Claims adjuster jobs in Fontana, CA

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

We're always looking for diverse, talented, service-oriented people to join our exceptional team. Loan Adjuster II The pay range for this position is listed below. Our pay ranges are built to allow for candidates with various levels of skill and experience to be considered, as well as for room for growth and tenure achieved in a role over time. Typical new hire salary offers fall within the minimum to midpoint of a pay range for many candidates. Any offer extended to a candidate will be based upon their unique set of knowledge, skills, education, and experience as well as internal equity. Pay Range: $22.00 - $31.90 Scheduled Weekly Hours: 40 What You'll Be Doing Collects on loans of all stages of delinquency made by the Credit Union where timely payments are not being received. Communicates with Members using advanced skills to identify the true cause of non-payment and provides a personalized options to each Member. * Works on all delinquency stages through inbound/out-bound calling, letters, and other approved methods, collects past due payments and/or negotiates payment arrangements or repayment plans to resolve delinquent loans or negative shares by identifying reason for delinquency and offering appropriate options to Members. * Documents all conversations and collections activity in collection systems. May be responsible for funding of workout loans or working collections reports, such as the available money letter report. * Maintains adherence to all federal and state regulations and credit union policies. * Performs file maintenance of delinquent accounts to reflect agreed upon collection activities. Processes adjustments to Member loans as needed, including but not limited to, due date changes, opening/closing lines of credit, closing negative accounts, and payment plan maintenance. * Recommends Members with delinquent accounts for work out loans, deferments, reages, reduced payments, repossession and charge-off. Refers complex situations to the appropriate resources to ensure timely resolution. * May provide suggestions for streamlining departmental and credit union operations. When assigned helps to complete projects and reports related to the department. * May perform more advanced research and analysis on accounts, may skip trace and perform asset searches. Additional Job Functions * Performs other duties as assigned * Complies with regulatory compliance and assigned training requirements including but not limited to BSA regulations corresponding to their specific job duties. Failure to do so may result in disciplinary and other employment related actions Qualifications * High School Diploma or GED required * 3-5 years of previous related experience required * Previous financial institution or credit union experience preferred Knowledge, Skills, and Abilities * Knowledge of bankruptcy laws, FDCPA, TCPA and SCRA * Excellent verbal and written skills. * Uses active listening skills to determine the Member's hardship and provides appropriate solution. * Ability to multi-task * Intermediate computer and typing skills * Experience with inbound/outbound phone system preferred * Conflict resolution and negotiation skills SchoolsFirst FCU is committed to Diverse, Equitable, and Inclusive Hiring At SchoolsFirst FCU we are dedicated to building and growing a diverse, inclusive, and authentic Dream Team, so if you're excited about a position or wanting to make a career change but your past experience doesn't align perfectly with every qualification in the job description, we encourage you to apply anyway. Many skills are transferrable and you may be just the right candidate for the position, or for other roles we are working on. SchoolsFirst Federal Credit Union is committed to fostering, cultivating, and preserving a culture of diversity and inclusion. SchoolsFirst FCU is an equal opportunity employer and prohibits discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities and prohibits discrimination against all individuals based on their race, color, religion, sex, national origin, age, sexual orientation, gender identity or expression, political affiliation, or genetic information. This organization participates in E-Verify.

**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** $67,000.00 - $110,600.00 **Target Openings** 1 **What Is the Opportunity?** This role is eligible for a sign-on bonus! LOCATION REQUIREMENT: This position services Insureds/Agents in Riverside County. The selected candidate must reside in or be willing to relocate at their own expense to the assigned territory. Ideal locations include Riverside, Redlands, Jurupa Valley, Moreno Valley, Beaumont, Grand Terrace, Colton, Bloomington, Rialto, and surrounding areas. Under moderate supervision, this position is responsible for the handling of first party property claims including: investigating, evaluating, estimating and negotiating to ensure optimal claim resolution for personal or business claims of moderate severity and complexity. Handles claims and other functional work involving one or more lines of business other than property (i.e. auto, workers compensation, premium audit, underwriting) may be required. 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. 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?** + Handles 1st party property claims of moderate severity and complexity as assigned. + Completes field inspection of losses including accurate scope of damages, photographs, written estimates and/or computer assisted estimates. + Broad scale use of innovative technologies. + Investigates and evaluates all relevant facts to determine coverage, damages and liability of first-party property damage claims (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 with multiple constituents, i.e.; contractors or insured's representatives 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 provides mentoring and coaching to less experienced claim professionals. + May attend depositions, mediations, arbitrations, pre-trials, trials and all other legal proceedings, as needed. + CAT Duty ~ This position will require participation in our Catastrophe Response Program, which could include deployment away for a minimum of 16 days (includes 2 travel days) to assist our customers in other states. + 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. + On a rotational basis, engage in resolution desk technical work and resolution desk follow up call work. + This position requires the individual to access and inspect all areas of a dwelling or structure, which is physically demanding requiring the ability to carry, set up and climb a ladder weighing approximately 38 to 49 pounds, walk on roofs, and enter tight spaces (such as attic staircases and entries, crawl spaces, etc.). 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?** + Bachelors Degree preferred. + General knowledge of estimating system Xactimate preferred. + Customer Service experience - preferred + Interpersonal and customer service skills - Advanced + Organizational and time management skills- Advanced + Ability to work independently - Intermediate + Judgment, analytical and decision making skills - Intermediate + Negotiation skills - Intermediate + Written, verbal and interpersonal communication skills including the ability to convey and receive information effectively -Intermediate + Investigative skills - Intermediate + Ability to analyze and determine coverage - Intermediate + Analyze, and evaluate damages -Intermediate + Resolve claims within settlement authority - Intermediate + Valid passport preferred. **What is a Must Have?** + High School Diploma or GED required. + A minimum of one year previous outside property claim handling experience or successful completion of Travelers Outside Claim Representative training program 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 ******************************************************** .

Workers' Compensation Claim Representative II Schedule: Monday-Friday, 8:00 AM-4:30 PM PST Salary Range: $70,000-$80,000 annually (dependent on experience) Build Your Career With Purpose at CCMSI At CCMSI, we partner with global clients to solve their most complex risk management challenges, delivering measurable results through advanced technology, collaborative problem-solving, and an unwavering commitment to their success. We don't just process claims-we support people. As the largest privately-owned Third Party Administrator (TPA), CCMSI delivers customized claim solutions that help our clients protect their employees, assets, and reputations. We are a certified Great Place to Work , and our employee-owners are empowered to grow, collaborate, and make meaningful contributions every day. Job Summary We are seeking a Workers' Compensation Claim Representative II to manage California workers' compensation claims from intake through resolution for a PEO/Staffing account. This role may be remote or hybrid, reporting to our Irvine, CA branch. This position is designed for an experienced adjuster who can independently manage claims, apply sound judgment, and deliver consistent results within California's complex regulatory environment. You'll handle more complex claim scenarios, contribute to claim strategy, and partner closely with supervisors, clients, and vendors to drive quality outcomes. Responsibilities When we hire adjusters at CCMSI, we look for professionals who understand that every claim represents a real person's livelihood, take ownership of outcomes, and see challenges as opportunities to solve problems with purpose and care. Independently investigate, evaluate, and resolve California workers' compensation claims in compliance with CCMSI standards and client handling instructions Manage claims cradle-to-grave, including compensability, medical management, litigation coordination, and resolution strategy Review medical, legal, and miscellaneous invoices for accuracy, reasonableness, and claim-relatedness; negotiate disputed bills Establish, monitor, and adjust reserves in accordance with authority levels and best practices Authorize and issue claim payments within assigned settlement authority Negotiate settlements with injured workers and attorneys in accordance with client authorization Coordinate with and assist in the selection and oversight of defense counsel Identify and pursue subrogation opportunities Prepare and maintain accurate claim documentation, reports, payments, and reserve summaries Ensure compliance with service commitments, jurisdictional requirements, and excess reporting obligations Deliver consistent, high-quality claim service aligned with CCMSI's corporate standards Qualifications What You'll Bring 5-10 years of workers' compensation claims experience, with demonstrated success handling California claims Proven ability to manage claims independently from intake through resolution Strong working knowledge of the California workers' compensation claims process Excellent communication, organization, and time-management skills Ability to prioritize work, meet deadlines, and manage a full caseload with minimal supervision Reliable, predictable attendance within established client service hours Preferred SIP designation or ability to obtain within a defined timeframe Associate degree or higher Experience supporting PEO and/or staffing accounts Proficiency with Microsoft Word, Excel, Outlook, and claims systems Bilingual (Spanish) proficiency - highly valued for communicating with claimants, employers, or vendors, but not required. Why You'll Love Working Here 4 weeks PTO + 10 paid holidays in your first year Comprehensive benefits: Medical, Dental, Vision, Life, and Disability Insurance Retirement plans: 401(k) and Employee Stock Ownership Plan (ESOP) Career growth: Internal training and advancement opportunities Culture: A supportive, team-based work environment How We Measure Success At CCMSI, great adjusters stand out through ownership, accuracy, and impact. We measure success by: • Quality claim handling - thorough investigations, strong documentation, well-supported decisions • Compliance & audit performance - adherence to jurisdictional and client standards • Timeliness & accuracy - purposeful file movement and dependable execution • Client partnership - proactive communication and strong follow-through • Professional judgment - owning outcomes and solving problems with integrity • Cultural alignment - believing every claim represents a real person and acting accordingly This is where we shine, and we hire adjusters who want to shine with us Compensation & Compliance The posted salary reflects CCMSI's good-faith estimate in accordance with applicable pay transparency laws. Actual compensation will be based on qualifications, experience, geographic location, and internal equity. This role may also qualify for bonuses or additional forms of pay. Visa Sponsorship: CCMSI does not provide visa sponsorship for this position. ADA Accommodations: CCMSI is committed to providing reasonable accommodations throughout the application and hiring process. Equal Opportunity Employer: CCMSI complies with all applicable employment laws, including pay transparency and fair chance hiring regulations. Our Core Values At CCMSI, we believe in doing what's right-for our clients, our coworkers, and ourselves. We look for team members who: Lead with transparency We build trust by being open and listening intently in every interaction. Perform with integrity We choose the right path, even when it is hard. Chase excellence We set the bar high and measure our success. What gets measured gets done. Own the outcome Every employee is an owner, treating every claim, every decision, and every result as our own. Win together Our greatest victories come when our clients succeed. We don't just work together-we grow together. If that sounds like your kind of workplace, we'd love to meet you. #NowHiring #WorkersCompensation #WCClaims #WCClaimRepII #ClaimsAdjuster #CaliforniaWorkersComp #CAClaims #CAAdjusters #InsuranceCareers #ClaimsCareers #TPACareers #PEOClaims #StaffingClaims #HybridWork #RemoteJobs #CaliforniaJobs #EmployeeOwned #GreatPlaceToWorkCertified #CareerWithPurpose #CCMSICareers #LI-Hybrid #LI-Remote

The Department of Risk Management is recruiting for a Medical Only Claims Adjuster who examines and adjusts "medical only" workers' compensation claims. Duties include, but are not limited to, the following: perform initial review of claim to determine the complexity of the claim and identify issues; determine the employee's status and if the illness or injury is compensable; advise employee of entitlement to workers' compensation benefits under State law and County policy; calculate and track salary continuation benefits; arrange and coordinate medical treatments; monitor and coordinate temporary modified duties with departments, etc. For more detailed information, please refer to the Medical Only Claims Adjuster job description. This excellent opportunity for career growth also offers a lucrative compensation and benefits package! To review job-specific benefits, refer to: * Benefits by Occupational Unit (BbOU) Summary * Employee Benefits * County Memoranda of Understanding (MOU) A hybrid telework schedule may be offered upon satisfactory work performance. The department may also offer a 9/80 schedule, where incumbents enjoy a nine-day biweekly schedule. CONDITIONS OF EMPLOYMENT Pre-Employment Process: Prior to appointment, applicants must successfully pass a background check, including fingerprinting, verification of employment history, and physical exam/drug test. Travel: Travel throughout the county may be required. Employees will be required to make provision for transportation. Mileage reimbursement may be available. Sponsorship: San Bernardino County is not able to consider candidates who will require visa sponsorship at the time of application or in the future. Certification: A valid California Self Insurance Administrator Certificate is required and must be obtained within twelve (12) months of hire or be terminated.Experience: Eighteen (18) months of full-time equivalent experience working as a workers' compensation claims assistant or medical only claims adjuster, calculating worker's compensation benefits, scheduling medical appointments, preparing benefit notices, authorizing payment for medical treatment, processing claims, and other related duties. Note: Workers' compensation claims experience must be clearly demonstrated in the work experience section of the application. Substitution: Six (6) months of the required experience may be substituted with one (1) of the following options: * Successful completion of one (1) course taken toward the Insurance Education Association (WCCA) certificate (or comparable coursework involving State of California workers' compensation laws) * Twelve (12) semester units or eighteen (18) quarter units of completed college coursework from an accredited institution in finance, accounting, biology, paralegal studies, or closely related If substituting coursework for experience, transcripts must be attached to the application. The ideal candidate will have extensive experience working in a public sector worker's compensation claims management environment. Examination Procedure: There will be a competitive evaluation of qualifications based on the information provided in the Application and Supplemental Questionnaire. You are encouraged to include detailed descriptions of your qualifying experience and skills, as only the most highly qualified applicants will be referred to the department. Do not refer to a resume; it will not be reviewed. Application Procedure: To be considered for this excellent opportunity, please complete and submit the online employment application and supplemental questionnaire by 5:00pm, Friday, December 26, 2025. To ensure timely and successful submission of your online application, please allow ample time to complete and submit your application before the posted filing deadline. Applicants will be automatically logged out if they have not submitted the application and all required materials prior to the posted deadline. Once your application has been successfully submitted, you will receive an onscreen confirmation and an email. We recommend that you save and/or print these for your records. Please note, if you do not receive an onscreen confirmation and an email acknowledging our receipt of your application, we have not received your application. All communications regarding the selection process will be via e-mail. Applicants are encouraged to check their e-mail frequently to learn additional information regarding this recruitment. Check your Government Jobs account for notifications. Update your firewalls to allow e-mails from San Bernardino County through governmentjobs.com. Update your Spam, Junk, and Bulk settings to ensure it will not spam/block/filter communications from e-mail addresses with the following domain "@hr.sbcounty.gov". Finally, be sure to keep your personal information updated. Taking these steps now will help ensure you receive all communications regarding this recruitment. If you require technical assistance, please follow the link to review the Government Jobs online application guide or contact their Toll-Free Applicant Support line at **************. Please note that Human Resources is not responsible for any issues or delays caused by the internet connection, computer or browser used to submit the application. EEO/ADA: San Bernardino County is an Equal Employment Opportunity (EEO) and Americans with Disabilities Act (ADA) compliant employer, committed to providing equal employment opportunity to all employees and applicants. ADA Accommodation: If you have a disability and require accommodations in the testing process, submit the Special Testing Accommodations Request Form within one week of a recruitment filing deadline. Veterans' Preference: Eligible veterans and their spouses or widows/widowers who are not current County employees may receive additional Veterans' Preference points. For details and instructions on how to request these points, please refer to the Veterans' Preference Policy. Review important Applicant Information and the County Employment Process for more information

Job Brief: Aspire General Insurance is seeking a detail-oriented and customer-focused Claims Adjuster to join our team. The Claims Adjuster will be responsible for investigating, evaluating, and settling insurance claims to ensure a fair and timely resolution for our policyholders. Responsibilities: Review and analyze insurance policies to determine coverage Investigate claims by interviewing claimants, witnesses, and medical experts Evaluate evidence, reports, and medical records to determine the extent of liability Negotiate settlements with claimants or their legal representatives Communicate with policyholders, agents, and other relevant parties throughout the claims process Maintain accurate and detailed claim files Skills Required: Bachelor's degree in Business, Finance, or related field 2+ years of experience in claims adjusting or related field Strong analytical and problem-solving skills Excellent communication and negotiation abilities Knowledge of insurance regulations and policies Proficiency in Microsoft Office and claims processing software If you are a motivated individual with a passion for helping others and a keen eye for detail, we encourage you to apply for the Claims Adjuster position at Aspire General Insurance.

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 Glendale 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.” Powered by JazzHR AKmjGapFDO

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.

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.

Healthcare Talent is assisting our client in hiring a Supervisor, Claims (CQI) for their Claims Department. The Claims Supervisor oversees the day-to-day operations of the Quality Analyst (QA) staff in the Continuous Quality Improvement (CQI) Unit of the Claims Department. This position is responsible for ensuring adherence to regulatory and internal guidelines in conjunction with company policies and procedures as they apply to claims processing and adjudication. Our client has a unique business philosophy; their goal is to provide employees with a place to excel - while really creating something meaningful in their work. This philosophy has helped them grow into an award-winning company. Employees are provided with room for advancement, competitive compensation, and an excellent benefit package. Job Description Position Responsibilities • Train, audit and supervise all QA staff to ensure adherence to the Medi-Cal and Medicare processing guidelines. Identify any new learning opportunities for staff (i.e. new desktops). • Monitor staff to ensure department turn-around times for claims auditing are met. Ninety five percent (95% of all claims must be paid or denied within 30 calendar days and 100% within 60 days from date of receipt to date of financial run. • Must serve as a back up to claims processing when needed to ensure the department turn-around times are met and maintain inventory within 21 days on hand. • Responsible for prompt communication with staff. Must schedule monthly unit meetings to go over any changes to programs or training issues; schedule monthly one-on-one meetings with staff to go over their monthly progress regarding their success factors (production, quality, etc). • Plan work for staff, assign daily claims and determine priorities of work done by staff. • Set or recommend work performance standards. • Review work procedures and recommend or change procedures to be more time/cost efficient. • Assist with interviewing job applicants and make recommendations for hire as needed. • Train, evaluate, and provide performance feedback to staff. • Conduct employee counseling/corrective interviews with the assistance of Human Resources. • Conduct claims presentations as assigned. • Other projects and duties as assigned. Qualifications Required Skills • Diffuse emotional situations with employees and/or provider representatives. • Interact with peers face-to-face, over the phone and in writing in a manner that is professional and productive. • Influence others using a positive approach. • Provide clear, concise instruction to individuals of varying skill levels. • Troubleshoot problem areas. • Encourage and utilize suggestions and new ideas. • Manage and keep track of multiple tasks. • Remain objective when dealing with emotional topics or when having to give feedback to staff. • Establish and maintain effective working relationships with all levels of staff, other programs, agencies, and the general public. • Effectively utilize computer and appropriate software and interact as needed with company claims processing systems. • Speak and write clearly and concisely. • Encourage the professional performance and development of subordinate staff. • Plan, organize and prioritize work. Required Experience Experience & Education • High school diploma or equivalent is required; some college preferred. • 3+ years of experience in a managed care environment that would have developed the knowledge and abilities listed. • Substantial practical knowledge and understanding of relevant business practices and applicable regulations/policies. • Previous experience in directing the work of others (i.e. training, responding to questions, etc.) and supervisory experience are preferred. • Demonstrated ability to work closely and often with others. Knowledge of: • Principles and techniques of effective supervision. • Technical area(s) of medical claims administration, including medical terminology, CPT, ICD-9 codes and HCPCS codes. • Medi-Cal and Medicare program guidelines. • Benefit interpretation and administration. • Department reports, their purpose and how to interpret them. • Department procedures, policies and expectations. • Fundamental principles of writing and grammar, including proper report and correspondence format, correct spelling and proper word usage, grammar, punctuation, and sentence structure. • Personal computers, keyboarding, and appropriate software to produce correspondence, charts, spreadsheets, and/or other information applicable to the position assignment. Additional Information If you feel that you have the skills we require, please respond to this posting with your contact information and your resume in a Word document. We look forward to hearing from you today! ************************ *********************************

Crum & Forster (C&F), with a proud history dating to 1822, provides specialty and standard commercial lines insurance products through our admitted and surplus lines insurance companies. C&F enjoys a financial strength rating of "A+" (Superior) by AM Best and is proud of our superior customer service platform. Our claims and risk engineering services are recognized as among the best in the industry. Our most valuable asset is our people: more than 2000 employees in locations throughout the United States. The company is increasingly winning recognition as a great place to work, earning several workplace and wellness awards, including the 2024 Great Place to Work Award for our employee-first focus and our steadfast commitment to diversity, equity and Inclusion. C&F is part of Fairfax Financial Holdings, a global, billion dollar organization. For more information about Crum & Forster, please visit our website: ************** Job Description Examines claims data and conducts investigations into routine and moderately complex claims to determine coverage, compensability, subrogation and benefits under moderate supervisory direction. Adjusts and manages claims within the limit of assigned authority. Experience with California Workers Compensation jurisdiction is required for this role. High preference for candidates in the West Coast. What you will do for C&F: Must be well versed in California Compensation statute claims. Receives lost time and complex medical only assignments. Verifies and determines applicability of coverage. Initiates 24-hour contact with employer, employee and 48-hour contact with attending physician. Handles catastrophic claims with supervisory oversight. Conducts telephone investigations as required by company claims handling manual and procedures. Evaluates and adjusts claims within the limits of authority. Consults with Claim Manager on those claims where assistance and consultation is needed. Makes assignments to nurse case management when indicated, monitoring their billing and performance. Sets reserves for anticipated exposure up to authority limits. Completes mandatory Reserve Worksheets. Establishes reserves requiring complex analysis with lifetime pharmacy and cost inflation. Coordinates return to work (RTW) and sets target dates. Maintain diaries on maximum three (3) month intervals. Documents files in the claims system. Reviews medical bills for causal relationship, medical bill charges for appropriateness and approves payments. Adheres to special account handling (SHI) instructions. Attends account meetings by telephone and in-person. Manages litigation on the files. What you will bring to C&F: College degree, B.A. or equivalent experience. 3+ years of experience handling workers compensation claims required, 5+ years preferred. Strong organizational skills. Good time management skills. Foreign language communications a plus. Excellent verbal and written communication skills are essential. Strong aptitude and knowledge of Microsoft Office programs and the ability to quickly learn new programs. Will abide by departmental policies and procedures, including authority levels, to comply with C&F's risk management controls. What C&F will bring to you Competitive compensation package Generous 401K employer match Employee Stock Purchase plan with employer matching Generous Paid Time Off Excellent benefits that go beyond health, dental & vision. Our programs are focused on your whole family's wellness, including your physical, mental and financial wellbeing A core C&F tenet is owning your career development, so we provide a wealth of ways for you to keep learning, including tuition reimbursement, industry-related certifications and professional training to keep you progressing on your chosen path A dynamic, ambitious, fun and exciting work environment We believe you do well by doing good and want to encourage a spirit of social and community responsibility, matching donation program, volunteer opportunities, and an employee-driven corporate giving program that lets you participate and support your community At C&F you will BELONG If you require special accommodations, please let us know. We value inclusivity and diversity. We are committed to equal employment opportunity and welcome everyone regardless of race, color, ancestry, religion, sex, national origin, sexual orientation, age, citizenship, marital status, disability, gender identity, or Veteran status. If you require special accommodations, please let us know For California Residents Only: Information collected and processed as part of your career profile and any job applications you choose to submit are subject to our privacy notices and policies, visit **************************************************************** for more information. Crum & Forster is committed to ensuring a workplace free from discriminatory pay disparities and complying with applicable pay equity laws. Salary ranges are available for all positions at this location, taking into account roles with a comparable level of responsibility and impact in the relevant labor market and these salary ranges are regularly reviewed and adjusted in accordance with prevailing market conditions. The annualized base pay for the advertised position, located in the specified area, ranges from a minimum of $55,800.00 to a maximum of $104,900.00. The actual compensation is determined by various factors, including but not limited to the market pay for the jobs at each level, the responsibilities and skills required for each job, and the employee's contribution (performance) in that role. To be considered within market range, a salary is at or above the minimum of the range. You may also have the opportunity to participate in discretionary equity (stock) based compensation and/or performance-based variable pay programs. #LI-AV1 #LI-Remote

Eastern Municipal Water District is seeking a highly motivated individual to fill one vacancy in our Safety, Risk & Emergency Management Department for the position of Safety & Claims Technician. If you meet the qualifications outlined below, and you are interested in joining a dynamic business environment working with a stellar team of professionals, we encourage you to apply for this excellent opportunity. CLOSING DATE & TIME: January 6, 2026 after 4:00PM Pacific Time SALARY: Range 215: $44.47 - $55.39 Hourly; $7,708.13 - $9,600.93 Monthly* *Effective December 28, 2025 The ideal candidate will have the following knowledge, skills, and abilities: Claims and Risk - knowledge and experience handling workers' compensation claims, tort liability claims, and the insurance industry are critical elements of this position. Safety - experience writing safety policies and procedures, interpreting safety regulations, application of best and leading safety practices, and meeting the requirements to train, coach, and develop. The selected candidate will need to be proficient in Microsoft office suite including Word, Excel, and PowerPoint. GENERAL PURPOSE Under general supervision, coordinates the District's Worker's Compensation and injury management processes, including light duty and return to work evaluations; supports the administration of the District's safety and general liability claims programs; interprets District policy and administrative regulations; coordinates all safety, risk, and emergency management training; and performs related work as assigned. DISTINGUISHING CHARACTERISTICS This fully qualified journey-level classification performs the full range of technical and administrative assignments in support of programs within the Safety, Risk, and Emergency Management Department by working independently, and exercising judgment and initiative. Positions at this level receive only occasional instruction or assistance as new or unusual situations arise and are fully aware of the operating procedures and policies of the work unit. SUPERVISION RECEIVED AND EXCERCISED Receives general supervision from assigned management and supervisory personnel. Exercises no direct supervision over staff. PLEASE NOTE: In-person, pre-employment interview and/or testing is part of the selection process for this position. BENEFITS: For an overview of EMWD's excellent benefits package please click on the following link: EMWD Benefits Summary To learn more about working at EMWD, view our Join EMWD video by clicking here. EMWD's mission is to deliver value to our diverse customers and the communities we serve by providing safe, reliable, economical and environmentally sustainable services. EMWD is a leader in sustainability efforts that provide long-term benefits to the environment and establishes EMWD as an industry front-runner in adapting to climate change. We have invested in solar energy programs that provide significant environmental benefits, are modernizing our fleet vehicles to be further reliant on clean energy and have a long-term strategic priority to further reduce our carbon footprint while reducing financial impacts to customers. Required Skills Knowledge of: Policies, procedures, practices, and methods related to workers' compensation and liability claim processing and administration. Principles, practices, operations, services, and activities of safety, occupational health, and emergency response programs. Federal, state, and local laws, codes, and regulations in assigned areas of responsibility. Methods and techniques of preparing training materials and conducting training sessions. Methods and techniques of conducting ergonomic evaluations. District personnel rules, policies, and labor contract provisions. Record keeping principles and procedures. District and mandated safety rules, regulations, and protocols. Techniques for providing a high level of customer service by effectively dealing with the public, vendors, contractors, and District staff. The structure and content of the English language, including the meaning and spelling of words, rules of composition, and grammar. Modern equipment and communication tools used for business functions and program, project, and task coordination, including computers and software programs relevant to work performed. Ability to: Review and administer workers' compensation and insurance claim documents for completeness and accuracy. Conduct safety trainings and orientation sessions. Serve as liaison between workers compensation administrators, medical professionals, and District staff. Prepare clear and concise reports, correspondence, policies, procedures, and other written materials. Maintain confidentiality of sensitive personal information of employees, former employees, and other matters affecting District employee relations. Understand, interpret, and apply all pertinent laws, codes, regulations, policies, and procedures, and standards relevant to work performed. Independently organize work, set priorities, meet critical deadlines, and follow-up on assignments. Use tact, initiative, prudence, and independent judgment within general policy, procedural, and legal guidelines. Understand, follow, and apply written and oral instructions. Effectively use computer systems, software applications relevant to work performed, and modern business equipment to perform a variety of work tasks. Communicate clearly and concisely, both orally and in writing, using appropriate English grammar and syntax. Establish, maintain, and foster positive and effective working relationships with those contacted in the course of work.

Alacrity Solutions Independent Contractor Daily Property Field Adjuster Alacrity Solutions is a full end-to-end provider delivering streamlined insurance claims, repair, and recovery solutions. As one of the largest independent providers of insurance claims services in North America, we provide property, auto, heavy equipment, and casualty claims management services. Our staffing capabilities, temporary housing services, managed repair network, and subrogation services support a fully integrated solution for all your needs from first notice of loss through completion of repairs. By assembling the best service providers through strategic acquisitions and relying on the right talent, Alacrity Solutions provides consistent, professional, and scalable services throughout the entire claim handling and resolution process. To learn more, visit ************************** The objective of a Daily Property Field Adjuster is to provide excellent claim handling services for our clients regarding daily claim work within your area which can include multiple perils. Contract Requirements Include: A contract will be issued within 24 hours of accepting your first claim assignment with Alacrity. This IA contract will include pay details and other pertinent information regarding your work as an independent contract with Alacrity. A completed contract is required to issue pay. Skills & Requirements/Licensure: MUST live within 50-100 miles of posted location and willing to travel to location. Minimum 2-3 years property field adjusting experience. Independent adjusting license in your home state (area of work), or a designated home state license if residing in a non-licensing state. Experienced in wind, hail, theft, fire, water losses and other perils preferred. Have reliable transportation, computer, digital camera, ladder, and other miscellaneous items necessary to perform adjuster responsibilities. Willing and able to climb roofs. Computer and Phone System Requirements: Smart Cell Phone able to access to internet. Xactimate and/or Symbility proficient with current subscription Working Laptop computer with reliable high-speed internet Digital camera and other miscellaneous items necessary to perform adjuster responsibilities. Working Conditions / Physical & Mental Demands: The physical demands described here are representative and must be met by the independent contractor to successfully perform this job. 100% travel is required within designated working territory based on the location of assignments received. Normal office or field claims environment. Ability to operate a motor vehicle for up to 8 hours daily, repeatedly entering and exiting the vehicle. Must be able to make physical inspections of auto loss sites. Must be able to work outdoors in all types of weather. Available to work catastrophic loss events. A willingness to work irregular hours and to travel with possible overnight requirements a plus. Why Choose Alacrity? Flexibility: Self-determined Scheduling Diversity Statement Alacrity is an equal opportunity employer and is committed to providing employees with a work environment free of discrimination and harassment. All decisions pertaining to an employee's employment are made without regard to race, color, religion, sex (including sexual orientation, pregnancy, childbirth), gender, gender identity or expression, age, national origin, ancestry, physical or mental disability, medical condition, reproductive health decisions, veteran's status, genetic information, creed, marital status, disability, citizenship status, or any other characteristic protected by applicable law. How Long We Retain Personal Information: We will keep your personal information for as long as necessary to fulfill legitimate business purposes and in accordance with applicable laws.

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

ATTENTION MILITARY AFFILIATED JOB SEEKERS - Our organization works with partner companies to source qualified talent for their open roles. The following position is available to Veterans, Transitioning Military, National Guard and Reserve Members, Military Spouses, Wounded Warriors, and their Caregivers . If you have the required skill set, education requirements, and experience, please click the submit button and follow the next steps. 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. 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 $67,000.00 - $110,600.00 What Is the Opportunity? This role is eligible for a sign-on bonus. Be the Hero in Someone's Story When life throws curveballs - storms, accidents, unexpected challenges - YOU become the beacon of hope that guides our customers back to stability. At Travelers, our Claims Organization isn't just a department; it's the beating heart of our promise to be there when our customers need us most. As a Claim Rep, you will be responsible for managing, evaluating, and processing claims in a timely and accurate manner. In this detail-oriented and customer focused role, you will work closely with insureds to ensure claims are resolved efficiently while maintaining a high level of professionalism, empathy, and service throughout the claims handling process What Will You Do? Provide quality claim handling of auto claims including customer contacts, coverage, investigation, evaluation, reserving, negotiation, and resolution in accordance with company policies, compliance, and state specific regulations. Communicate with policyholders, claimants, providers, and other stakeholders to gather information and provide updates. Determine claim eligibility, coverage, liability, and settlement amounts. Ensure accurate and complete documentation of claim files and transactions. Identify and escalate potential fraud or complex claims for further investigation. Coordinate with internal teams such as investigators, legal, and customer service, as needed Additional Qualifications/Responsibilities What Will Our Ideal Candidate Have? Bachelor's Degree. Three years of experience in insurance claims, preferably auto claims. Experience with claims management and software systems. Strong understanding of insurance principles, terminology with the ability to understand and articulate policies. Strong analytical and problem-solving skills. Proven ability to handle complex claims and negotiate settlements. Exceptional customer service skills and a commitment to providing a positive experience for insureds and claimants What is a Must Have? High School Degree or GED with a minimum of one year bodily injury liability claim handling experience or successful completion of Travelers Claim Representative training program is 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.

The Claims Analyst is responsible for analyzing and adjudicating medical claims. Performs payment reconciliations and/or adjustments related to retroactive contract rate and fee schedule changes. Resolve claims payment issues as presented through Provider Dispute Resolution (PDR) process or CSIM (Customer Service Inquiry Module). Identifies root causes of claims payment errors and reports to Management. Responds to provider inquiries/calls related to claims payments. Generates and develop reports which include but not limited to root causes of PDRs and CSIMs. Collaborates with other departments and/or providers in successful resolution of claims related issues. QUALIFICATIONS: •Minimum 1-2 years financial analyses/accounting experience and 2-5 years medical claims examining experience, or a combination/equivalent of the two •2 or more years experience in managed care organization a plus •Minimum typing speed of 45 WPM and use of Ten-Key by touch •Knowledge of ICD9-CM, HCPCS level II and III, CPT, and revenue Codes, DRG and APC coding a plus •Knowledge of different payment methodologies such as Medi-Cal, RBRVS, DRG and other Medicare reimbursements a plus •Ability to write analytical reports and comprehensive summaries •Advanced proficiency in Microsoft Word and Excel; Access knowledge a plus •Must be detail oriented •Ability to effectively communicate with internal and external associates •Ability to deal with complex claim issues •Knowledge of DMHC, DHS, CMS, Title XX II CRC, Title 42, and Medi-Cal and Medicare processing guidelines a plus •Ability to work in a fast pace environment with minimal supervision •Ability to handle multiple projects and is able to prioritize workflow ESSENTIAL DUTIES AND RESPONSIBILITIES TO INCLUDE BUT NOT LIMITED TO: •Conducts claims payment analyses to identify root cause of claims issues/deficiencies. •Adjudicates medical claims according to regulatory and Care1st Health Plan processing guidelines and contractual agreements: ◦Verifies patient account, eligibility, benefits and authorizations. ◦Prioritizes assigned claims according to regulatory timelines. ◦Requests additional information for incomplete or unclean claims; follows up with provider as necessary. ◦Contacts providers on claims related issues as necessary. •Notifies Claims Management immediately when claims or other projects cannot be completed within the processing timelines. •Performs payment reviews and adjustments due to retroactive effective date of contracts and/or fee schedule changes: ◦Runs claims report to adjudicate adjustments due to retroactive effective date of contract or fee schedule changes. •Responds to provider inquiries/calls related to claims payments. •Resolve claims payment issues as presented through Provider Dispute Resolution (PDR) process, CSIM (Customer Service Inquiry Module) and/or provider calls. •Generates and develop reports which include but not limited to root causes of PDRs and CSIMs •Maintains productivity and quality standards as defined by Management. •Communicates with other departments (such as Provider Data Maintenance, Provider Network Operations, and Utilization Management) to resolve provider claims related issues. •Contacts providers either telephonically or in writing for additional information to resolve or clarify submitted claims issues. •Handles misdirected claims inquiries: ◦Corresponds with IPAs/Medical Groups regarding misdirected claims. ◦Reviews Division of Financial Responsibility (DOFR) to ensure proper routing of claims. ◦Notifies Management and/or Provider Network Operations (PNO) Department of any issues related to misdirected claims routing. •Complies with company's attendance and punctuality standards. •Promotes teamwork and cooperation with other staff members and management. •Performs additional related duties as assigned by Additional Information All your information will be kept confidential according to EEO guidelines.

Company Cox Automotive - USA Job Family Group Vehicle Operations Job Profile Arbitrator I Management Level Individual Contributor Flexible Work Option No remote option; must work at a specified Cox location Travel % No Work Shift Day Compensation Hourly base pay rate is $19.38 - $29.09/hour. The hourly base rate may vary within the anticipated range based on factors such as the ultimate location of the position and the selected candidate's knowledge, skills, and abilities. Position may be eligible for additional compensation that may include commission (annual, monthly, etc.) and/or an incentive program. Job Description At Manheim (a Cox Automotive company), we strive to make sure every customer is completely satisfied when they do business with us. On the off-chance we fall short, we do our best to make things right, pronto. That's where you come in. We're looking for an Arbitrator I to learn the ropes of resolving customer complaints and ensuring we don't make the same mistake again. Do you have the skills we're looking for? Keep reading for more details! Benefits * We all have lives and responsibilities outside of work. We have an exceptional work/life balance at Cox, with accommodating work schedules and flexible time-off policies. * We show our appreciation for our talent with a competitive salary package and top-notch bonus & incentive plans. * How does a great healthcare benefits package from day one sound? Multiple options are available for individuals and families. One employee-only plan could be FREE, if you participate in our health screening program. * 10 days of free child or senior care through your complimentary Care.com membership. * Generous 401(k) retirement plans with up to 6% company match. * Employee discounts on hundreds of items, from cars to computers to continuing education. * Looking to grow your family? You'll have access to our inclusive parental leave policies, plus comprehensive fertility coverage and adoption assistance. * Want to volunteer in your community? We encourage that, and even offer paid hours for you to do so. * We all love our pets-whether they walk, crawl, fly, swim or slither-and we're happy to supply insurance for them as well. At Cox, we believe in being transparent - please click on this link (Cox Benefits Overview) to learn more about our amazing benefits. What You'll Do From your very first day on the job, you'll receive guidance and coaching so you can learn the ropes. You'll work with everyone from buyers to sellers to dealers in coordinating and validating customer returns and claims. With Guidance, responsibilities include: * Reviews customer claims to verify that they meet Manheim's National Arbitration policies and any account-specific guidelines. * Investigates basic, less complex cases (e.g., late title claims, basic condition report claims, vehicle availability, post-sale inspection fails, mechanical/structural/undisclosed vehicle damage, etc.) or those requiring more prescriptive decision-making. * Interfaces with all departments involved in the complaint (i.e., reconditioning, front office, dealer services, vehicle entry, etc.), including during the fact finding and investigative phases. * Uses appropriate resources to investigate and facilitate relevant inspection, documentation, and communication to ensure appropriate actions are completed to move cases forward or to resolution. * Uses appropriate levels/limits of financial approval authority to resolve cases. * Evaluate claims by obtaining, comparing, evaluating, and validating various forms of information. * Prepares and facilitates communication for resolution via telephone, email, and in-person discussion. * Mediates disputes and negotiates repair and/or pricing of disputed vehicles to arrive at a mutually acceptable solution and to keep vehicles sold. * Monitors and maintains accurate files for each arbitration case, verifying the accuracy of all required documentation, including invoices and settlement agreements. * Engages with supervisor/manager to determine if escalation is required. * Performs other duties as assigned. Who You Are You've got a knack for negotiation. You're ethical, dependable, and trustworthy. You're eager to learn. You also have the following qualifications: Minimum * A high school diploma or GED and less than 2 years of related experience. * Accuracy and attention to detail. * Organizational and time management skills. * The ability to adapt in a fluid and changing environment. Preferred * 1+ years of automotive or body shop experience. * Claims adjuster experience. Cox is a great place to be, wouldn't you agree? Apply today! Drug Testing To be employed in this role, you'll need to clear a pre-employment drug test. Cox Automotive does not currently administer a pre-employment drug test for marijuana for this position. However, we are a drug-free workplace, so the possession, use or being under the influence of drugs illegal under federal or state law during work hours, on company property and/or in company vehicles is prohibited. Benefits Employees are eligible to receive a minimum of sixteen hours of paid time off every month and seven paid holidays throughout the calendar year. Employees are also eligible for additional paid time off in the form of bereavement leave, time off to vote, jury duty leave, volunteer time off, military leave, and parental leave. About Us Through groundbreaking technology and a commitment to stellar experiences for drivers and dealers alike, Cox Automotive employees are transforming the way the world buys, owns, sells - or simply uses - cars. Cox Automotive employees get to work on iconic consumer brands like Autotrader and Kelley Blue Book and industry-leading dealer-facing companies like vAuto and Manheim, all while enjoying the people-centered atmosphere that is central to our life at Cox. Benefits of working at Cox may include health care insurance (medical, dental, vision), retirement planning (401(k)), and paid days off (sick leave, parental leave, flexible vacation/wellness days, and/or PTO). For more details on what benefits you may be offered, visit our benefits page. Cox is an Equal Employment Opportunity employer - All qualified applicants/employees will receive consideration for employment without regard to that individual's age, race, color, religion or creed, national origin or ancestry, sex (including pregnancy), sexual orientation, gender, gender identity, physical or mental disability, veteran status, genetic information, ethnicity, citizenship, or any other characteristic protected by law. Cox provides reasonable accommodations when requested by a qualified applicant or employee with disability, unless such accommodations would cause an undue hardship. Applicants must currently be authorized to work in the United States for any employer without current or future sponsorship.

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

Description:Claims Specialist - Job Description Jurupa Valley, CA - Onsite Who We Are Mountain Valley Express (MVE) is a leading LTL Carrier and 3PL Services provider with locations across California, Arizona, and Nevada. With years of experience, a dedicated team, and cutting-edge technology, MVE offers a broad range of services, including less-than-truckload (LTL), full truckload, custom invoicing and auditing, optimization, warehousing and distribution, engineering solutions, and packaging and shipping supplies. Our deep understanding of the market, along with strong carrier partnerships, allows us to deliver highly tailored services that meet the unique needs of our customers. Benefits · Comprehensive medical, dental, and vision insurance. · 401(k) plan with company match. · Company-paid Life and AD&D Insurance policies. · Paid vacation, sick leave, and holidays. The Opportunity We are seeking a Claims Specialist to join our team. In this role, you will be responsible for managing the end-to-end freight claims process, including receipt, investigation, documentation, and resolution. This position is integral to maintaining MVE's reputation for accuracy, transparency, and customer service excellence. You will work closely with the Operations, Customer Service, and Accounting teams to ensure claims are resolved efficiently and in compliance with company policies and federal regulations. Essential Duties and Responsibilities • Claims Management: Receive, review, and process freight loss and damage claims in accordance with company policies and industry regulations. • Investigation and Documentation: Collect all supporting documentation, including photos, inspection reports, and terminal or driver statements, to thoroughly evaluate each claim. • Communication and Resolution: Maintain clear and professional communication with customers, internal departments, and third parties throughout the claims process. • Reporting and Analysis: Track claim data, analyze trends, and identify areas for process improvement or risk mitigation. • Compliance and Recordkeeping: Ensure all claims are handled in compliance with applicable laws and carrier liability rules while maintaining accurate digital records within the TMS system. • Collaboration: Partner with operations and leadership teams to recommend corrective actions that prevent recurring claim issues. Skills & Attributes • Strong analytical and investigative skills with excellent attention to detail. • Exceptional written and verbal communication skills. • Ability to manage multiple priorities in a fast-paced environment. • Proficiency in Microsoft Office Suite (Excel, Word, Outlook); experience with TMS or claims software preferred. • Knowledge of LTL operations, NMFC classifications, and cargo liability principles is highly desirable. • Strong organizational and problem-solving abilities with a customer service mindset. Requirements:Minimum Requirements · Education: High school diploma or equivalent required; Associate's or Bachelor's degree in Business, Logistics, or a related field preferred. · Experience: Minimum of 2 years of experience in freight claims, transportation, logistics, or a related administrative role. Compensation · Compensation: $20.00 - $24.00 per hour, based on experience and location. · Classification: Non-Exempt, subject to all applicable state and federal laws. Work Environment This is a full-time, at-will position with typical work hours scheduled from Monday to Friday, 8:00 a.m. to 5:00 p.m. Physical Requirements: · Prolonged periods of sitting at a desk and working on a computer · Frequent walking throughout the facility and between departments as part of daily operational tasks · Ability to lift and/or move up to 20-25 pounds. · Ability to navigate each department and the company's facilities as needed. Equal Opportunity Employer Mountain Valley Express is an at-will and equal opportunity employer. We are committed to employing and assigning the best-qualified candidates without discrimination based on race, color, religion, gender, marital status, age, national origin, physical or mental disability, sexual orientation, veteran/reserve and National Guard status, or any other status or characteristic protected by law.