Claims representative jobs in Tustin, CA - 230 jobs
All
Claims Representative
Claim Specialist
Adjuster
Claim Investigator
Claims Technician
Claim Processor
Claims Investigator
Apex Investigation
Claims representative job in Riverside, CA
About the Company
For over 40 years, APEX Investigation has been dedicated to reducing insurance risk and combating fraud through trusted, high-quality investigations. We build lasting client relationships through integrity, clear communication, and timely, actionable results. Specializing in suspicious claims across multiple coverage areas-including workers' compensation, property, casualty, and auto liability-we provide critical information that supports efficient claims resolution, cost control, and reduced financial loss.
About the Role
The Claims Investigator plays a critical role in the investigation of insurance claims-primarily workers' compensation-by conducting recorded statements, field investigations, scene and medical canvasses, and producing clear, well-documented reports.
This position requires adaptability, strong communication skills, sound judgment, and the ability to manage both fieldwork and detailed administrative responsibilities. Travel and variable schedules are a regular part of this role.
Key Responsibilities
Case Management & Communication
Receive, review, and manage assigned cases from start to completion.
Communicate professionally with clients, claimants, witnesses, and other involved parties.
Provide timely case updates and correspondence in accordance with company guidelines via CaseLink.
Maintain objectivity and professionalism in all interactions.
Investigative Field Work
Conduct recorded statements at various locations, including claimants' homes, workplaces, medical offices, and public settings.
Ask open-ended questions, interpret responses, and conduct appropriate follow-up without reliance on scripted questionnaires.
Perform scene and neighborhood canvasses, including walking on varied terrain.
Meet with treating physicians and medical offices as required.
Travel to designated locations, including overnight stays when necessary.
Respond to rush cases within business hours when required.
Documentation & Reporting
Enter case updates, notes, hours worked, mileage, and expenses into CaseLink on a daily basis.
Upload all obtained statements, documents, recordings, photographs, and evidence to CaseLink the same day they are acquired.
Compose clear, concise, and grammatically correct case updates within 24 hours of obtaining statements.
Prepare and submit comprehensive investigative reports within 72 hours of final update submission.
Evidence & Records Handling
Retrieve records from agencies and entities both in-person and remotely.
Take clear photographs and video when necessary and label all electronic files accurately.
Securely collect, store, and maintain custody of evidence when required.
Maintain organized and protected case files and establish backup procedures to safeguard data in the event of technical failure.
Additional Responsibilities
Identify and recommend additional investigative services outside the scope of the original assignment when appropriate.
Work overtime as needed to meet case demands and deadlines.
Maintain an efficient, safe, and organized telecommuter workspace.
Physical & Work Environment Requirements
Ability to sit for extended periods performing computer-based work and report writing.
Ability to stand for extended periods while conducting interviews and canvasses.
Ability to lift and carry items weighing between 5-30 lbs (e.g., laptop, briefcase, equipment).
Ability to operate digital audio recording equipment.
Qualifications
Experience with workers' compensation claims and investigative processes.
Strong written and verbal communication skills.
Ability to work independently, manage time effectively, and meet strict deadlines.
Willingness and ability to travel up to (but not limited to) 150 miles per assignment.
Possession of a personal credit card with available balance for reimbursable business expenses.
Proficiency with case management systems; CaseLink experience preferred.
Access to a personal scanner for document upload and record handling.
Preferred Qualifications
Prior experience conducting recorded statements and field investigations.
Experience with process service assignments.
Familiarity with evidence handling and documentation standards.
Background in insurance investigations or a related field.
$44k-60k yearly est. 4d ago
Looking for a job?
Let Zippia find it for you.
Claims Processor
Pacer Staffing
Claims representative job in Whittier, CA
Job Title - Claims Processor
Hourly Pay - $30/hr
Shift - Day 5x8-Hour (07:00 - 15:30)
Job Description -
SPECIFIC SKILLS NEEDED
Knowledge of HMO/or IPA operations; medical terminology; ICD-10, RVS, and CPT coding knowledge; knowledge of Medicare and Medi-Cal guidelines; 10-key skills by touch; excellent communication skills; knowledge of system applications; ability to function effectively under time deadlines; strong organizational skills.
Required:
Formal training will be indicated by a high school diploma or equivalent;
Four years medical claims processing.
DUTIES AND RESPONSIBILITIES
1. Safeguards and preserves the confidentiality of patient's protected health information in accordance with State and Federal (HIPAA) regulatory requirements, hospital and departmental policies.
2. Ensures a safe patient environment and adherence to safety practices per policy.
3. With consideration to age, employee utilizes the approved process to resolve biophysical, psychological, educational and environmental needs of patient/significant other when administering care.
4. Assist the Claims Director in the training and education of the Claims department staff
5. Coordinate the generation and review of claims audit, status and pending claims reports ensuring authorized claims are paid in accordance with company guidelines
6. Investigate, process and track payment adjustments including refunds, overpayments and underpayments
7. Act as a confidential and professional resource for group providers and other staff.
8. Act as a resource for providers, members, insurance carriers, attorneys and co-workers, researching and responding to questions in a timely manner
9. Create, maintain and generate system reports
10.Review and audit member liability denials and Provider Dispute Resolution claims to ensure compliance with regulatory requirements and passing audit scores from health plans
$30 hourly 3d ago
Claims Technician
Insight Global
Claims representative job in Los Angeles, CA
About the Role
We're partnering with a leading insurance company to find a Claims Technician. In this role, you'll be responsible for initiating, directing, and supporting case management and claims processes. You'll work closely with the claims team to ensure accuracy and professionalism in every step.
Key Responsibilities
Process insurance claims with attention to detail and accuracy
Support case management activities under moderate guidance
Assist the Claims organization with additional responsibilities as needed
Maintain professionalism and adhere to company standards
Qualifications
Experience: 6 months to 1 year of office experience
Skills: Proficiency in Microsoft Office Suite
Education: Bachelor's degree preferred (not required)
Claims experience: Is a plus, but training provided on internal systems
Strong professionalism and cultural fit
Additional Details
Interview: One round, on-site
Background Check: Full employment and education verification.
Work Environment: Desk-based, 8-hour shifts
$36k-47k yearly est. 4d ago
Bottler Claims Representative (Temp to Hire)
Monster 4.7
Claims representative job in Corona, CA
Energy:
Forget about blending in. That's not our style. We're the risk-takers, the trailblazers, the game-changers. We're not perfect, and we don't pretend to be. We're raw, unfiltered, and a bit unconventional. But our drive is unrivaled, just like our athletes. The power is in your hands to define what success looks like and where you want to take your career. It's not just about what we do, but about who we become along the way. We are much more than a brand here. We are a way of life, a mindset. Join us.
A day in the life:
As a Bottler ClaimsRepresentative 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.
$17-23 hourly 60d+ ago
Adjuster II - LA
Tokio Marine Group 4.5
Claims representative job in Los Angeles, CA
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.
$34-47 hourly Auto-Apply 39d ago
Publishing - Content Claiming Specialist
Create Music Group 3.7
Claims representative job in Los Angeles, CA
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.
$44k-75k yearly est. Auto-Apply 60d+ ago
Public Adjuster I
Allied Public Adjusters Inc.
Claims representative job in Newport Beach, CA
Job DescriptionOur Company: At Allied Public Adjusters (APA), our North Star is clear: we envision a world where every property loss is settled truthfully and equitably. Since 1997, weve worked on behalf of policyholders to demand whats right using technical expertise, field investigations, and uncompromising quality. We empower policyholders with the most skillful representation, while ensuring that carriers have the information they need to do whats right.
Our team is a dedicated group of professionals committed to ensuring individuals receive fair insurance settlements. We combine licensed expertise with an in-house assortment of legal professionals, construction estimators, accountants, and adjusters. At Allied, were not just about claims; were about people. Join us as we advocate for transparency, equity, and the rightful interests of our community.
Core Values:
We Show Up with G.R.I.T.:
Go-Getters, Relationship Builders, Intelligent Experts, Truth Champions
Every day. In every role. Through every decision and every moment of every engagement. This is the ethos that defines us. So, lets define it for one another.
Role:
APA is currently expanding and is looking for motivated individuals to come onboard as public adjusters. The Public Adjuster I is a professional claims handler who advocates for the policyholder in appraising and negotiating a claimant's insurance claim throughout the claim process. The PA works well in a rapid paced environment, model behaviors that reflect APAs core values and reports to a Managing Public Adjuster. The purpose of a PA I is to develop foundational skills in claims handling, client communication, and documentation while supporting more senior adjusters. The PA I will learn to manage claims with structured guidance.
Responsibilities:
Assist in managing assigned claims with support and guidance
Learn and apply policy interpretation and coverage fundamentals
Promptly handle claims that are assigned, creating a positive client experience
Conduct onsite inspections (with direction or supervision as necessary)
Capture photos and measurements to accurately measure losses
Prepare detailed scope and cost estimates (including using experts when needed)
Investigate claims thoroughly and present strong cases to negotiate settlements for clients.
Follow internal processes, documentation standards, and timelines
Maintain timely client communication and expectations
Draft reports and claim documentation
Properly document claim files pursuant to company standards
Effectively and efficiently utilize support teams such as legal, engineering, and leadership where needed to resolve claims and maximize value for our clients
Be a good team player and assist others where needed. This may include mentoring junior staff members in various situations.
Other duties may be performed, both major and minor, which are not mentioned below. Specific activities may change from time to time.
Qualifications:
02 years claims, construction, property, insurance, legal, or related experience
State Public Adjuster License (or ability to obtain)
Strong writing, organization, follow-through, and professionalism
Understanding of the insurance Industry standards, policies applicable laws and regulations
Construction knowledge and experience
Within your first year, you will have:
Built and manage a full and dynamic case load with timely movement on each claim
Achieve strong claim outcomes for clients
Demonstrate relentless advocacy while maintaining professionalism
Maintain excellent communication standards : proactive client updates, clear expectations, well documented outreach
Build trust and strong relationships with clients to produce high client satisfaction and referral feedback
Meet or exceed claim cycle time standards while balancing quality and urgency
Produce audit-ready files with complete documentation
Collaborate effectively with company departments to drive results
Demonstrate strategic, clear intentioned claim critical thinking
Show ownership mentality by treating every claim like it matters in a proactive manner
Demonstrate resilience and persistence, and embrace objections and denials
Contribute positively to the company culture and results
Key Performance Indicators:
Client satisfaction scores
Response & follow-up timeliness
Documentation accuracy
Claim cycle time
Learning progression benchmarks
Financial goals
Benefits:
Salary: Salary: $80,000- 105,000 annually plus up to 10% bonus
401(k) with 3% non-elective contribution.
Health, dental and vision insurance. Along with voluntary selections as well.
Generous paid holidays and paid time-off.
Opportunities for career advancement and professional growth.
Car and phone allowance, if needed.
We are an equal opportunity employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability status, protected veteran status, or any other characteristic protected by law.
$80k-105k yearly 10d ago
Public Adjuster
The Misch Group
Claims representative job in Los Angeles, CA
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!
$75k-100k yearly 15d ago
Adjuster II - LA
Tokio Marine North America, Inc. (TMNA
Claims representative job in Los Angeles, CA
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.
$34-47 hourly Auto-Apply 40d ago
Claims Specialist
Elite Sourcing
Claims representative job in Costa Mesa, CA
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
$50k-70k yearly 14d ago
General Liability Claims Specialist
Your Next Career
Claims representative job in Santa Fe Springs, CA
The 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
Range: $90,000 - $100,000 annually
Superior will not inquire about or seek information about applicant's criminal history until after a conditional offer of employment has been made to the applicant.
TO VIEW THE APPLICANT, NOTICE ABOUT YOUR PERSONAL INFORMATION CLICK THE LINK BELOW.
https://superiorgrocers.com/about-us/privacy-disclosure/
$90k-100k yearly 42d ago
Claims Specialist
Dk Law's Open Roles
Claims representative job in Costa Mesa, CA
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
$38k-66k yearly est. 60d+ ago
Auto Claims Specialist I (Manheim)
Cox Enterprises 4.4
Claims representative job in Anaheim, CA
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 $19.90 - $29.81/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. No OPT, CPT, STEM/OPT or visa sponsorship now or in future.
$19.9-29.8 hourly Auto-Apply 14d ago
Claims Specialist, Risk Management
Heritage Grocers
Claims representative job in Ontario, CA
At Heritage Grocers Group, LLC, how we work is defined by shared values that include absolute integrity, respect, and collaboration. But it's more than that, it's smart and highly driven people united in purpose to serve one another. Bring your energy and unique perspective and you'll have the opportunity to grow with us professionally, personally, and financially. You'll be part of a team that genuinely cares about helping you succeed, and you'll work alongside talented colleagues, while making a difference in our communities.
POSITION SUMMARY:
The Claims Specialist will be responsible for directing, monitoring, and processing all workers' compensation and general liability claims for HGG business units. A successful candidate will provide high-level support and customer service to team members across the organization. Primarily communicating with store administrators, store directors, human resources department, industrial clinics, insurance adjusters and legal representatives.
ESSENTIAL DUTIES AND RESPONSIBILITIES:
The essential duties and responsibilities of this position include, but are not limited to, the following:
* Oversee and navigate the complete lifecycle of the workers' compensation claims and general liability claims, guaranteeing precise and punctual resolution.
* Evaluate and review all claim intake paperwork for accuracy.
* Ensure the claim files follow company best practices.
* Report on-the-job injuries of team members to the third-party administrator via online portal within 24-hours of receipt of injury.
* Report customer incidents and injuries to the third-party administrator via online portal within 24-hours of receipt of Letter of Representation or failure to resolve the incident in-house.
* Maintain incident and claim information in the claims' assignment log and in the SharePoint folder.
* Monitor to ensure all the necessary paperwork is submitted to the third-party administrator.
* Communicate with injured team members, store administrators, store directors and insurance adjusters to provide updates on claims and medical status.
* Monitor the claims to ensure they are processed accordingly, and that proper medical treatment is provided to the injured team member.
* Provide support to store administrators/store directors for submission of transitional work report documents and ensure modified work restrictions are being followed.
* Investigate, address, and resolve any inconsistencies in the handling of the claims.
* Communicate to insurance adjusters, legal representatives, and other outside parties with questions involving medical/indemnity/litigated claims within 24 hours.
* Collaborate with the Safety Department when a workplace danger or safety risk is recognized for investigation and documentation.
* Prepare and analyze various reports - disbursement expenses such as replenishment and claim activity payments from Third Party Administrators.
* Adhere to strict confidentiality and ethical standards when handling sensitive claim information.
* Other projects and duties as assigned.
EDUCATION AND EXPERIENCE:
* High School Graduate (college degree, professional certifications and licenses preferred).
* Minimum 1-3 years of claims management experience; workers' compensation preferred.
* Must be bilingual in Spanish including in writing.
SKILLS AND QUALIFICATIONS:
* Attention to detail and thoroughness of work completed.
* Positive attitude and ability to manage multiple tasks at once.
* Timely execution of deliverables.
* Proficiency in typing required.
* Basic to intermediate proficiency with Microsoft Office applications.
* Excellent communication, collaboration, organizational, and critical thinking skills.
PHYSICAL DEMANDS AND WORK CONDITIONS:
The physical demands and work conditions below represent those that must be met to successfully perform the essential functions of this job. Some requirements may be modified to accommodate individuals with disabilities:
* While performing the duties of this job, the employee is regularly required to sit, stand, and use the hands to handle objects, tools or controls.
* Successful performance requires vision abilities that include close vision and the ability to adjust focus.
* The work environment is that typical of an office.
* Ability to lift up to 10lbs.
IMPORTANT DISCLAIMER NOTICE
The job duties, elements, responsibilities, skills, functions, experience, educational factors, and the requirements and conditions listed in this are representative only and not exhaustive of the tasks that an employee may be required to perform. The Employer reserves the right to revise this job description at any time and to require employees to perform other tasks as circumstances or conditions of its business or the work environment change.
Disclaimer :
Pay Scale $22 to $23
The pay scale above is the salary or hourly wage range that the Company reasonably expects to pay for this position.
Within this range, individual pay is determined by location and other factors including, but not limited to, specific skills, relevant work experience, and relevant education and/or training. This information is provided to applicants in accordance with California Labor Code § 432.3 and state and local minimum wage standards.
$38k-66k yearly est. 32d ago
Claims Specialist - Provider Claims
Kinetic Personnel Group, Inc.
Claims representative job in Ontario, CA
Pay range is $26-$28/hr
Kinetic Personnel Group is recruiting for a Claims Specialist - Provider Claims for a $5 billion/year Public Health Plan in the Ontario California area. This government agency is renowned for the work it does in the community and being a great place to work.
This position is remote with occasional meetings in the office. Candidates should be local to Southern California. This will be a temporary position initially, with the possibility of converting to a permanent government job after 6 months. Pay rate can increase,and includes CalPERS pension, ~10% yearly bonus, 457b (~6% contribution) and excellent benefits including excellent PTO/Holiday schedule (year one).
The Claims Specialist- Provider Claims is responsible for fulfilling the technical support needs of appeals and support staff, while ensuring that appeals and call center tasks are conducted consistently and accurately. Additional responsibilities include handling escalated claim-related telephone inquiries, assisting with cross-training as needed, performing complex claim adjustment projects, and processing Provider Disputes in accordance with regulatory requirements.
Job duties:
Review and process provider dispute resolutions according to state and federal designated timeframes.
Review and assist with applying identified refunds submitted by the CART team.
Research reported issues; adjust claims and determine the root cause of the dispute.
Draft written responses to providers in a professional manner within required timelines.
Independently review and price complex edits related to all claim types to determine the appropriate handling for each including payment or denial.
Complete the required number of weekly reviews deemed appropriate for this position.
Respond to provider inquiries regarding disputes that have been submitted.
Maintain, track, and prioritize assigned caseload through provider dispute database to ensure timely completion.
Maintain knowledge of claims procedures and all appropriate reference materials; participate in ongoing training as needed.
Communicate with a variety of people, both verbally and in writing, to perform research, gather information related to the case that is under review.
Recommend opportunities for improvement identified through the trending and analysis of all incoming PDRs.
Requirements:
Four (4) years of experience in a managed care environment in the area of claims processing; appeals & adjustments, and customer service, preferably in an HMO or Managed Care setting
Medi-Cal/Medicare experience and prior experience in a lead role preferred
High school diploma or GED required (will be verified)
KPG123
$26-28 hourly 4d ago
Insurance Claims Specialist
Actalent
Claims representative job in Long Beach, CA
We are seeking an Insurance Claim Specialist to support the vehicle fleet for our Field Services Group, for an engineering firm. This role is pivotal in maintaining operational efficiency and asset management within the organization. This role will focus in filing insurance claims for vehicles that have been damaged. Also will setup fuel cards with pin numbers, selling vehicles and purchasing vehicles. Prior experience with a vehicle insurance claim company or submitting vehicle insurance claims is required.
Responsibilities
+ Manage the assignment of equipment such as vehicles, ATVs/UTVs, and PIN numbers.
+ Maintain and update the asset schedule.
+ Assist in asset purchasing when necessary.
+ Submit insurance claims for vehicles.
+ Order transponders, fuel cards, and vehicle registrations as required.
+ Process vendor invoices efficiently.
+ Oversee the sales of company-owned assets.
+ Maintain documentation for vehicles, trailers, and ATVs/UTVs.
+ Manage vehicle registrations and renewals, ensuring communication with relevant staff about requirements.
+ Assist in preparing asset inventory for tracking installations.
+ Update and maintain various databases.
+ Process fuel cards and insurance documentation for new vehicle purchases.
+ Handle incoming mail distribution related to the fleet.
+ Process the cancellation of Telematics devices.
+ Dispatch necessary fleet-related items via FedEx to dealerships or upon driver requests.
Essential Skills
+ Ability to work effectively in with employees who work in the field.
+ Experience submitting insurance claims for vehicles.
+ Skilled in Excel, experience with pivot tables is ideal.
+ Proficiency in Adobe PDF editor or Adobe Acrobat Pro is a plus.
+ Competency in Microsoft Office Suite.
Additional Skills & Qualifications
+ Ability to complete tasks within 24 hours, particularly for urgent matters such as fuel cards and registrations.
+ Maintain a 24-hour response rate for emails to ensure timely communication.
Work Environment
This is a full-time, 40-hour in-office position, operating Monday through Friday from 7:30 am to 4:30 pm. You will work in the office supporting field staff nationally. A company laptop and phone will be provided. The dress code is business casual, allowing jeans without holes.
Job Type & Location
This is a Contract to Hire position based out of Long Beach, CA.
Pay and Benefits
The pay range for this position is $27.00 - $27.00/hr.
Eligibility requirements apply to some benefits and may depend on your job classification and length of employment. Benefits are subject to change and may be subject to specific elections, plan, or program terms. If eligible, the benefits available for this temporary role may include the following: - Medical, dental & vision - Critical Illness, Accident, and Hospital - 401(k) Retirement Plan - Pre-tax and Roth post-tax contributions available - Life Insurance (Voluntary Life & AD&D for the employee and dependents) - Short and long-term disability - Health Spending Account (HSA) - Transportation benefits - Employee Assistance Program - Time Off/Leave (PTO, Vacation or Sick Leave)
Workplace Type
This is a fully onsite position in Long Beach,CA.
Application Deadline
This position is anticipated to close on Jan 29, 2026.
About Actalent
Actalent is a global leader in engineering and sciences services and talent solutions. We help visionary companies advance their engineering and science initiatives through access to specialized experts who drive scale, innovation and speed to market. With a network of almost 30,000 consultants and more than 4,500 clients across the U.S., Canada, Asia and Europe, Actalent serves many of the Fortune 500.
The company is an equal opportunity employer and will consider all applications without regard to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.
If you would like to request a reasonable accommodation, such as the modification or adjustment of the job application process or interviewing due to a disability, please email actalentaccommodation@actalentservices.com (%20actalentaccommodation@actalentservices.com) for other accommodation options.
$27-27 hourly 4d ago
Complex Claims Specialist - Cyber, Technology, Media & Crime
Hiscox
Claims representative job in Los Angeles, CA
Job Type: Permanent Build a brilliant future with Hiscox Put your claims skills to the test and join one of the top Professional Liability Insurers in the Industry as a Complex Claims Specialist! Please note that this position is hybrid and requires working in office two (2) days per week. Position can be based near the following office locations:
* West Hartford, CT (preferred)
* Atlanta, GA
* Boston, MA
* Chicago, IL
* Los Angeles, CA
* Manhattan, NY
About the Hiscox Claims team:
The US Claims team at Hiscox is a growing group of professionals with experience across private practice and in-house roles, working together to provide the ultimate product we offer to the market. Complex Claims Specialists are empowered to manage their claims with high levels of authority to provide fair and fast resolution of claims for our insured and broker partners.
The Role:
The primary role of a Complex Claims Specialist is to analyze liability claim submissions for potential coverage, set adequate case reserves, promptly and professionally respond to inquiries from our customers and their brokers, and to proactively drive early resolution of claims arising from our commercial lines of insurance. This particular role is open to Atlanta and will be focused on servicing claims and potential claims arising from our book of Cyber, Tech PL, Media and/or Crime professional liability lines of business. This is a fantastic opportunity to join Hiscox USA, a growing business where you will be able to make a real impact. Together, we aim to be the best people producing the best insurance solutions and delivering the best service possible.
What you'll be doing as the Complex Claims Specialist:
Key Responsibilities: To perform all core aspects of in-house claims management, including but not limited to:
* Reviewing and analyzing claim documentation and legal filings
* Drafting coverage analyses for tech E&O, first and third party cyber claims
* Strategizing and maximizing early resolution opportunities
* Monitoring litigation and managing local defense and breach counsel
* Attending mediations and/or settlement conferences, either in person or by phone as appropriate
* Smartly managing and tracking third-party vendor and service provider spend
* Continually assessing exposures and adequacy of claim reserves, and escalating high exposure and/or volatile claims to line manager
* Liaising directly on daily basis with insureds and brokers
* Maintaining timely and accurate file documentation/information in our claims management system
Our Must-Haves:
* 5+ years of professional lines claims handling experience
* A JD from an ABA-accredited law school and bar admission in good standing may be considered as a supplement to claims handing experience
* A minimum of 2-3 years professional experience in the area of Cyber and Technology coverage experience required
* Proven ability to positively affect complex claims outcomes through investigation, negotiation and effectively leading litigation
* Advanced knowledge of coverage within the team's specialty or focus
* Advanced knowledge of litigation process and negotiation skills
* Excellent verbal and written communication skills
* Advanced analytical skills
* B.A./B.S degree from an accredited College or University, JD degree from an ABA accredited law school is preferred
What Hiscox USA Offers:
* Competitive salary and bonus (based on personal & company performance)
* Comprehensive health insurance, Vision, Dental and FSA (medical, limited purpose, and dependent care)
* Company paid group term life, short-term disability and long-term disability coverage
* 401(k) with competitive company matching
* 24 Paid time off days with 2 Hiscox Days
* 10 Paid Holidays plus 1 paid floating holiday
* Ability to purchase 5 additional PTO days
* Paid parental leave
* 4 week paid sabbatical after every 5 years of service
* Financial Adoption Assistance and Medical Travel Reimbursement Programs
* Annual reimbursement up to $600 for health club membership or fees associated with any fitness program
* Company paid subscription to Headspace to support employees' mental health and wellbeing
* Recipient of 2024 Cigna's Well-Being Award for having a best-in-class health and wellness program
* Dynamic, creative and values-driven culture
* Modern and open office spaces, complimentary drinks
* Spirit of volunteerism, social responsibility and community involvement, including matching charitable donations for qualifying non-profits via our sister non-profit company, the Hiscox USA Foundation
About Hiscox USA:
Hiscox USA was established in 2006 to focus primarily on the needs of small and middle market commercial clients, via both the broker and direct distribution channels and is today the fastest-growing business unit within the Hiscox Group.
Today, Hiscox USA has a talent force of about 420 employees mostly operating out of 6 major cities - New York, Atlanta, Dallas, Chicago, Los Angeles and San Francisco. Hiscox USA offers a broad portfolio of commercial products, including technology, cyber & data risk, multiple professional liability lines, media, entertainment, management liability, crime, kidnap & ransom, commercial property and terrorism.
You can follow Hiscox on LinkedIn, Glassdoor and Instagram (@HiscoxInsurance)
Salary Range: $125,000- $160,000
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.
We are an Equal Opportunity Employer and do not discriminate against any employee or applicant for employment because of race, color, sex, age, national origin, religion, sexual orientation, gender identity, status as a veteran, and basis of disability or any other federal, state or local protected class.
#LI-RM1
Work with amazing people and be part of a unique culture
$39k-66k yearly est. Auto-Apply 11d ago
Claims Specialist
TCI Transportation 3.6
Claims representative job in Los Angeles, CA
Job Description
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.
$25 hourly 12d ago
Claims Investigator
Apex Investigation
Claims representative job in Los Angeles, CA
About the Company
For over 40 years, APEX Investigation has been dedicated to reducing insurance risk and combating fraud through trusted, high-quality investigations. We build lasting client relationships through integrity, clear communication, and timely, actionable results. Specializing in suspicious claims across multiple coverage areas-including workers' compensation, property, casualty, and auto liability-we provide critical information that supports efficient claims resolution, cost control, and reduced financial loss.
About the Role
The Claims Investigator plays a critical role in the investigation of insurance claims-primarily workers' compensation-by conducting recorded statements, field investigations, scene and medical canvasses, and producing clear, well-documented reports.
This position requires adaptability, strong communication skills, sound judgment, and the ability to manage both fieldwork and detailed administrative responsibilities. Travel and variable schedules are a regular part of this role.
Key Responsibilities
Case Management & Communication
Receive, review, and manage assigned cases from start to completion.
Communicate professionally with clients, claimants, witnesses, and other involved parties.
Provide timely case updates and correspondence in accordance with company guidelines via CaseLink.
Maintain objectivity and professionalism in all interactions.
Investigative Field Work
Conduct recorded statements at various locations, including claimants' homes, workplaces, medical offices, and public settings.
Ask open-ended questions, interpret responses, and conduct appropriate follow-up without reliance on scripted questionnaires.
Perform scene and neighborhood canvasses, including walking on varied terrain.
Meet with treating physicians and medical offices as required.
Travel to designated locations, including overnight stays when necessary.
Respond to rush cases within business hours when required.
Documentation & Reporting
Enter case updates, notes, hours worked, mileage, and expenses into CaseLink on a daily basis.
Upload all obtained statements, documents, recordings, photographs, and evidence to CaseLink the same day they are acquired.
Compose clear, concise, and grammatically correct case updates within 24 hours of obtaining statements.
Prepare and submit comprehensive investigative reports within 72 hours of final update submission.
Evidence & Records Handling
Retrieve records from agencies and entities both in-person and remotely.
Take clear photographs and video when necessary and label all electronic files accurately.
Securely collect, store, and maintain custody of evidence when required.
Maintain organized and protected case files and establish backup procedures to safeguard data in the event of technical failure.
Additional Responsibilities
Identify and recommend additional investigative services outside the scope of the original assignment when appropriate.
Work overtime as needed to meet case demands and deadlines.
Maintain an efficient, safe, and organized telecommuter workspace.
Physical & Work Environment Requirements
Ability to sit for extended periods performing computer-based work and report writing.
Ability to stand for extended periods while conducting interviews and canvasses.
Ability to lift and carry items weighing between 5-30 lbs (e.g., laptop, briefcase, equipment).
Ability to operate digital audio recording equipment.
Qualifications
Experience with workers' compensation claims and investigative processes.
Strong written and verbal communication skills.
Ability to work independently, manage time effectively, and meet strict deadlines.
Willingness and ability to travel up to (but not limited to) 150 miles per assignment.
Possession of a personal credit card with available balance for reimbursable business expenses.
Proficiency with case management systems; CaseLink experience preferred.
Access to a personal scanner for document upload and record handling.
Preferred Qualifications
Prior experience conducting recorded statements and field investigations.
Experience with process service assignments.
Familiarity with evidence handling and documentation standards.
Background in insurance investigations or a related field.
$44k-61k yearly est. 4d ago
Public Adjuster I
Allied Public Adjusters Inc.
Claims representative job in Glendale, CA
Job DescriptionOur Company: At Allied Public Adjusters (APA), our North Star is clear: we envision a world where every property loss is settled truthfully and equitably. Since 1997, weve worked on behalf of policyholders to demand whats right using technical expertise, field investigations, and uncompromising quality. We empower policyholders with the most skillful representation, while ensuring that carriers have the information they need to do whats right.
Our team is a dedicated group of professionals committed to ensuring individuals receive fair insurance settlements. We combine licensed expertise with an in-house assortment of legal professionals, construction estimators, accountants, and adjusters. At Allied, were not just about claims; were about people. Join us as we advocate for transparency, equity, and the rightful interests of our community.
Core Values:
We Show Up with G.R.I.T.:
Go-Getters, Relationship Builders, Intelligent Experts, Truth Champions
Every day. In every role. Through every decision and every moment of every engagement. This is the ethos that defines us. So, lets define it for one another.
Role:
APA is currently expanding and is looking for motivated individuals to come onboard as public adjusters. The Public Adjuster I is a professional claims handler who advocates for the policyholder in appraising and negotiating a claimant's insurance claim throughout the claim process. The PA works well in a rapid paced environment, model behaviors that reflect APAs core values and reports to a Managing Public Adjuster. The purpose of a PA I is to develop foundational skills in claims handling, client communication, and documentation while supporting more senior adjusters. The PA I will learn to manage claims with structured guidance.
Responsibilities:
Assist in managing assigned claims with support and guidance
Learn and apply policy interpretation and coverage fundamentals
Promptly handle claims that are assigned, creating a positive client experience
Conduct onsite inspections (with direction or supervision as necessary)
Capture photos and measurements to accurately measure losses
Prepare detailed scope and cost estimates (including using experts when needed)
Investigate claims thoroughly and present strong cases to negotiate settlements for clients.
Follow internal processes, documentation standards, and timelines
Maintain timely client communication and expectations
Draft reports and claim documentation
Properly document claim files pursuant to company standards
Effectively and efficiently utilize support teams such as legal, engineering, and leadership where needed to resolve claims and maximize value for our clients
Be a good team player and assist others where needed. This may include mentoring junior staff members in various situations.
Other duties may be performed, both major and minor, which are not mentioned below. Specific activities may change from time to time.
Qualifications:
02 years claims, construction, property, insurance, legal, or related experience
State Public Adjuster License (or ability to obtain)
Strong writing, organization, follow-through, and professionalism
Understanding of the insurance Industry standards, policies applicable laws and regulations
Construction knowledge and experience
Within your first year, you will have:
Built and manage a full and dynamic case load with timely movement on each claim
Achieve strong claim outcomes for clients
Demonstrate relentless advocacy while maintaining professionalism
Maintain excellent communication standards : proactive client updates, clear expectations, well documented outreach
Build trust and strong relationships with clients to produce high client satisfaction and referral feedback
Meet or exceed claim cycle time standards while balancing quality and urgency
Produce audit-ready files with complete documentation
Collaborate effectively with company departments to drive results
Demonstrate strategic, clear intentioned claim critical thinking
Show ownership mentality by treating every claim like it matters in a proactive manner
Demonstrate resilience and persistence, and embrace objections and denials
Contribute positively to the company culture and results
Key Performance Indicators:
Client satisfaction scores
Response & follow-up timeliness
Documentation accuracy
Claim cycle time
Learning progression benchmarks
Financial goals
Benefits:
Salary: $80,000 - 105,000 plus up to 10% bonus
401(k) with 3% non-elective contribution.
Health, dental and vision insurance. Along with voluntary selections as well.
Generous paid holidays and paid time-off.
Opportunities for career advancement and professional growth.
Car and phone allowance, if needed.
We are an equal opportunity employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability status, protected veteran status, or any other characteristic protected by law.
How much does a claims representative earn in Tustin, CA?
The average claims representative in Tustin, CA earns between $31,000 and $59,000 annually. This compares to the national average claims representative range of $28,000 to $53,000.
Average claims representative salary in Tustin, CA
$43,000
What are the biggest employers of Claims Representatives in Tustin, CA?
The biggest employers of Claims Representatives in Tustin, CA are: