Claims representative jobs in Mission Viejo, CA

Work directly with regional Claims Managers to supervise employees in the assigned claims office. This includes assisting with recruiting, hiring and management of required staff. Supervise, evaluate, train, discipline and support staff. Ensure that supervised staff follows policies and procedures to ensure company compliance with regulatory standards, company policies and procedures, and best practices. Assist the manager in the day to day operations of the assigned office. Must be able to handle multiple jurisdictions with strong California experience or knowledge. RESPONSIBILITIES: Monitor the production and measure the performance of claims staff for full compliance with procedure manual and adopted best practices. Assign new claims and when necessary transfer existing claims to appropriate adjusters based on expertise of adjuster. Assist claims manager with training in claims related topics. Address claims related concerns and issues directly with the claims manager. Complete regular claim reviews for each assigned employee and address any concerns that may be identified, including but not limited to: timely determinations, accurate calculations of wages and benefits, statutory and regulatory compliance, reserve adequacy, subrogation, claim investigations, surveillance, litigation management, subsequent injury fund, reinsurance/excess insurance reporting and assist adjusters in addressing all topics. Assist in the development and implementation of work performance standards for claims adjusters. Ensure claims adjusters are responding to telephone calls, e-mails and correspondence timely and effectively. Complete annual performance evaluations of each assigned adjuster in accord with adopted procedures and best practices. Work directly with clients, brokers, agents, and employers in the explanation of claims related services for policy holders. When required, work directly with state regulators to address claims questions, complaints, and audits to ensure full compliance with applicable laws, regulations and directives from the regulator(s). Timely address concerns with injured workers, medical providers and employers. Other related assignments as assigned. Eligible for remote or hybrid work arrangement. QUALIFICATIONS: High school diploma or GED required Bachelor's degree or equivalent experience preferred Minimum of 5 years claims management experience. Insurance industry knowledge required Excellent technical skills associated with claims management Strong organizational skills Strong oral and written communication skills

Job Title: Claims Analyst Duration: 12 + Months Contract Job Location: Chino, CA, 91710 (Onsite) Pay Rate: $23-25/hr on W2 Ensures that complaints are resolved effectively and without delay and that those not resolved at the entity organization level have been escalated and taken into account in the competent entities. Drive Customer Centricity - for the entity. What do you get to do in this position? - Ensure that complaints are resolved effectively and without delay and those not resolved have been escalated to the appropriate entity - Collaborate with other organizations in order to contain, correct, and prevent problems affecting customers - Utilize I2P tools to process claims on a timely basis - Ensure that Complaint process is supported with warm loop - Share critical customer feedback information with management and all employees at all levels of meetings and on information boards - Work in collaboration with continuous improvement engineer - Update Logistics dashboard Key Responsibilities: - Act as the Customer Experience advocate. - Drive Customer Centricity in entities. - Ensure the Customer Experience is measured according to the Business priorities. - Define and follow-up the improvement action plan and priorities with the Business stakeholders. - Ensure that Customer dissatisfactions are solved quickly and effectively through containment, correction and prevention steps. Qualifications: We know skills and competencies show up in many ways and can be based on your life experience. If you do not necessarily meet all the requirements that are listed, we still encourage you to apply for the position. This job might be for you if: - Excellent verbal and written communication skills, listen effectively and solicit input from others. - Excellent organizational skills including the ability to handle multiple demands and assignments, the ability to prioritize tasks effectively and efficiently, and drive issues/ tasks to closure - Candidate must be a self-starter, highly motivated, and results driven. - Strong problem-solving skills and experience with root cause analysis and implementation of corrective action for process related concerns. - Proficiency with MS Office suite of products, especially Power point and Excel. - Ability to work effectively in a group setting as well as independently.

About Us: Astiva Health, Inc., located in Orange, CA is a premier healthcare provider specializing in Medicare and HMO services. With a focus on delivering comprehensive care tailored to the needs of our diverse community, we prioritize accessibility, affordability, and quality in all aspects of our services. Join us in our mission to transform healthcare delivery and make a meaningful difference in the lives of our members. SUMMARY: Under the direction of the Vice President of Claims, this position is responsible for manual input and adjudication of claims submitted to the health plan. The ideal candidate will need to interpret and utilize capitation contracts, payor matrixes, subscriber benefit plan, and provider contracts; as well as resolving customer service inquiries, status calls, andclaim tracers. ESSENTIAL DUTIES AND RESPONSIBILITIES include the following: • Data enter paper claims into EZCAP. • Review and interpret provider contracts to properly adjudicate claims. • Review and interpret Division of Financial Responsibility (DOFR) for claims processing. • Perform delegated duties in a timely and efficient manner. • Verify eligibility and benefits as necessary to properly apply co-pays. • Understands eligibility, enrollment, and authorization process. • Knowledge of prompt payment guidelines for clean and unclean claims • Process claims efficiently and maintains acceptable quality of at least 95% on reviewed claims. • Meets daily production standards set for the department. • Prepares claims for medical review and signature review per processing guidelines. • Identify the correctly received date on claims, with knowledge of all time frames for meeting compliance for all lines of business. Maintains good working knowledge of system/internet and online tools used to process claims • Good knowledge of CPT/HCPCS/ICD-10, and Revenue Codes, including modifiers. • Assist customer service as needed to assist in claims resolution on calls from providers. • Research authorizations and properly selects appropriate authorization for services billed. • Coordinate with the claims clerks on issues related to the submission and forwarding of claims determined to be financial responsibility of another organization. • Coordinate Benefits on claims for which member has another primary coverage • Run monthly reports. • Review pre and post check run. • Regular and consistent attendance • Other duties as assigned QUALIFICATION REQUIREMENTS: To perform this job successfully, an individual must be able to perform each essential duty satisfactorily, including regular and consistent attendance. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. EDUCATION and/or EXPERIENCE: • High School Diploma or GED required. • 1 to 3 years of previous experience in a health plan, IPA or medical group. • Strong understanding of the benefit process including member services or customer service. • Demonstrated proficiency in MS Office (Excel, Word, Outlook, and PowerPoint). • Able to navigate difficult situations with empathy, discretion, and professionalism. • Strong understanding of Senior Medicare Advantage Health plans. • Able to explain member benefits, answer questions and concerns using a “Customer Service First” attitude. • Able to live our mission, vision, and values, • Bilingual in another language (written and oral) preferred.

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.

DETAILS Claims Supervisor Department: Workers' Compensation Reports To: Division Claims Manager FLSA Status: Exempt Job Grade: 14 Career Ladder: Next step in progression could include Division Claims Manager 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 Claims Supervisor to support our Southern California Workers Compensation department. Management that lives less than 36 miles from the Orange, CA office AND have a direct report in the office, are required to work once a week in the office. The remaining days can be worked remotely if technical requirements are met, and the employee resides in Southern California. Athens offices are open for business Monday-Friday from 7:30 a.m. to 5:30 p.m. Employee work a 37.5-hour work week with the ability to work a flex schedule with every third Monday or Friday off. As a Claims Supervisor, you'll play a pivotal role in leading and collaborating with Athens management to achieve exciting company goals, run insightful reports, and streamline processes. You'll make impactful daily claims decisions, review files for accuracy, and approve payments that exceed examiner authority. Additionally, you'll ensure top-notch file handling, accurate claims coding, and meet unit closing goals. You'll be the guiding force for your team, planning, organizing, delegating workloads, supervising daily activities, providing training, and offering valuable guidance. In client management, you'll address policy and claims issues, build and maintain strong relationships, attend key meetings, ensure compliance with client instructions, and document interactions, always acting in the client's best interest. Join us and make a difference every day! 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: Claims Leadership Work with Athens management to achieve company initiatives and performance goals Consistently strive to improve and streamline current processes Authorize release of payment and settlement Make daily claims decisions regarding plan of action, handling of payment, etc. Review claim files for accuracy Run various reports with an eye for accuracy and confidentiality Approve payments and reserve increases when they rise above Examiner's authority level Work collaboratively with internal and clients' senior management as well as with attorneys to draft settlements and assist with litigation strategies Provide timely information to clients, attorneys, doctors, investigators and injured workers with strong, professional communication Discuss appropriateness of medical treatment with medical case manager Assure consistent and accurate claims coding is occurring on the team Ensure quality file handling and resolution. This includes meeting unit closing goals, verifying proper reserves, providing thorough claims analysis and guiding to correct resolution Use flexibility when working in demanding and changing situations Employee Management Effectively plan, organize and delegate workload for optimal results and to ensure time commitments are met Supervise daily activities of the team by monitoring progress, ensuring compliance with policies, and promptly addressing any issues or conflicts Identify, coordinate, coach, and perform training with staff to improve performance and increase their growth and knowledge in claims Participate in the interview process, onboarding and training of new hires Provide general guidance to the team by offering support and advice on work-related issues, fostering a positive work environment, encouraging professional development, and reviewing performance through evaluations, feedback, goal setting, and identifying areas for improvement Provide direct feedback and use sound coaching techniques to solve disciplinary or workflow problems. Manage and document employee relations issues at all levels. Work in conjunction with Human Resources to ensure performance issues are managed in a timely and consistent manner Regularly lead organized and collaborative staff unit meetings, including both remote and on-site employees Maintain an open-door policy and an approachable attitude, and foster open communication with staff Client Management Work with clients with issues regarding policies, programs and/or claims Manage existing client relationships by being accessible, making regular service calls, and proactively identifying and solving potential problems Attend client meetings, internal meetings, and workers' compensation meetings both virtual and in-person Ensure notepads and diaries are set and completed timely in accordance with client handling instructions and Athens Best Practices and have meaningful action plans and information and are concise and well-written Obtain audit results meets or exceeds best practice standards of Athens and client Display integrity and always acts in the best interest of the client Document client meeting notes in appropriate shared location Supervisory Responsibilities Supervising, scheduling, assigning, monitoring, and evaluating work of assigned staff are responsibilities for supervisory positions. Provide direct supervision for 6-10 employees, typically consisting of Senior Claims Examiners, Future Medical Claims Examiners, Claims Examiners, Assistant Claims Examiners and Assistant Claims Examiner Trainees. Attend on-site Leadership Summit at Athens Concord headquarters every 18 months (including overnight) Fiscal Responsibilities Review and approve direct report's monthly expense reports Ensure that all expenditures are in the best interest of the Company Use effective monitoring and reporting mechanisms to control expenses without lowering quality Search for and implement hidden cost improvements Obtain, maintain, and demonstrate an understanding of wage and hour laws as applicable for employees Ensure timely, accurate review and approval of timecards for your staff on payroll processing days. 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 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) Administrators Certificate from Self-Insurance Plans. If not already obtained, the Administrators Certificate from Self-Insurance Plans will be required within one year of employment Completion of IEA or equivalent courses Solid and in-depth knowledge of workers' compensation laws, policies, and procedures 3+ years' recent workers compensation claims handling experience at a high level 5+ years' experience in a Workers' Comp claims lead or supervisor position preferred At least 2 years Claims Supervisory experience required Proficiency in determining case value and negotiating settlements Prior Third-Party Administrator (TPA) experience preferred Understanding of medical and legal terminology Strong attention to detail and organizational skills and the ability to research and resolve problems and meet multiple deadlines and to plan and effectuate short- and long-range Company and department objectives. Proficiency at applying business and technical acumen by understanding how the business works and how technology supports business initiatives. Leverages technology for self and staff to improve efficiency. Partnering with team to ensure on time task completion; done through delegation and leading by example, executing tasks rather than just instructing them to execute tasks Handles stressful situations and deadline pressures well Must demonstrate accuracy and thoroughness in work product Effectively influences people to achieve unit and organizational objectives Must be flexible, adaptable, and positive. Exhibit passion and energy to ensure that all employees are respected and treated in a manner consistent with Athens Values. Able to plan, prioritize and organize claims workload for a unit Skilled at presenting in small and large group settings Ability to create reports as required, using the report writing tools available or creating custom documents. Skilled at developing and maintaining effective relationships with others (co-workers, customers, vendors, management, and other key stakeholders) to achieve organizational goals Embrace the leadership role and can be counted on to help senior management drive towards the desired results and to exceed goals successfully. Able to interpret information from multiple sources and draw logical conclusions; consults others based on analysis of data; able to think strategically and use data findings to consult others for improved business results. Negotiating skills Mathematical calculating skills Exercise independent judgment and analytic ability in solving complex and sensitive problems Highly developed verbal and written communication skills with strong attention to detail Computer processing skills, including the ability to leverage technology for self and staff to improve efficiency Proficient in Microsoft Office Suite Ability to type quickly, accurately and for prolonged periods Ability to learn additional computer programs ClaimsXpress program experience preferred but not required 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 Athens' operations involve handling confidential, proprietary, and highly sensitive information, such as health records, client financials, and other personal data. Therefore, maintaining honesty and integrity is essential for all roles within the company. Valid Driver's license and availability for travel including in office file reviews and meetings 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. The Company will consider qualified applicants with arrest or conviction records in accordance with the Los Angeles Fair Chance Ordinance for Employers and the California Fair Chance Act. Applicants can learn more about the Los Angeles County Fair Chance Act, including their rights, by clicking on the following link: ************************************************************************************************* 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. We offer a variety of benefit plans including Medical, Vision, Dental, Life and AD&D, Long Term Care, Critical Care, Accidental, Hospital Indemnity, HSA & FSA options, 401k (and Roth), Company-Paid STD & LTD and more! Further information about our comprehensive benefits package may be found on our website at https://*******************/careers/why-work-here

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. 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 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. 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 *********************************************************

About Monster 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: In the thrilling role of Customer Operations Representative, you'll be at the heart of dynamic operations, orchestrating the complete order lifecycle for finished goods with precision and agility in SAP. As the vital link between our valued customers, vibrant sales force, strategic supply chain, and logistics teams, you'll drive exceptional service and operational excellence, ensuring seamless and timely delivery that keeps the energy flowing at Monster Energy! The impact you'll make: * Order Lifecycle Management in SAP: Enter, validate, and maintain customer orders in SAP. Ensure pricing, quantities, and delivery dates are accurate. * Cross-Functional Coordination: Collaborate with Sales, Supply Chain, and Logistics to resolve order issues. Communicate proactively on delays or changes. * Customer Communication and Issue Resolution: Provide timely updates to customers on order status. Investigate and resolve discrepancies or complaints. * Reporting: Prepare reports for internal stakeholders. * Continuous Improvement and Process Support: Participate in projects to improve order management processes. Who you are: * Prefer a Bachelor's Degree in the field of Communications, Supply Chain, or related field of study. * Additional Experience Desired: Between 1-3 years of experience in Customer Service. * Additional Experience Desired: Between 1-3 years of experience in Supply Chain Operations. * Computer Skills Desired: Proficient in Microsoft Office Suite. SAP experience preferred. Monster Energy provides competitive total compensation. This position has an annual estimated hourly rate of $17.00 - $23.00. The actual pay may vary depending on your skills, qualifications, experience, and work location.

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.

Job Description Property Damage Claims Specialist Elite Sourcing is seeking an experienced Property Damage Claim Specialist to join a well-known Law Firm in Costa Mesa, CA. You will be responsible for investigating and evaluating property damage claims arising from automobile accidents, working closely with the demands team and clients to ensure fair compensation for damages. Responsibilities: Investigate property damage claims involving auto accidents, including reviewing police reports, witness statements, and damage assessments Evaluate claims and determine fair and reasonable settlements, considering policy coverage, damages, and other relevant factors Maintain accurate and detailed records of claims, investigations, and settlements Communicate effectively with customers, agents, and other stakeholders throughout the claims process Stay up-to-date with industry developments, regulations, and best practices to ensure compliance and minimize risk Collaborate with other adjusters, supervisors, and support staff to resolve complex claims and ensure efficient claims handling Requirements: 1+ years of experience as an auto claims adjuster or in CA personal injury law (preferred) Bilingual in Spanish (preferred) Strong understanding of CA insurance laws and regulations Ability to work in large teams and be computer savvy. Experienced with Microsoft Office Suite Excellent time management, communication, organizational, and analytical skills Experienced working in a paperless environment. Must be able to type at least 40 wpm Pay/Benefits: $50K-$70K DOE Medical, Dental, Vision 401K PTO

Company Cox Automotive - USA Job Family Group Vehicle Operations Job Profile Arbitrator I Management Level Individual Contributor Flexible Work Option No remote option; must work at a specified Cox location Travel % No Work Shift Day Compensation Hourly base pay rate is $19.38 - $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.

Job Description Job Details: Seeking a Claims Specialist for our Orange County office. This role involves handling technical and administrative responsibilities related to managing assigned claim files and taking on a larger caseload of highly complex claims. The Senior Claims Specialist also plays an active role in the ongoing training and oversight of Claims Specialist I and II team members. Responsibilities: Manage medical malpractice claims, including the assignment, direction, and control of defense counsel, under supervision and in compliance with the Claims Technical Manual, the Defense Attorney Guidelines, and the MPT Agreement. Manage increasingly complex cases with larger financial exposure. Investigate and evaluate claim files, including complying with the standards of performance, interviewing members, reviewing medical records, corresponding with plaintiff attorneys, obtaining preliminary expert evaluation/opinions, and preparing interview summaries. Prepare case evaluation reports for publication and presentation to the CRC and CSC. Prepare case evaluation reports for discretionary authority on selected cases. Manage and participate in all litigation activity, including discovery plan, mediation, MSC, and negotiation under supervision, as necessary. Monitor arbitrations, including daily progress reports to the member and defense attorney with support. Prepare claim file resolution documentation. Timely update of the claims database. Document all important case developments under the chronology tab. Code the claims file and update as relevant information is available. Timely review and index documents to the On Base system. Education and/or Experience: Bachelor's degree from a four-year college or university. Relevant legal and/or medical education background or the equivalent. 5 years of medical malpractice claims management experience or 3 years of claims experience

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

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.

Every person deserves compassion, dignity, and the safety of a place to call home.” Homelessness is the largest social and public health crisis in California. Illumination health + home is a growing non-profit organization dedicated towards disrupting the cycle of homelessness by providing targeted, interdisciplinary services in our recuperative care centers, emergency shelters, housing services and children's and family programs. IF currently has 13+ facilities with 22+ micro-communities scattered across Orange County, Los Angeles County and the Inland Empire. Job Description The role of a Billing Claims Specialist involves overseeing the billing process for customers or patients, processing payments, maintaining financial records, and ensuring accurate billing and claims submissions. In addition, the Claims specialist is also responsible for keeping account receivables for CalAIM current, claim follow-up and escalation, and must have knowledge of billing codes and standard procedures. The pay rate for this role is $25-$27 per hour. The schedule for this role is a hybrid schedule with Monday/Thursday in office and Tuesday/Wednesday/Friday WFH. Responsibilities: CalAIM Billing and Follow up Reviewing data and creating Claims for services rendered Ensure claims meet the standards of our contracts and programs. Verifying authorizations via provider portals or authorization letters on Kipu prior to claim submission. Verifying eligibility prior to claim submission via provider or DHCS portals Review client records to extract applicable data necessary for billing purposes, including but limited to ICD 10 Diagnosis codes, CPT codes for services rendered etc. Review and follow up on outstanding account receivables Review any rejected or denied claims and conduct proper follow up procedures (Escalations/Appeals/Claim corrections) Monitor and maintain county aging and escalating trends, write offs, etc. Have knowledge in understanding, reading EOB's and Remittance Advice Posting payment accurately to claims and continuing with the claim close out process Assist supervisors in any projects related to billing that may come up Attend monthly team meetings or trainings at Corporate location Expectations: Communicate with tact and professionalism Be able to meet targets and work under pressure with a high volume of claims Maintain knowledge of industry standard CMS guidelines for Billing Must be motivated to work independently as well as in a group setting. Minimum Qualifications/Preferred Experience: High School Diploma or equivalent. 1-2 years' relevant experience. Basic computer skills, including the ability to send and receive emails and summarize data in spreadsheets. Prior experience work in Electronic Billing Platforms and EHR systems Prior experience working with claims and communication with health networks Proficiency in Microsoft (Mail, Word, Excel, Calendar). Associate's degree or higher Medical Billing Certificate Experience in Medical Billing and Primary Care Billing Benefits Medical Insurance funded up to 91% by Illumination Health + Home (Kaiser and Blue Shield), depending on the plan Dental and Vision Insurance Life, AD&D and LTD Insurance funded 100% by Illumination Health + Home Employee Assistance Program Professional Development Reimbursement 401K with Company Matching 10 days vacation PTO/year 6 days of sick pay/year Potential eligibility for the Public Service Loan Forgiveness Program (PSFL) for federally qualified loans

Role and Responsibilities will identify, prevent, and mitigate potential penalties as well as assistant the claims department: Input date entry on all new claims Provide indemnity payment and cycles. Identify, prevent, and mitigate potential case penalties. Deliver 3-point contact ( Medical Only &/ or Indemnity files) to verify the mechanics of the injury, compensability, and discharge. - Calculate and pay mileage benefits. Verify lost time and waiting periods. Perform maintenance of current legal claims Identify issues requiring conversion to Indemnity to include supporting documentation. Input basic notes relating to claim, status and treatment. Process medical/legal bills daily to avoid penalty and interest. Return phone calls on a timely manner. Input status letters, delay letters, or any other required initial letters. Comply to subpoenas Interaction with nurse on case management regarding return to work status. New hires protocol Background checks Coordinating PPE supplies request. Assist safety team on identifying injury trends. Performs other related duties as assigned

Schedule: Full-time | Monday-Friday, 8:00 a.m. - 5:00 p.m. Compensation: Starting $25.00/hour plus quarterly incentives About Us At TCI, we're committed to delivering outstanding logistics solutions with integrity, teamwork, and innovation. We're seeking a detail-oriented and motivated Claims Specialist to join our team. This is a great opportunity to work in a fast-paced environment where your organizational skills and problem-solving abilities will make a real impact. Position Overview: The Claims Specialist is responsible for investigating, evaluating, and resolving claims involving auto, bodily injury, property damage, freight, and subrogation. This role requires direct interaction with claimants, insurance carriers, attorneys, vendors, and internal stakeholders to ensure claims are handled efficiently, fairly, and in compliance with company policies. The claims specialist plays a key role in controlling costs while delivering responsive, customer-focused claims service. What You'll Do Investigate and evaluate claims by reviewing incident reports, inspecting damages, interviewing involved parties, and gathering supporting documentation. Determine liability and damages by assessing coverage, establishing responsibility, and calculating fair settlements for auto, property, bodily injury, and freight claims. Negotiate and resolve claims with claimants, attorneys, and carriers to reach fair and timely settlements. Communicate with stakeholders, including insurance carriers, internal departments, and external partners, throughout the claims process. Manage claim files by documenting all activities, maintaining detailed notes, and ensuring compliance with company requirements. Work with the team to approve repairs, determine fair market value, and manage asset salvage, disposal, or sale decisions. Respond to inquiries from claimants, vendors, and internal teams, providing updates and follow-up information. Prepare reports on claim activity, outcomes, and trends for management review. Support continuous improvement by identifying opportunities to improve claims handling processes and outcomes. What We're Looking For Strong administrative, organizational, and customer service skills. Excellent written and verbal communication. Ability to thrive in a fast-paced environment with accuracy and attention to detail. A team-oriented, flexible, and solution-driven mindset. High level of confidentiality and professional ethics. Preferred Skills & Experience Proficiency in Microsoft Excel, Word, Teams, Adobe, DocuSign, and Outlook Prior experience in transportation, logistics, or insurance claims adjusting Familiarity with freight and subrogation claim processes Why Join Us? Be part of a dedicated, supportive team in a growing company. Contribute directly to resolving claims and improving processes. Work in a culture that values innovation, accountability, and teamwork. Compensation: Starting at $25/Hourly plus quarterly incentives About Us: We are a family-owned company doing business since 1978. We are dedicated and committed to safety, each other, and our customers. Our team is positive and passionate and come to work each day with a "Can Do" attitude. We strive to be creative problem solvers who bring innovative thinking in all our work. Being ethical, transparent, and accountable has helped shape our team and how we do business. We are looking for more people that match our core values to join our team.

DETAILS Claims Supervisor Department: Workers' Compensation Reports To: Division Claims Manager FLSA Status: Exempt Job Grade: 14 Career Ladder: Next step in progression could include Division Claims Manager 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 Claims Supervisor to support our Southern California Workers Compensation department. Management that lives less than 36 miles from the Orange, CA office AND have a direct report in the office, are required to work once a week in the office. The remaining days can be worked remotely if technical requirements are met, and the employee resides in Southern California. Athens offices are open for business Monday-Friday from 7:30 a.m. to 5:30 p.m. Employee work a 37.5-hour work week with the ability to work a flex schedule with every third Monday or Friday off. As a Claims Supervisor, you'll play a pivotal role in leading and collaborating with Athens management to achieve exciting company goals, run insightful reports, and streamline processes. You'll make impactful daily claims decisions, review files for accuracy, and approve payments that exceed examiner authority. Additionally, you'll ensure top-notch file handling, accurate claims coding, and meet unit closing goals. You'll be the guiding force for your team, planning, organizing, delegating workloads, supervising daily activities, providing training, and offering valuable guidance. In client management, you'll address policy and claims issues, build and maintain strong relationships, attend key meetings, ensure compliance with client instructions, and document interactions, always acting in the client's best interest. Join us and make a difference every day! 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: Claims Leadership Work with Athens management to achieve company initiatives and performance goals Consistently strive to improve and streamline current processes Authorize release of payment and settlement Make daily claims decisions regarding plan of action, handling of payment, etc. Review claim files for accuracy Run various reports with an eye for accuracy and confidentiality Approve payments and reserve increases when they rise above Examiner's authority level Work collaboratively with internal and clients' senior management as well as with attorneys to draft settlements and assist with litigation strategies Provide timely information to clients, attorneys, doctors, investigators and injured workers with strong, professional communication Discuss appropriateness of medical treatment with medical case manager Assure consistent and accurate claims coding is occurring on the team Ensure quality file handling and resolution. This includes meeting unit closing goals, verifying proper reserves, providing thorough claims analysis and guiding to correct resolution Use flexibility when working in demanding and changing situations Employee Management Effectively plan, organize and delegate workload for optimal results and to ensure time commitments are met Supervise daily activities of the team by monitoring progress, ensuring compliance with policies, and promptly addressing any issues or conflicts Identify, coordinate, coach, and perform training with staff to improve performance and increase their growth and knowledge in claims Participate in the interview process, onboarding and training of new hires Provide general guidance to the team by offering support and advice on work-related issues, fostering a positive work environment, encouraging professional development, and reviewing performance through evaluations, feedback, goal setting, and identifying areas for improvement Provide direct feedback and use sound coaching techniques to solve disciplinary or workflow problems. Manage and document employee relations issues at all levels. Work in conjunction with Human Resources to ensure performance issues are managed in a timely and consistent manner Regularly lead organized and collaborative staff unit meetings, including both remote and on-site employees Maintain an open-door policy and an approachable attitude, and foster open communication with staff Client Management Work with clients with issues regarding policies, programs and/or claims Manage existing client relationships by being accessible, making regular service calls, and proactively identifying and solving potential problems Attend client meetings, internal meetings, and workers' compensation meetings both virtual and in-person Ensure notepads and diaries are set and completed timely in accordance with client handling instructions and Athens Best Practices and have meaningful action plans and information and are concise and well-written Obtain audit results meets or exceeds best practice standards of Athens and client Display integrity and always acts in the best interest of the client Document client meeting notes in appropriate shared location Supervisory Responsibilities Supervising, scheduling, assigning, monitoring, and evaluating work of assigned staff are responsibilities for supervisory positions. Provide direct supervision for 6-10 employees, typically consisting of Senior Claims Examiners, Future Medical Claims Examiners, Claims Examiners, Assistant Claims Examiners and Assistant Claims Examiner Trainees. Attend on-site Leadership Summit at Athens Concord headquarters every 18 months (including overnight) Fiscal Responsibilities Review and approve direct report's monthly expense reports Ensure that all expenditures are in the best interest of the Company Use effective monitoring and reporting mechanisms to control expenses without lowering quality Search for and implement hidden cost improvements Obtain, maintain, and demonstrate an understanding of wage and hour laws as applicable for employees Ensure timely, accurate review and approval of timecards for your staff on payroll processing days. 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 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) Administrators Certificate from Self-Insurance Plans. If not already obtained, the Administrators Certificate from Self-Insurance Plans will be required within one year of employment Completion of IEA or equivalent courses Solid and in-depth knowledge of workers' compensation laws, policies, and procedures 3+ years' recent workers compensation claims handling experience at a high level 5+ years' experience in a Workers' Comp claims lead or supervisor position preferred At least 2 years Claims Supervisory experience required Proficiency in determining case value and negotiating settlements Prior Third-Party Administrator (TPA) experience preferred Understanding of medical and legal terminology Strong attention to detail and organizational skills and the ability to research and resolve problems and meet multiple deadlines and to plan and effectuate short- and long-range Company and department objectives. Proficiency at applying business and technical acumen by understanding how the business works and how technology supports business initiatives. Leverages technology for self and staff to improve efficiency. Partnering with team to ensure on time task completion; done through delegation and leading by example, executing tasks rather than just instructing them to execute tasks Handles stressful situations and deadline pressures well Must demonstrate accuracy and thoroughness in work product Effectively influences people to achieve unit and organizational objectives Must be flexible, adaptable, and positive. Exhibit passion and energy to ensure that all employees are respected and treated in a manner consistent with Athens Values. Able to plan, prioritize and organize claims workload for a unit Skilled at presenting in small and large group settings Ability to create reports as required, using the report writing tools available or creating custom documents. Skilled at developing and maintaining effective relationships with others (co-workers, customers, vendors, management, and other key stakeholders) to achieve organizational goals Embrace the leadership role and can be counted on to help senior management drive towards the desired results and to exceed goals successfully. Able to interpret information from multiple sources and draw logical conclusions; consults others based on analysis of data; able to think strategically and use data findings to consult others for improved business results. Negotiating skills Mathematical calculating skills Exercise independent judgment and analytic ability in solving complex and sensitive problems Highly developed verbal and written communication skills with strong attention to detail Computer processing skills, including the ability to leverage technology for self and staff to improve efficiency Proficient in Microsoft Office Suite Ability to type quickly, accurately and for prolonged periods Ability to learn additional computer programs ClaimsXpress program experience preferred but not required 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 Athens' operations involve handling confidential, proprietary, and highly sensitive information, such as health records, client financials, and other personal data. Therefore, maintaining honesty and integrity is essential for all roles within the company. Valid Driver's license and availability for travel including in office file reviews and meetings 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. The Company will consider qualified applicants with arrest or conviction records in accordance with the Los Angeles Fair Chance Ordinance for Employers and the California Fair Chance Act. Applicants can learn more about the Los Angeles County Fair Chance Act, including their rights, by clicking on the following link: ************************************************************************************************* 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. We offer a variety of benefit plans including Medical, Vision, Dental, Life and AD&D, Long Term Care, Critical Care, Accidental, Hospital Indemnity, HSA & FSA options, 401k (and Roth), Company-Paid STD & LTD and more! Further information about our comprehensive benefits package may be found on our website at https://*******************/careers/why-work-here

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 *********************************************************

About Monster 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.