Claims representative jobs in South Whittier, 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: Workers' Compensation Senior Claim Representative Duration: 6 Months (Contract to Hire-CTH) Job hours-8:00-4:30 Job schedule-40 hours on site Interview process-WEBEX prescreen/Then in-person interview Job Description: Client is currently seeking a Workers' Compensation Lost Time Senior Claim Examiner for our West Coast/Pacific region. The successful applicant will be handling claims from California. The position will report and reside in our Los Angeles, CA Duties & Responsibilities: • Handles all aspects of workers' compensation lost time claims from set-up to case closure ensuring strong customer relations are maintained throughout the process. • Reviews claim and policy information to provide background for investigation. • Conducts 3-part ongoing investigations, obtaining facts and taking statements as necessary, with insured, claimant and medical providers. • Evaluates the facts gathered through the investigation to determine compensability of the claim. • Informs insureds, claimants, and attorneys of claim denials when applicable. • Prepares reports on investigation, settlements, denials of claims and evaluations of involved parties, etc. • Timely administration of statutory medical and indemnity benefits throughout the life of the claim. • Sets reserves within authority limits for medical, indemnity and expenses and recommends reserve changes to Team Leader throughout the life of the claim. • Reviews the claim status at regular intervals and makes recommendations to Team Leader to discuss problems and remedial actions to resolve them. • Prepares and submits to Team Leader unusual or possible undesirable exposures when encountered. • Works with attorneys to manage hearings and litigation • Controls and directs vendors, nurse case managers, telephonic cases managers and rehabilitation managers on medical management and return to work initiatives. • Complies with customer service requests including Special Claims Handling procedures, file status notes and claim reviews. • Files workers' compensation forms and electronic data with states to ensure compliance with statutory regulations. • Refers appropriate claims to subrogation and secures necessary information to ensure that recovery opportunities are maximized. • Works with in-house Technical Assistants, Special Investigators, Nurse • Consultants, Telephonic Case Managers as well as Team Supervisors to exceed customer's expectations for exceptional claims handling service. Technical Skills & Competencies: • Lost Time Claim Examiner position with prior experience in workers' compensation as a lost time examiner, or similar examiner experience in short-term / long-term disability, auto personal injury protection / medical injury, or general liability claims. • Requires basic knowledge of workers' compensation statutes, regulations, and compliance. • Ability to incorporate data analytics and modeling into daily activities to expedite fair and equitable resolution of claims and claim issues. • Exceptional customer service and focus. • Ability to openly collaborate with leadership and peers to accomplish goals. • Demonstrates a commitment to a career in claims. • Exceptional time management and multi-tasking capabilities with consistent follow through to meet deadlines. • Use analytical skills to find mutually beneficial solutions to claim and customer issues. • Ability to prepare and make exceptional presentations to internal and external customers. • Conscientious about the quality and professionalism of work product and relationships with co-workers and clients. • Willing to take ownership and tackle obstacles to meet Client's quality standards for service, investigation, reserving, inventory management, teamwork, and diversity appreciation. • Superior verbal and written communication skills. Experience, Education & Requirements: • Experience working in a customer focused, fast-paced, fluid environment • Experience utilizing strong communication and telephonic skills • Prior experience requiring a high level of organization, follow-up, and accountability • Prior workers' compensation claim handling experience or other similar type of claim handling experience is required (healthcare, short-term / long-term disability, auto personal injury protection / medical injury, or general liability). • Prior insurance, legal or corporate business experience is a plus but not required • AIC, RMA, or CPCU completed coursework or designation(s) is a plus but not required • Proficiency with Microsoft Office Products • Knowledge of medical terminology is required • Knowledge of bill processing is required • Certification to handle CA Workers Compensation claims is required • Experience handling claims in the states of CO, UT, NV and AZ preferred • If you do not already have one, you will be required to obtain an applicable resident or designated home state adjusters license and possibly additional state licensure.

JOB TITLE:Claims Advocate FLSA CLASSIFICATION:Salaried - Exempt The Claims Advocate plays an essential role in mitigating BBSI's risk related to workers' compensation claims. This role requires exceptional business and customer service acumen and significant experience in workers' compensation claims, including claims handling. This role will coordinate the essential duties related to the claims advocacy program. Duties and related issues by assisting in the monitoring of new loss intake to confirm an appropriate beginning to each claim, assisting injured workers in navigating the claims process and communicating with external client customers and internal personnel. REPORTING RELATIONSHIPS: This position reports to the Corporate Claims Manager and interacts with the Corporate Claims team and local branch personnel. DUTIES AND RESPONSIBILITIES: Maintain clear focus on mitigating BBSI's financial risk associated with workers' compensation claims. Understand and articulate BBSI's business objectives internally and with key partners Written communication with injured workers when new claims are received. value workers compensation claims. Serve as a resource responding to questions and concerns from internal and external customers, vendor partners, and injured workers. Serve as back up to Claim Consultants members. activity. Approve reserve activity within authority. workers compensation claims, including status of the claims. Provide claims information for the coordination of human resource and safety efforts and requirements. relative to workers compensation. by third parties administrators CORE TRAITS/COMPETENCIES: Exceptional business acumen Customer service acumen Flexibility and adaptability Innately curious Highly developed interpersonal and communication skills QUALIFICATIONS: Four-year college degree is preferred, as well as 2-5 years of directly relevant claims experience Customer service acumen Bi-lingual (Spanish) would be preferred or familiarity with translation vendors Multi-Jurisdictional Workers' Compensation experience preferred Salary and Other Compensation: The starting hourly rate for this position is between 87,500-95,000. Factors which may affect starting pay within this range may include geography, skills, education, experience, certifications, and other qualifications of the candidate. This position is also eligible for annual incentive pay equal to 8% of annual regular pay, prorated in the first year, in accordance with the terms of the Company's plan. Benefits: The Company offers the following benefits for this position, subject to applicable eligibility requirements: medical insurance, health savings account, flexible savings account, dental insurance, vision insurance, 401(k) retirement plan, accidental death and dismemberment, life insurance, voluntary life insurance, voluntary disability insurance, voluntary accident, voluntary critical care, voluntary hospital indemnity, legal, identity & fraud protection, commuter benefits, pet insurance, employee stock purchase program, and an employee assistance program. Paid Time Off: Accrued sick leave of 1 hour for every 40 hours of work, with maximum based on state or regional requirements; vacation accrues up to 80 hours in the first year, up to 120 hours in years 2-4, and up to 160 hours in the fifth year; 6 paid holidays annually, 4 paid volunteer days annually. Diversity and Inclusion are critical parts of our corporate culture. BBSI strives to create a workplace where everyone feels included and empowered to bring their full, authentic selves to work, and is treated fairly. BBSI is an equal opportunity employer and makes employment decisions on the basis of merit. If you meet the above requirements, we welcome the opportunity to learn more about you. For more information, visit us at www. bbsi.com Please apply via this posting and not by contacting our local or corporate offices. Click here to review the BBSI Privacy Policy: ***********************************

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.

Marketing Statement: TM Claims Service (TMCS) is an independent global claims management firm established in 1987 to provide clients with a broad range of claims related services in the areas of transportation, product liability and overseas travel accident insurance. As part of the Tokio Marine Group of companies TM Claims Service provides claims handling services throughout the US and the Americas. Founded in 1879, Tokio Marine is recognized as Japan's oldest insurer and one of the largest insurance groups in the world. Tokio marine has offices in 38 countries staffed by more than 15000 employees outside of Japan. ($34.00 to $47.00 hourly) Job Summary: Adjust Marine and Inland Marine claims, which includes surveyor appointment, reserve notification, and file maintenance. Understand claims relative to loss history and application of special claims procedures as may be required for individual accounts. Responsible for pursuing recovery against liable carriers. Essential Job Functions: Process and adjust ocean and inland marine claims. Determine liability and/or necessity of surveyor with availability for occasional travel to loss sites. Review survey reports or supporting documentation for determining loss. Determine whether coverage exists for loss. Prepare necessary correspondence with assured/claimant/broker inclusive of loss control and damage prevention reporting. Handle tasks that require a high level of organization and attention to detail. Conclude all settlement agreements. Responsible for protecting all rights against third parties and/or responsible parties which may be liable. Such responsibility may include direct recovery handling. Comply with MCD business plan by conducting self audits, meet expectations of TMM/TMNF audits, and follow SLR procedures. Participate in training seminars and additional technical training courses. Responsible for complying with proper internal controls as necessary to conduct job functions and/or carry out responsibilities and/or administrative activities at Company. Qualifications: College degree preferred Strong PC skills, including Word and Excel Strong written and oral communication skills Auto industry experience preferred Minimum 3 years claims handling experience. Ability to work as part of a team EEO Statement: Tokio Marine Group of Companies (including, but not limited to the Philadelphia Insurance Companies, Tokio Marine America, Inc., TMNA Services, LLC, TM Claims Service, Inc. and First Insurance Company of Hawaii, Ltd.) is an Equal Opportunity Employer. In order to remain competitive we must attract, develop, motivate, and retain the most qualified employees regardless of age, color, race, religion, gender, disability, national or ethnic origin, family circumstances, life experiences, marital status, military status, sexual orientation and/or any other status protected by law.

Create Music Group is currently looking for a Youtube Publishing Administrator to join our Publishing Department. This role is responsible for ensuring complete delivery of our publishing content, as well as maintaining internal systems and metadata to company standards. This is a full-time position located in our Hollywood office. YouTube monetization provides an alternative consulting and revenue-generating resource for our clients to grow their audience and earnings. We have helped our clients monetize and collected millions in previously unclaimed revenue for artists and labels. REQUIREMENTS: 1-3 years work experience Excellent communication skills, both written and verbal Internet culture and social media platforms, especially YouTube Conducting basic level research Organizing large amounts of data efficiently Proficiency with Mac OSX, Microsoft Office, and Google Apps PLUSES: Strong understanding of the online video market (YouTube, Instagram, TikTok) Bilingual - any language, although Spanish, Mandarin, and Russian is preferred RESPONSIBILITIES: Watching YouTube videos for several hours daily Content claiming Uploading and defining intellectual assets Administrative metadata tasks Researching potential clients Staying on top of accounts for current client roster You are required to bring your own laptop for this position. BENEFITS: Paid company holidays, paid time off, and health benefits (medical, dental, vision, and supplementary policies) are included. TO APPLY: Send us your resume and cover letter (in one file). After you apply, you will be redirected to take our Culture Index survey here. Otherwise, copy and paste the link to your web browser: ********************************************************* Info.php?cfilter=1&COMPANY_CODE=cYEX5Omste Applications without a cover letter and Culture Index survey will not be considered. OPTIONAL: Link relevant social media campaigns and/or writing samples from your portfolio.

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 DescriptionDescriptionPosition: Production Public Adjuster (Licensed) Compensation: $75,000 - $100,000 compensation + Performance-based bonuses QUICK FACTS: Must have Public Adjuster License Must have experience with Xactimate Must have network of Condo, Apartment, Property Management partners Must be able to physically examine all buildings top to bottom (roofs as well) About the Company:A well-established, industry-leading public adjusting firm is seeking motivated and driven Outside Sales Representatives to join our growing team. We specialize in advocating for policyholders, ensuring they receive fair settlements for property damage claims. Our sales team plays a critical role in developing strong client relationships and driving company growth. Position Overview:We are looking for a results-oriented Outside Sales Representative with a strong background in direct-to-consumer (D2C) or business-to-business (B2B) sales. This role requires a motivated self-starter who thrives in building and maintaining client relationships while working in a fast-paced, competitive environment. Key ResponsibilitiesKey Responsibilities: Identify and pursue new business opportunities with homeowners, contractors, and referral partners. Educate prospective clients on our services and guide them through the insurance claims process. Develop and maintain a pipeline of leads through prospecting and networking efforts. Conduct presentations and training sessions to build brand awareness and establish partnerships. Provide exceptional customer service to existing clients, ensuring their satisfaction and retention. Work closely with internal teams to optimize the sales process and improve closing rates. Maintain accurate records of sales activities and client interactions. Skills, Knowledge and ExpertiseQualifications & Experience: 3+ years of proven sales experience as a licensed Public Adjuster Strong ability to generate leads, manage relationships, and close deals. Bachelor's degree in Business, Marketing, Communications, or equivalent experience. Familiarity with CRM tools, Microsoft Office Suite, and digital communication platforms. Highly organized with strong follow-through skills in a fast-paced environment. Public Adjuster license BenefitsWhat We Offer: Extensive training and support to help you succeed. Flexible work environment with opportunities for growth and career advancement. A team-oriented culture with strong leadership and professional development opportunities. If you're a highly motivated sales professional looking for a rewarding career with a company that makes a difference, apply today!

Marketing Statement: TM Claims Service (TMCS) is an independent global claims management firm established in 1987 to provide clients with a broad range of claims related services in the areas of transportation, product liability and overseas travel accident insurance. As part of the Tokio Marine Group of companies TM Claims Service provides claims handling services throughout the US and the Americas. Founded in 1879, Tokio Marine is recognized as Japan's oldest insurer and one of the largest insurance groups in the world. Tokio marine has offices in 38 countries staffed by more than 15000 employees outside of Japan. ($34.00 to $47.00 hourly) Job Summary: Adjust Marine and Inland Marine claims, which includes surveyor appointment, reserve notification, and file maintenance. Understand claims relative to loss history and application of special claims procedures as may be required for individual accounts. Responsible for pursuing recovery against liable carriers. Essential Job Functions: * Process and adjust ocean and inland marine claims. * Determine liability and/or necessity of surveyor with availability for occasional travel to loss sites. * Review survey reports or supporting documentation for determining loss. * Determine whether coverage exists for loss. * Prepare necessary correspondence with assured/claimant/broker inclusive of loss control and damage prevention reporting. * Handle tasks that require a high level of organization and attention to detail. * Conclude all settlement agreements. * Responsible for protecting all rights against third parties and/or responsible parties which may be liable. * Such responsibility may include direct recovery handling. * Comply with MCD business plan by conducting self audits, meet expectations of TMM/TMNF audits, and follow SLR procedures. * Participate in training seminars and additional technical training courses. * Responsible for complying with proper internal controls as necessary to conduct job functions and/or carry out responsibilities and/or administrative activities at Company. Qualifications: * College degree preferred * Strong PC skills, including Word and Excel * Strong written and oral communication skills * Auto industry experience preferred * Minimum 3 years claims handling experience. * Ability to work as part of a team EEO Statement: Tokio Marine Group of Companies (including, but not limited to the Philadelphia Insurance Companies, Tokio Marine America, Inc., TMNA Services, LLC, TM Claims Service, Inc. and First Insurance Company of Hawaii, Ltd.) is an Equal Opportunity Employer. In order to remain competitive we must attract, develop, motivate, and retain the most qualified employees regardless of age, color, race, religion, gender, disability, national or ethnic origin, family circumstances, life experiences, marital status, military status, sexual orientation and/or any other status protected by law.

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

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.

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.

Reports to: Claims Supervisor Employment Status: Full-Time FLSA Status: Non-Exempt We are searching for a diligent Claims Specialist to ensure the timely and accurate collection of medical claims. The specialist will work closely with insurance companies to rectify payment denials, settle disputes, and receive due reimbursements. The ideal candidate will possess strong communication skills, a deep understanding of medical billing and coding, and the determination to resolve outstanding claims. Duties/Responsibilities: · Reviews and works on unpaid claims, identifying and rectifying billing issues. · Communicates with insurance companies regarding any discrepancy in payments if necessary. · Conducts research and appeals denied claims timely. · Reviews Explanation of Benefits (EOBs) to determine denials or partial payment reasons. · Provides detailed notes on actions taken and next steps for unpaid claims. · Collaborates with the billing team to ensure accurate claim submission. · Maintains a comprehensive understanding of the insurance follow-up process, payer guidelines, and compliance requirements. · Resubmits claims with necessary corrections or supporting documentation when needed. · Tracks and documents trends related to denials and work towards a resolution with the billing team. · Assists patients with inquiries related to their insurance claims, providing clear and accurate information. · All other duties as assigned. Required Skills/Abilities: · Proficiency in healthcare billing software. · Strong analytical, organizational, and multitasking skills. · Excellent verbal and written communication abilities. · Ability to navigate payer websites and use online resources to resolve outstanding claims. Education and Experience: · High school diploma or equivalent required. · Experience in medical billing collections or a similar role in a Behavioral Health industry specializing in Substance Abuse and Mental Health is strongly preferred. · Knowledge of medical terminology, CPT and ICD-10 coding is a plus. · Knowledge of HIPAA and other healthcare industry regulations. Benefits · Health Insurance · Vision Insurance · Dental Insurance · 401(k) plan with matching contributions View all jobs at this company

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

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