fair, and equitable settlement of a claim, where there is policy liability. Keeps the electronic claim file properly documented with accurate, clear and timely information and reports that reflects the adjustment activities and substantiates any payments made. Provide guidance to inexperienced team members and may act as a mentor to other entry level adjusters. Qualifications: 10 years plus experience in an insurance company handling residential & commercial property and casualty claims required 2 years' experience handling losses in excess of $ 200,000.00 required Bachelor's degree required Must have a valid CA Driver License Ability and willingness to travel to the site of catastrophe for assignments. Capability to build and maintain positive relationships Ability to train and mentor less experienced team members Ability to write business correspondence, produce accurate work, manage projects and vendors; and use core applications/spreadsheets Empathetic and Compassionate advocate for policy holder Someone invested in protecting and defending the best interests of the claimant The ability to be an avid listener and a conscientious member of our team Compensation: Competitive salary (Base plus commission package worth $150k to $175k per year) Company Offered Benefits: Health, Dental, Vision Coverage 401K ESOP LTD Coverage Find out how you can become a dynamic part of our growing team and employee owned company.

Ahold Delhaize USA, a division of global food retailer Ahold Delhaize, is part of the U.S. family of brands, which includes five leading omnichannel grocery brands - Food Lion, Giant Food, The GIANT Company, Hannaford and Stop & Shop. Our associates support the brands with a wide range of services, including Finance, Legal, Sustainability, Commercial, Digital and E-commerce, Technology and more. Position Summary Primary responsibilities include investigation of General Liability claims to determine liability exposure. This role has direct responsibility of managing the claim in its entirety while maintaining service level targets and achieving established claims goals. This role is the primary interface to associates, attorneys, healthcare providers, vendor partners and Brand partners. Primary responsibilities include investigation of General Liability claims to determine liability exposure. This role has direct responsibility of managing the claim in its entirety while maintaining service level targets and achieving established claims goals. This role is the primary interface to associates, attorneys, healthcare providers, vendor partners and Brand partners. Our flexible/hybrid work schedule includes 1 in-person day at one of our core locations and 4 remote days. Applicants must be currently authorized to work in the United States on a full-time basis. Principle Duties and Responsibilities: Claims Management Manage caseload within established targets and appropriate level. Performance standards include thorough investigations, evaluations, negotiation and disposition of all claims, while ensuring that all claims are in compliance with statutory and legal obligations. Monitor and ensure timely execution of all statutory deadlines or legal filings as needed. Analyze facts of the loss to understand the nature of the claim to develop strategies that provide optimal outcome and mitigate the overall Total Cost of Risk to the Banners' bottom lines. Identify fraud indicators and actively pursue subrogation opportunities. Collaborate with the Safety department in identifying hazards that exist in the retail and distribution operations and ways to minimize these risks. Build and maintain positive relationships with internal (Brands, Distributions Centers, Transportation, Ecommerce, Human Resources, Legal, Insurance) and external (vendors, healthcare providers, outside attorneys) customers. Financial Impact Administration Manage book of claims business (up to $ 2million) with authority to settle/negotiate a single claim within their authority of up to $25,000. Communicate ongoing causes of incidents to Safety and Brands. Serve as the primary point of contact to address and resolve claim issues impacting customer, associate, vendor, and the Brands. Research and resolve claim/legal issues. Provide timely communication related to the claim, resolving issues, and responding to questions via phone, email, and online applications. Basic Qualifications: Licensed adjuster (as appropriate by jurisdiction) Bachelor's degree or experience handling General Liability claims or equivalent expertise. Thorough knowledge of rules, regulations, statutes, and procedures pertaining to general liability claims. Knowledge of medical terminology involved in complex claims Negotiates resolution of claims of various exposure and complexity Skills and Abilities: Demonstrates relationship building and communication skills, both written and verbal. Highly self-motivated, goal oriented, and works well under pressure. Customer focused solid understanding of legal procedures, processes, practices and standards in the handling of general liability claims Ability to identify problems and effectuate solutions Ability to manage multiple tasks simultaneously with excellent follow-up and attention to detail Able to apply critical thinking when solving problems and making decisions. ME/NC/PA/SC Salary Range: $63,440-$95,160 IL/MA/MD/NY Salary Range: $72,880 - $109,320 Actual compensation offered to a candidate may vary based on their unique qualifications and experience, internal equity, and market conditions. Final compensation decisions will be made in accordance with company policies and applicable laws. #LI-SM1 #LI-Hybrid At Ahold Delhaize USA, we provide services to one of the largest portfolios of grocery companies in the nation, and we're actively seeking top talent. Our team shares a common motivation to drive change, take ownership and enable our brands to better care for their customers. We thrive on supporting great local grocery brands and their strategies. Our associates are the heartbeat of our organization. We are committed to offering a welcoming work environment where all associates can succeed and thrive. Guided by our values of courage, care, teamwork, integrity (and even a little humor), we are dedicated to being a great place to work. We believe in collaboration, curiosity, and continuous learning in all that we think, create and do. While building a culture where personal and professional growth are just as important as business growth, we invest in our people, empowering them to learn, grow and deliver at all levels of the business.

WHAT WE'RE LOOKING FORBerkshire Hathaway Homestate Companies has an immediate opportunity for an experienced workers compensation adjuster. We're looking for self-starters who can work under minimum direction, can achieve defined results, and are willing to accept ownership for their work product. This Claims Professional is responsible for the management of a caseload of workers compensation indemnity claims from inception to resolution, performing initial investigation and compensability determination, reserve analysis and strategic planning, timely benefit administration to injured workers, and coordination of medical care and legal process, while maintaining the highest level of service to our insureds. ESSENTIAL RESPONSIBILITIES Conducts the investigation of reported claims via three-point contact calls to determine coverage, compensability and severity, and to gather all other relevant information, documenting all relevant information thoroughly and escalating the investigation for further investigation when appropriate. Calculates appropriate reserves for each claim and ensures that reserves are adjusted as needed per authority guidelines. Calculates and administers benefits in accordance with statutory requirements, including timely issuance of appropriate notices and filings. Develops and updates a Plan of Action for the successful resolution of each claim; timely updates Plan as new information is obtained. Makes prompt, sound decisions on issues that arise in claims based on the best information available, ensuring that work is performed in accordance with Company standards, training, supervisory direction, and applicable laws. Timely escalates issues/red flags to Supervisor and/or appropriate internal team. Ensures that the actions of all other professionals involved in claim, including attorneys, nurse case managers, and investigators, are coordinated to achieve a successful resolution of the claim. Assigns appropriate tasks to a Claims Assistant and/or Claims Clerical Assistant and ensures they are performed correctly and efficiently. Accurately and thoroughly prepares litigation referrals, AOE/COE investigation referrals, and MSA referrals for submission to vendor; obtains proper approval from Management. Prepares timely and accurate settlement recommendations (within designated authority parameters) and effectively negotiates settlement of claims. Fosters a positive and close working relationship with partner company staff, including the Call Center, Medical Management, Special Investigations, Client Services, Underwriting, and Claims Legal. Communicates effectively with individuals outside the company, including clients, medical providers, and injured workers. Collaborates with Adjusting staff and relevant interdepartmental personnel on special projects focused on process efficiency. Ensures continual education requirements are met. REQUIRED QUALIFICATIONS EDUCATION: Minimum of a High School diploma required or equivalent certificate required; Bachelor's degree from four-year College or university preferred. DESIGNATION: Designated as a Claims Adjuster or Experienced Claims Adjuster per the California Code of Regulations and has completed the minimum required continuing education credits to adjust workers compensation claims for the State of California; Self-Insured certification a plus. EXPERIENCE: Minimum of three years of indemnity adjusting experience managing large and/or complex claims and accounts within a workers' compensation carrier required Maintains qualifying educational criteria to adjust workers' compensation claims for the State of California; Self-Insured certification preferred. Inquisitive, critical thinker; agile learner with adaptive, smart time management skills. To perform this job successfully, an individual should be proficient in the Microsoft Office Suite of applications (highly proficient in Excel preferred), and be proficient on applicable databases, systems and vendor software programs. WHAT WE OFFER Work-Life Balance Work From Home Program (up to 2 days per week) Reasonable caseload with in-house Medical Management support (UR, Med Bill Review, Resource Nurses); In-house Claims Assistant support Modern Office Setting Free On-Site Fitness Facility Free downtown shuttle route Two-minute walk from Walnut Creek BART Station Three-minute car ride from CA-24 and I-680 Free On-Site Garage Parking Paid Time Off Paid Holidays Retirements Savings Match Group Health Insurance (Medical, Dental, and Vision) Life and AD&D Insurance Long Term Disability Insurance Accident and Critical Illness Insurance Flexible Savings Accounts Paid Community Volunteer Day Employee Assistance Program Tuition Reimbursement Program Employee Referral Program Diversity, Equity and Inclusion Program ABOUT USWith more than 50 years in business, BHHC has grown from a regional organization to a national insurance group, offering insurance products from coast to coast. Relationships are the cornerstone of our culture, and we believe in doing the right thing. That means we invest in our business in every way possible to deliver on our mission and demonstrate that people are what powers our success. Our commitment to financial strength and integrity means our customers can rest assured that we will be there when it counts. At BHHC we embrace diversity and foster an environment where our people can be their authentic selves. Our differences make us stronger and better together, which fosters a harmonious workplace-something we truly value. We've created an approachable and collaborative atmosphere. Here you'll find a welcoming workplace where everyone can feel valued, supported, and inspired to do great work. Together, we raise the bar by being curious, remaining customer-focused, and operating with integrity.

Company Details W. R. Berkley Corporation, founded in 1967, is one of the nation's premier commercial lines property casualty insurance providers. Founded in 2004, Berkley Environmental has underwriting and account executive units in seven regions. Berkley Environmental offers an array of coverages for virtually all classes traditionally known to have environmental liability exposures on both an admitted and non-admitted basis. We provide a comprehensive portfolio of commercial property casualty insurance, automobile liability and workers' compensation, along with claim services, providing expertise to meet the unique business needs of our customers. Company URL: ********************************* The company is an equal opportunity employer. Responsibilities Senior Claims Examiner - Lost Time (California Workers' Compensation) Location: Remote or Hybrid (3 days in-office, location dependent) Key functions include but are not limited to the following: * Manage a caseload of lost time claims, ranging from minor to complex. * Ensure compliance with California Workers' Compensation laws and regulations. * Conduct thorough investigations, evaluate claims, and determine appropriate benefits. * Collaborate with internal and external stakeholders to drive timely and fair claim resolutions. * Identify and pursue subrogation opportunities where applicable. Qualifications * Minimum 10 years of experience handling California Workers' Compensation claims. * Familiarity with other WC jurisdictions is a strong plus. * In-depth knowledge of California Labor Code and Regulations. * Strong analytical, communication, and negotiation skills. * Experience with subrogation is highly desirable. Additional Company Details We do not accept any unsolicited resumes from external recruiting agencies or firms. The company offers a competitive compensation plan and robust benefits package for full time regular employees which for this role include: • Base Salary Range: $76,000 - $125,000 • Eligible to participate in annual discretionary bonus. • Benefits: Health, Dental, Vision, Life, Disability, Wellness, Paid Time Off, 401(k) and Profit-Sharing plans. 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. Sponsorship Details Sponsorship not Offered for this Role Responsibilities Senior Claims Examiner - Lost Time (California Workers' Compensation) Location: Remote or Hybrid (3 days in-office, location dependent) Key functions include but are not limited to the following: - Manage a caseload of lost time claims, ranging from minor to complex. - Ensure compliance with California Workers' Compensation laws and regulations. - Conduct thorough investigations, evaluate claims, and determine appropriate benefits. - Collaborate with internal and external stakeholders to drive timely and fair claim resolutions. - Identify and pursue subrogation opportunities where applicable.

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 2 What Is the Opportunity? This is an entry level position that requires satisfactory completion of required training to advance to Claim Professional, Outside Property. This position is intended to develop skills for investigating, evaluating, negotiating and resolving claims on losses of lesser value and complexity. Provides quality claim handling throughout the claim life cycle (customer contacts, coverage, investigation, evaluation, reserving, negotiation and resolution) including maintaining full compliance with internal and external quality standards and state specific regulations. As part of the hiring process, this position requires 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. This position is based 100% remotely and may include a combination of mobile work and/or work from your primary residence. What Will You Do? * Completes required training which includes the overall instruction, exposure, and preparation for employees to progress to the next level position. It is a mix of online, virtual, classroom, and on-the-job training. The training may require travel. * The on the job training includes practice and execution of the following core assignments: * Handles 1st party property claims of moderate severity and complexity as assigned. * Establishes accurate scope of damages for building and contents losses and utilizes as a basis for written estimates and/or computer assisted estimates. * Broad scale use of innovative technologies. * Investigates and evaluates all relevant facts to determine coverage (including but not limited to analyzing leases, contracts, by-laws and other relevant documents which may have an impact), damages, business interruption calculations and liability of first party property claims under a variety of policies. Secures recorded or written statements as appropriate. * Establishes timely and accurate claim and expense reserves. * Determines appropriate settlement amount based on independent judgment, computer assisted building and/or contents estimate, estimation of actual cash value and replacement value, contractor estimate validation, appraisals, application of applicable limits and deductibles and work product of Independent Adjusters. * Negotiates and conveys claim settlements within authority limits. * Writes denial letters, Reservation of Rights and other complex correspondence. * Properly assesses extent of damages and manages damages through proper usage of cost evaluation tools. * Meets all quality standards and expectations in accordance with the Knowledge Guides. * Maintains diary system, capturing all required data and documents claim file activities in accordance with established procedures. * Manages file inventory to ensure timely resolution of cases. * Handles files in compliance with state regulations, where applicable. * Provides excellent customer service to meet the needs of the insured, agent and all other internal and external customers/business partners. * Recognizes when to refer claims to Travelers Special Investigations Unit and/or Subrogation Unit. * Identifies and refers claims with Major Case Unit exposure to the manager. * Performs administrative functions such as expense accounts, time off reporting, etc. as required. * Provides multi-line assistance in response to workforce management needs; including but not limited to claim handling for Auto, Workers Compensation, General Liability and other areas of the business as needed. * May attend depositions, mediations, arbitrations, pre-trials, trials and all other legal proceedings, as needed. * Must secure and maintain company credit card required. * In order to perform the essential functions of this job, acquisition and maintenance of Insurance License(s) may be required to comply with state and Travelers requirements. Generally, license(s) must be obtained within three months of starting the job and obtain ongoing continuing education credits as mandated. * In order to progress to Claim Representative, a Trainee must demonstrate proficiency in the skills outlined above. Proficiency will be verified by appropriate management, according to established standards. * This position requires the individual to access and inspect all areas of a dwelling or structure which is physically demanding including walk on roofs, and enter tight spaces (such as attic staircases, entries, crawl spaces, etc.) The individual must be able to carry, set up and safely climb a ladder with a Type IA rating Extra Heavy Capacity with a working load of 300 LB/136KG, weighing approximately 38 to 49 pounds. While specific territory or day-to-day responsibilities may not require an individual to climb a ladder, the incumbent must be capable of safely climbing a ladder when deploying to a catastrophe which is a requirement of the position * Perform other duties as assigned. What Will Our Ideal Candidate Have? * Bachelor's Degree preferred or a minimum of two years of work OR customer service related experience preferred. * Demonstrated ownership attitude and customer centric response to all assigned tasks - Basic * Verbal and written communication skills -Intermediate * Attention to detail ensuring accuracy - Basic * Ability to work in a high volume, fast paced environment managing multiple priorities - Basic * Analytical Thinking - Basic * Judgment/ Decision Making - Basic * Valid passport preferred. What is a Must Have? * High School Diploma or GED and one year of customer service experience OR Bachelor's Degree required. * Valid driver's license - required. 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 *********************************************************

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.

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.

Company Details W. R. Berkley Corporation, founded in 1967, is one of the nation's premier commercial lines property casualty insurance providers. Founded in 2004, Berkley Environmental has underwriting and account executive units in seven regions. Berkley Environmental offers an array of coverages for virtually all classes traditionally known to have environmental liability exposures on both an admitted and non-admitted basis. We provide a comprehensive portfolio of commercial property casualty insurance, automobile liability and workers' compensation, along with claim services, providing expertise to meet the unique business needs of our customers. Company URL: ********************************* The company is an equal opportunity employer. Responsibilities Senior Claims Examiner - Lost Time (California Workers' Compensation) Location: Remote or Hybrid (3 days in-office, location dependent) Key functions include but are not limited to the following: Manage a caseload of lost time claims, ranging from minor to complex. Ensure compliance with California Workers' Compensation laws and regulations. Conduct thorough investigations, evaluate claims, and determine appropriate benefits. Collaborate with internal and external stakeholders to drive timely and fair claim resolutions. Identify and pursue subrogation opportunities where applicable. Qualifications Minimum 10 years of experience handling California Workers' Compensation claims. Familiarity with other WC jurisdictions is a strong plus. In-depth knowledge of California Labor Code and Regulations. Strong analytical, communication, and negotiation skills. Experience with subrogation is highly desirable. Additional Company Details We do not accept any unsolicited resumes from external recruiting agencies or firms. The company offers a competitive compensation plan and robust benefits package for full time regular employees which for this role include: • Base Salary Range: $76,000 - $125,000 • Eligible to participate in annual discretionary bonus. • Benefits: Health, Dental, Vision, Life, Disability, Wellness, Paid Time Off, 401(k) and Profit-Sharing plans. 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. Sponsorship Details Sponsorship not Offered for this Role

Workers Compensation - Sr. Work Comp Claims Adjuster) Must have a California SIP Salary/Pay: Salary is $85,000 - $95,000 requiring two (2) days in the office) Under minimal supervision manages all aspects of indemnity claims handling from inception to conclusion within established authority and guidelines. DUTIES AND RESPONSIBILITIES: Effectively manages a caseload of 130 to 150 workers' compensation files, including very complex claims. Initiates and conducts investigation in a timely manner. Determines compensability of claims and administer benefits, based upon state law and in accordance with established Company guidelines. Manages medical treatment and medical billing, authorizing as appropriate. Refers cases to outside defense counsel. Directs and manages as appropriate. Communicates with claimants, providers and vendors regarding claims issues. Computes and set reserves within Company guidelines. Limits are larger than those allowed for Claims Adjuster I and Claims Adjuster II. Settles and/or finalize all claims and obtains authority as designated. Maintains diary system for case review and documents file to reflect the status and work being performed on the file. Communicates appropriate information promptly to the client to resolve claims efficiently, including any injury trends or other safety related concerns. Adheres to all Company policies and procedures. Conducts file reviews independently. Other duties as assigned. * Essential job function. EQUIPMENT OPERATED/USED: Computer, fax machine, copier, printer, and other office equipment. QUALIFICATIONS REQUIRED: Education/Experience: Bachelor's degree in related field (preferred); five (5) or more years related experience; or equivalent combination of education and experience. Knowledge, Skills and Abilities: Technical knowledge of statutory regulations and medical terminology. Analytical skills. Excellent written and verbal communication skills, including ability to convey technical details to claimants, clients and staff. Ability to interact with persons at all levels in the business environment. Ability to independently and effectively manage very complex claims. Proficient in Word and Excel (preferred). Other Qualifications: Certifications and/or licenses as required by State regulation. Here are some of the benefits you can enjoy in this role: Medical, Dental, Vision, Disability & Life Insurance 401(k) plan Paid time off Paid holidays

Progressive is dedicated to helping employees move forward and live fully in their careers. Your journey has already begun. Apply today and take the first step to Destination: Progress. As an auto damage claims adjuster, you'll serve as Progressive's point of contact with customers - directing and making decisions regarding the repair process from beginning to end. Managing your own inventory while working independently, you'll work closely with body shops and others to negotiate repair pricing and assess liability. Ideal candidates will possess leadership and conflict management skills, along with strong attention to detail and a passion for providing excellent customer service. This is a field position with access to a company car and frequent driving within your assigned geographical area. We assess our workload collectively, which means you may cover assignments outside your geographical area. You may also be required to report into an office occasionally. Location: Candidate must within 25 miles of Hayward/Milpitas/Union City and surrounding areas Duties and responsibilities * Complete vehicle inspections, write estimates, determine total loss evaluations, and set clear expectations and timelines * Negotiate repair process with body shops * Document information related to the claim and make decisions consistent with claims standards and local laws * Evaluate and handle claim payments and resolution of claims without payments * Review and determine validity of any supplement requests Must-have qualifications * A minimum of four years of relevant work experience with one year appraisal/estimatics or insurance experience * {OR} Associate's degree and a minimum of three years relevant work experience with one year appraisal/estimatics or insurance experience * {OR} Bachelor's degree and a minimum of one year appraisal/estimatics or insurance experience * Valid driver's license, auto insurance, and compliance with Progressive's driving standards and/or policies * Compensation * You'll be paid $37.50 - $45.87/hour depending on experience * Gainshare annual cash incentive payment up to 16% of your eligible earnings based on company performance Benefits * 401(k) with dollar-for-dollar company match up to 6% * Medical, dental & vision, including free preventative care * Wellness & mental health programs * Health care flexible spending accounts, health savings accounts, & life insurance * Paid time off, including volunteer time off * Paid & unpaid sick leave where applicable, as well as short & long-term disability * Parental & family leave; military leave & pay * Diverse, inclusive & welcoming culture with Employee Resource Groups * Career development & tuition assistance Share: Apply Now

Job Description The Field Adjuster will investigate and evaluate daily property claims for clients pursuant to client and company direction. Provide timely, accurate, fair, and professional service to all clients and insured parties while maintaining a high level of production. Essential Functions: Handles all assigned claims promptly and effectively, with minimal need for direction and oversight. Inspect damaged property and determine claim related damage. Makes decisions within delegated authority as outlined in company policies and procedures. Understands insurance coverage and applies appropriate claims practices to resolve claims in alignment with company guidelines. Sets and relays adequate reserves according to carrier guidelines. Maintains current knowledge of insurance policies and carrier guidelines. Maintains current knowledge of local industry repair procedures and local market pricing. Submits severe incident reports, insured to value (ITV) reports and other information to claims management as needed. Delivers outstanding customer service experience to all internal, external, current, and prospective customers nationwide. Adheres to high standards of professional conduct while providing delivery of outstanding claim's service. Perform other duties as assigned. Job Requirements: Bachelors preferred; High School required. Must have a valid adjuster license for state residing/covering. Must have a valid driver's license to travel to insureds locations. 2-3 years of experience with property claims required. Experience preparing estimates with Symbility required. Xactimate preferred. Knowledge of insurance policies, theories, and practices. General understanding of construction concepts and principles strongly preferred. Must have the ability to climb ladders, get in attics/crawlspaces, get on roofs, kneel, bend, etc. Must complete continuing education credits where required to maintain licensing. Strong investigative, analytical, and problem-solving skills Capability to plan, organize and manage time efficiently. Ability to work within specific client guidelines concerning both service timelines and preparation of estimates.

CCMS & Associates is looking for a 1099 Field Adjuster in California, specifically the Oakland area. We are looking to add to our existing roster. The time is now to get on board with our team! We are seeking a residential or commercial field adjuster with at least 1 year of field experience. Requirements: Minimum 1 year first-party commercial and/or residential property adjusting experience Maintain own current estimating software - Xactimate preferred (Symbility experience a plus) Working computer - internet access and Microsoft Word required Must demonstrate strong time management and customer service skills Experience in preparing Statement of Loss, Proof of Loss, and denial letters California state adjusters license Must have a valid drivers license Responsibilities: Complete residential and commercial field property inspections utilizing Xactimate software Investigate claims by obtaining recorded statements from insureds, claimants, or witnesses and by interviewing fire, police, or other governmental officials as well as inspecting claimed damages Recommend claim reserves based on investigation, through well-supported reserve report Obtain and interpret official reports Review applicable coverage forms and endorsements, provide a thorough analysis of coverage and any coverage issues in a well-documented initial captioned report to the client Maintain acceptable product quality through compliance with established best practices Knowledge and Skills: In-depth knowledge of property and liability insurance coverage and industry standards Ability to prepare full-captioned reports by collecting and summarizing required information Strong verbal and written communications skills Prompt, reliable, and friendly Preferred but Not Required: College degree AIC, IICRC, HAAG or other professional designations All candidates must pass a full background check (void in states where prohibited) CCMS & Associates offers multi-line claim adjusting and third-party administration services dedicated to solving the challenges of the complex claim in the property and casualty insurance industry. We create programs that drive a successful claim life cycle while strategically managing all aspects of the complicated issues carriers and policyholders are facing. Servicing excess and surplus/domestic carriers in the United States.

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 CategoryClaimCompensation 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 - $86,800.00Target Openings2What Is the Opportunity?This is an entry level position that requires satisfactory completion of required training to advance to Claim Professional, Outside Property. This position is intended to develop skills for investigating, evaluating, negotiating and resolving claims on losses of lesser value and complexity. Provides quality claim handling throughout the claim life cycle (customer contacts, coverage, investigation, evaluation, reserving, negotiation and resolution) including maintaining full compliance with internal and external quality standards and state specific regulations. As part of the hiring process, this position requires 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. This position is based 100% remotely and may include a combination of mobile work and/or work from your primary residence.What Will You Do? Completes required training which includes the overall instruction, exposure, and preparation for employees to progress to the next level position. It is a mix of online, virtual, classroom, and on-the-job training. The training may require travel. The on the job training includes practice and execution of the following core assignments: Handles 1st party property claims of moderate severity and complexity as assigned. Establishes accurate scope of damages for building and contents losses and utilizes as a basis for written estimates and/or computer assisted estimates. Broad scale use of innovative technologies. Investigates and evaluates all relevant facts to determine coverage (including but not limited to analyzing leases, contracts, by-laws and other relevant documents which may have an impact), damages, business interruption calculations and liability of first party property claims under a variety of policies. Secures recorded or written statements as appropriate. Establishes timely and accurate claim and expense reserves. Determines appropriate settlement amount based on independent judgment, computer assisted building and/or contents estimate, estimation of actual cash value and replacement value, contractor estimate validation, appraisals, application of applicable limits and deductibles and work product of Independent Adjusters. Negotiates and conveys claim settlements within authority limits. Writes denial letters, Reservation of Rights and other complex correspondence. Properly assesses extent of damages and manages damages through proper usage of cost evaluation tools. Meets all quality standards and expectations in accordance with the Knowledge Guides. Maintains diary system, capturing all required data and documents claim file activities in accordance with established procedures. Manages file inventory to ensure timely resolution of cases. Handles files in compliance with state regulations, where applicable. Provides excellent customer service to meet the needs of the insured, agent and all other internal and external customers/business partners. Recognizes when to refer claims to Travelers Special Investigations Unit and/or Subrogation Unit. Identifies and refers claims with Major Case Unit exposure to the manager. Performs administrative functions such as expense accounts, time off reporting, etc. as required. Provides multi-line assistance in response to workforce management needs; including but not limited to claim handling for Auto, Workers Compensation, General Liability and other areas of the business as needed. May attend depositions, mediations, arbitrations, pre-trials, trials and all other legal proceedings, as needed. Must secure and maintain company credit card required. In order to perform the essential functions of this job, acquisition and maintenance of Insurance License(s) may be required to comply with state and Travelers requirements. Generally, license(s) must be obtained within three months of starting the job and obtain ongoing continuing education credits as mandated. In order to progress to Claim Representative, a Trainee must demonstrate proficiency in the skills outlined above. Proficiency will be verified by appropriate management, according to established standards. This position requires the individual to access and inspect all areas of a dwelling or structure which is physically demanding including walk on roofs, and enter tight spaces (such as attic staircases, entries, crawl spaces, etc.) The individual must be able to carry, set up and safely climb a ladder with a Type IA rating Extra Heavy Capacity with a working load of 300 LB/136KG, weighing approximately 38 to 49 pounds. While specific territory or day-to-day responsibilities may not require an individual to climb a ladder, the incumbent must be capable of safely climbing a ladder when deploying to a catastrophe which is a requirement of the position Perform other duties as assigned. What Will Our Ideal Candidate Have? Bachelor's Degree preferred or a minimum of two years of work OR customer service related experience preferred. Demonstrated ownership attitude and customer centric response to all assigned tasks - Basic Verbal and written communication skills -Intermediate Attention to detail ensuring accuracy - Basic Ability to work in a high volume, fast paced environment managing multiple priorities - Basic Analytical Thinking - Basic Judgment/ Decision Making - Basic Valid passport preferred. What is a Must Have? High School Diploma or GED and one year of customer service experience OR Bachelor's Degree required. Valid driver's license - required. 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 *********************************************************

Salary Range: $50.42 - $68.08 The Contracts and Legal Claims Specialist oversees contracts management the organization's system. and contract lifecycle, from drafting and preparation to execution; ensuring contractual accountability and duties are met by all parties involved. The role ensures effective administration of the full contract lifecycle, from drafting and review. to execution and compliance monitoring. The Contracts and Legal Claims Specialist is also responsible for coordinating claims and legal matter in collaboration with Vice President, outside legal counsel, insurance carriers and internal stakeholders. The Contracts and Legal Claims Specialist is also responsible for the following duties: Oversite and daily management Management System of the health system's Contract administrative function. Oversite and management of health system policies and numbered memorandums lifecycle with the collaboration stakeholders. on internal Subpoena intake and management for the healthcare system, ensuring timely and accurate response to subpoenas and related data requests and coordinating with legal counsel and internal departments and external vendor to manage the subpoena lifecycle Daily management of the health system's Public Record Request website and coordinate with the appropriate stake holders and legal counsel to ensure compliance with regulatory requirements for responding to requests. Supporting the Vice President and Chief Compliance & Risk Officer with management of litigation claims and other legal matter logistics. Facilitates the claims filing and adjudication process with malpractice carriers and collaborates malpractice carriers with legal counsel and to ensure timely coordination of the discovery process for litigation. Works with legal counsel to coordinate meetings, interviews depositions with and support. staff and medical staff and provides logistical In addition to performing the essential functions listed below, may also be assigned other duties as required. Washington Hospital Health System does not utilize any form of electronic chatting, such as Google chat for the purposes of interviewing candidates for employment. If you are contacted by any entity or individual attempting to engage you in this format, do not disclose any personal information and contact Washington Hospital Healthcare System.

To supervise the Medi-Cal Claims Specialists and Examiners. Ensures delivery of highest level of customer service to the community and its medical providers. Responsibilities Supervises the Medi-Cal claims specialists and examining staff. Daily supervision of the claims workflow. Supports claim examining and specialist functions. Maintains claim inventories within established goals. Interviews and participates in the selection of qualified candidates for the Medi-Cal claims specialist and examining positions. Evaluates performance and provides developmental opportunities to staff. Provides training of new staff as appropriate. Counsels performance problems or issues when needed. Reviews and signs time cards. Reviews quality control audits with staff to ensure compliance within established department guidelines, policies and procedures. Identifies errors and deficiencies; develops and implements corrective action and training plans for staff. Reviews department policies and procedures, recommends changes for more efficient operations, communicates changes and updates to staff when appropriate. Monitors and maintains pended claims within established department guidelines. Reviews and researches reasons for the lags related to pended claims. Reviews and maintains Batch Error reports within established department guidelines. Reviews Medi-Cal RAs weekly. Prepares production statistics and related reports for the Manager's/Director's review. Reviews and signs claim adjustments and high dollar claims within established guidelines. Other duties as assigned. Qualifications Education and Experience Bachelor's degree in related field preferred; minimum three (3) years supervisor experience in a claims environment; or equivalent combination of education and experience; prior Medi-Cal claims experience preferred. Special Skills, Licenses and Certifications Thorough knowledge of CPT, HCPC procedure coding, and ICD-9 diagnostic coding. Knowledge of medical terminology. Expertise in automated claims procedures and related problems resolution. Typing speed 30 wpm and proficient use of 10-key calculator preferred. Valid California driver's license and proof of current automobile insurance compliant with PHC policy are required to operate a vehicle and travel for company business. Performance Based Competencies Excellent oral and written communication skills. Excellent interpersonal skills with ability to lead and supervise staff to effectively complete assignments within established time frames and standards. Ability to effectively exercise good judgment and handle sensitive issues with frequent interruptions. Good organization skills. Work Environment And Physical Demands Must be able to work in a fast paced environment and maintain courtesy and composure when dealing with internal and external customers. More than 70% of work time is spent in front of a computer monitor. When required, ability to move, carry, or lift objects of varying sizes, weighing up to 10 lbs. All HealthPlan employees are expected to: Provide the highest possible level of service to clients; Promote teamwork and cooperative effort among employees; Maintain safe practices; and Abide by the HealthPlan's policies and procedures, as they may from time to time be updated. HIRING RANGE: $45.04 - $56.30 IMPORTANT DISCLAIMER NOTICE The job duties, elements, responsibilities, skills, functions, experience, educational factors and the requirements and conditions listed in this are representative only and not exhaustive or definitive of the tasks that an employee may be required to perform. The employer reserves the right to revise this job description at any time and to require employees to perform other tasks as circumstances or conditions of its business, competitive considerations, or work environment change.

About the Positions We're seeking Contracts and Claims Managers to support large, heavy-civil infrastructure programs-including highways, roads, bridges, transit (including rail and bus), and airport projects delivered through both traditional and alternative methods. You'll safeguard the owner's commercial interests, steer change order negotiations, and resolve claims in ways that keep budgets protected and project momentum intact. This posting is for future roles and not for a specific opportunity that is available right now. We accept applications and conduct interviews in advance of upcoming hiring needs. When a candidate is selected, their profile is activated in our talent pool for this specialty area. We notify our talent pool candidates first whenever we have a project need. This posting targets the greater San Francisco Bay Area, CA. Responsibilities may include, but are not limited to, the following: Develop and implement contract and/or commercial-management strategies across DBB, DB, CM/GC, and P3 delivery models. Lead and/or support the end-to-end change-management and claims process-from entitlement review through negotiation, settlement, or formal dispute resolution. Draft, review, and negotiate contract amendments, change orders, and service agreements in alignment with FAR, FIDIC, or state statutory frameworks. Coordinate with project controls, schedulers, estimators, and legal counsel to quantify cost-and-time impacts and maintain an auditable change and claims log. Prepare risk exposure analyses and executive briefings that connect commercial issues to contingency, schedule float, and program KPIs. Represent the owner in mediation, arbitration, or litigation; manage outside counsel and expert consultants as required. Coach project teams on contract-compliance and claims-avoidance best practices, embedding lessons learned into future procurement documents. May establish change order and claims management procedures, ensuring consistency across multiple contracts and delivery partners. Attributes Excellent written and verbal communication and interpersonal skills. You are a persuasive communicator and skilled negotiator who builds trust across technical, legal, and executive audiences. Excellent multitasking and organizational skills. Strong analytical mindset with the ability to translate schedule and cost data into actionable commercial strategies. Collaborative mindset that fosters teamwork, trust, and positive relationships and thrives in multidiscipline, owner-representative environments. Natural curiosity, problem-solving abilities, and a passion for continuous improvement. Minimum Qualifications Bachelor's degree in engineering, construction management, business, or related field, or an equivalent combination of education and experience. 10+ years of hands-on contracts, change order, or claims management experience on heavy-civil infrastructure programs. Experience with alternative delivery methods (e.g., DB, CM/GC, P3) and associated risk-allocation mechanisms. Demonstrated success administering and negotiating complex civil works contracts as an owner's representative or in a role protecting client interests. Ability to interpret design documents, schedules, cost reports, and commercial terms to build clear entitlement narratives and quantum analyses. Proficiency with industry standard project management software (e.g., Primavera P6, MS Project, etc.). Proficiency with Microsoft Office Suite/Office 365 (e.g., Outlook, Teams, Word, PowerPoint, etc.). Preferred Qualifications Advanced degree (e.g., JD, LLM, or MBA) with construction law emphasis. Active professional certifications such as CCM (CMAA), MRICS/FRICS (RICS), PMP (PMI), or CCA (AACE). Experience with large (>$500M), complex, heavy-civil infrastructure projects that include highways, roads, bridges, transit (including rail and bus), and/or airport projects. Prior success steering claims through mediation, DRB, or litigation. Experience with Microsoft Power BI, Oracle Cloud Analytics, or other dashboard KPI reporting software. Compensation Details The salary range listed for this role is $150k-$190k/year ($72-$91/hour). The final salary offered will be based on multiple factors and thoughtfully aligned with each candidate's level of experience, breadth of skills, total education achieved, certifications/licenses that have been obtained, geographic location, etc. Just LOOK at the Benefits We Offer! Unlimited flexible time off Paid holidays Paid parental leave Health, dental, and vision insurance Flexible spending accounts (healthcare and dependent or elder care) Long-term disability insurance Short-term disability insurance Life insurance and accidental death and dismemberment 401(k) plan with guaranteed employer contribution Formal career planning and development program $2,500 annually toward professional development Wellness program with monthly wellness stipend Company cell phone or cell phone plan reimbursement Free personalized meal planning and nutrition support with a registered dietitian Free personal financial planning services Employee assistance program Employee discounts Employee referral bonus Specific plan details and coverage for each benefit noted above will be provided upon offer. Luster is committed to creating an inclusive work environment with a diverse workforce. All qualified applicants will receive consideration for employment without regard to criminal history, race, color, religion, gender, gender identity or expression, sexual orientation, national origin, genetics, disability, age, or veteran status. This employer participates in E-Verify. The employer will provide the Social Security Administration (SSA) and, if necessary, the Department of Homeland Security (DHS) with information from each new employee's I-9 to confirm work authorization. All positions may be subject to a background check and drug test once a conditional offer of employment is made for any convictions directly related to its duties and responsibilities, in accordance with all applicable local, state, and/or federal regulations. This job description is meant to describe the general nature and level of work being performed; it is not intended to be construed as an exhaustive list of all responsibilities, duties and skills for the position. Luster does not accept unsolicited resumes. In the absence of a signed agreement, Luster will not consider or agree to payment of any kind. Any unsolicited resumes presented to Luster personnel, including those submitted to Luster hiring managers, are deemed to be the property of Luster. Please email ***************** for accommodations necessary to complete the application process.

By joining Sedgwick, you'll be part of something truly meaningful. It's what our 33,000 colleagues do every day for people around the world who are facing the unexpected. We invite you to grow your career with us, experience our caring culture, and enjoy work-life balance. Here, there's no limit to what you can achieve. Newsweek Recognizes Sedgwick as America's Greatest Workplaces National Top Companies Certified as a Great Place to Work Fortune Best Workplaces in Financial Services & Insurance Workers Compensation Claims Representative Trainee | West Hills, CA (In-Office) Are you looking for an impactful job requiring no prior experience that offers an opportunity to develop a professional career? + A stable and consistent work environment in an office setting. + A training program to learn how to help employees and customers from some of the world's most reputable brands. + An assigned mentor and manager who will guide you on your career journey. + Career development and promotional growth opportunities through increasing responsibilities. + A diverse and comprehensive benefits package to take care of your mental, physical, financial and professional needs. **PRIMARY PURPOSE OF THE ROLE:** To be oriented and trained as new industry professional with the ability to analyze workers compensation claims and determine benefits due. **OFFICE LOCATIONS** Onsite - West Hills, CA **ARE YOU AN IDEAL CANDIDATE?** We are seeking enthusiastic individuals for an entry-level trainee position. This role begins with a comprehensive 4-week classroom-based professional training program designed to equip you with the foundational skills needed for a successful career in claims adjusting. Over the course of a few years, you'll have the opportunity to grow and advance within the field. **ESSENTIAL RESPONSIBLITIES MAY INCLUDE** + Attendance and completion of designated classroom claims professional training program. + Performs on-the-job training activities including: + Adjusting lost-time workers compensation claims under close supervision. May be assigned medical only claims. + Adjusting low and mid-level liability and/or physical damage claims under close supervision. + Processing disability claims of minimal disability duration under close supervision. + Documenting claims files and properly coding claim activity. + Communicating claim action/processing with claimant and client. + Supporting other claims examiners and claims supervisors with larger or more complex claims as assigned. + Participates in rotational assignments to provide temporary support for office needs. **QUALIFICATIONS** Bachelor's or Associate's degree from an accredited college or university preferred. **EXPERIENCE** Prior education, experience, or knowledge of: - Customer Service - Data Entry - Medical Terminology (preferred) - Computer Recordkeeping programs (preferred) - Prior claims experience (preferred) Additional helpful experience: - State license if required (SIP, Property and Liability, Disability, etc.) - WCCA/WCCP or similar designations - For internal colleagues, completion of the Sedgwick Claims Progression Program **TAKING CARE OF YOU** + Entry-level colleagues are offered a world class training program with a comprehensive curriculum + An assigned mentor and manager that will support and guide you on your career journey + Career development and promotional growth opportunities + A diverse and comprehensive benefits offering including medical, dental vision, 401K, PTO and more **WORK ENVIRONMENT** When applicable and appropriate, consideration will be given to reasonable accommodations. **Mental** **:** Clear and conceptual thinking ability; excellent judgment and discretion; ability to handle work-related stress; ability to handle multiple priorities simultaneously; and ability to meet deadlines **Physical** **:** Computer keyboarding, travel as required **Auditory/Visual** **:** Hearing, vision and talking The statements contained in this document are intended to describe the general nature and level of work being performed by a colleague assigned to this description. They are not intended to constitute a comprehensive list of functions, duties, or local variances. Management retains the discretion to add or to change the duties of the position at any time. _As required by law, Sedgwick provides a reasonable range of compensation for roles that may be hired in jurisdictions requiring pay transparency in job postings. Actual compensation is influenced by a wide range of factors including but not limited to skill set, level of experience, and cost of specific location. For the jurisdiction noted in this job posting only, the range of starting pay for this role is $27.69/hr. A comprehensive benefits package is offered including but not limited to, medical, dental, vision, 401k and matching, PTO, disability and life insurance, employee assistance, flexible spending or health savings account, and other additional voluntary benefits._ \#claimsrepresentative #claims #LI-DA1 Qualified applicants with arrest or conviction records will be considered for employment in accordance with the Los Angeles County Fair Chance Ordinance for Employers, the City of Los Angeles' Fair Chance Initiative for Hiring Ordinance, the San Diego Fair Chance Ordinance, the San Francisco Fair Chance Ordinance, the California Fair Chance Act, and all other applicable laws. Sedgwick is an Equal Opportunity Employer and a Drug-Free Workplace. **If you're excited about this role but your experience doesn't align perfectly with every qualification in the job description, consider applying for it anyway! Sedgwick is building a diverse, equitable, and inclusive workplace and recognizes that each person possesses a unique combination of skills, knowledge, and experience. You may be just the right candidate for this or other roles.** **Sedgwick is the world's leading risk and claims administration partner, which helps clients thrive by navigating the unexpected. The company's expertise, combined with the most advanced AI-enabled technology available, sets the standard for solutions in claims administration, loss adjusting, benefits administration, and product recall. With over 33,000 colleagues and 10,000 clients across 80 countries, Sedgwick provides unmatched perspective, caring that counts, and solutions for the rapidly changing and complex risk landscape. For more, see** **sedgwick.com**

WestCoast Children's Clinic, located in Oakland, California, is a non-profit community psychology clinic that provides mental health services to Bay Area children, youth and families. Working at WestCoast Children's Clinic means being part of an organization that is client-centered, trauma-informed, collaborative, and committed to justice and equity. Position Details Title: Medi-Cal Claims Billing Specialist Classification: Full time (1.0 FTE) Non-Exempt (Hourly), 40 hours per week Location: Oakland, CA / Hybrid (In-person for first 90 days) Regular Work Schedule: Monday - Friday Compensation: * Hourly range: $26.00-$28.00 per hour The Medi-Cal Claims Billing Specialist will hold the crucial responsibility of inputting claims and corrections with precision and timeliness. Additionally, this role involves the monthly reconciliation of data between external and internal Electronic Health Record (EHR) systems. We are seeking an individual who is not only detail-oriented, but also embraces the opportunity to contribute to the seamless integration and accuracy of our healthcare data. Responsibilities: * Generate billing reports from Welligent (WestCoast's internal EHR) and input claims data into Alameda County's EHR (Smart Care) and upload services to the City and County San Francisco EHR (EPIC). * Collaborate with providers, supervisors, and county staff to complete billing process to correct claims. * Reconcile monthly claims generated from Smart Care and EPIC systems to internally generated reports. * Prepare and submit Correction Claim Reports for Alameda and San Francisco with appropriate supporting documentation. * Prepares monthly invoices for Alameda and San Francisco Medi-Cal. * Monthly preparation of HCFA forms for OHC billings. Key Qualifications: * BA/BS degree preferred * Minimum one year of experience with Microsoft Office applications - Excel and Word * At least one year of experience with Google Suite * Professional experience in an office setting * At least one year of experience with Medi-Cal billing procedures and processes is preferred. Competencies (Skills, Abilities, and Knowledge): * Ability to work independently and collaboratively as part of a team * Strong ability to prioritize projects with competing deadlines * Knowledge of issues of race, class, and ethnicity and experience working with diverse communities * Solid understanding of processing Medi-Cal services and claims * Experienced and knowledgeable with EHR systems; preferred experience with Smart Care, EPIC and/or Welligent EHR systems * Excellent interpersonal, communication, and writing skills * Knowledge of MS Office Suite including Excel, PowerPoint, Google Calendar, and Google Mail on a Mac OS platform Benefits: * Employer-paid Medical Benefits for Employees * 100% employer-paid dental and vision * Dependent medical, dental and vision (50% employer-paid) * Medical and Dependent Care FSA and commuter plans * 100% employer-paid life insurance long-term disability insurance * Voluntary accident, term life and hospital indemnity insurance * Annual incentive compensation (10% per year) * 403(b) and ROTH retirement plan options, employer contribution targeted at 7.5% after first year of employment * Three weeks PTO during the first year of employment, 4+ weeks PTO with additional years of service * 12 paid holidays plus one paid floating holiday per year * 4 paid self-care days per year * Wellness stipend ($100.00 per month) * Employee Assistance Program (EAP) Join us and make a difference in the lives of vulnerable children and families in the Bay Area. WCC is passionate about leading and encouraging open conversations around race, gender, power, and privilege and how these impact community mental health. We are an equal opportunity employer. We are committed to diminishing the influence of privilege and discrimination in our field and our workplace, whether due to differences concerning age, citizenship, color, disability, marital or parental status, race, religion, gender, or sexual orientation.