Claims jobs in San Diego, California - Page 5Create job alerts

Claims Advisor, Environmental | Professional Liability | Remote.

The Payment Integrity team is responsible for ensuring healthcare claims are paid accurately, both in a pre-pay and post-pay context.Some examples of payment integrity include validating coding rules, determining the correct party, membership eligibility, contractual adherence, and conducting root c

Director, Claims Recovery (Building). The Claims Recovery practice is part of the Forensics Risk division specializing in quantifying, compiling, and preparing property damage, extra expense, and business interruption insurance claims for various insured perils. The Director, Claims Recovery (Build

Primary Purpose: To analyze complex or technically difficult general liability and auto liability claims to determine benefits due; to work with high exposure claims involving litigation and rehabilitation; to ensure ongoing adjudication of claims within service expectations, industry best practices

The Data Scientist will collaborate closely with business partners in Underwriting, Claims, Finance, Actuarial, HR, Law and Technology to help us realize the value in our extensive data resources. Partner effectively with data engineering and MLOps teams to ensure internal and external data pipeline

We are seeking an experienced Account Manager to join our Employee Benefits Department. Our service professionals play a vital role in supporting our clients with day-to-day account management, claims management, and underwriting services that ensure they have what they need to protect what matters

The Claims Examiner handles a variety of claims with a focus on providing the highest level of service for policyholders and ICW Group to bring claims to an equitable conclusion within Company standards and best practice guidelines. Bachelor's degree from an accredited institution (or equivalent edu

Company is a worldwide provider of legal services, serving law firms, corporations, financial institutions and government agencieshelping them streamline the administration of business operations.Its scalable, flexible technology is designed to help you quickly and efficiently turn huge amounts of d

Monitors third party claims; maintains periodical review of litigated claims, serious vocational rehabilitation claims, questionable claims and sensitive claims as determined by client. To supervise the operation of multiple teams of examiners and technical staff for workers compensation for clients

Are you actively working as a Licensed Claims Adjuster with 100 claims or more under your belt?. If so, that's great! If not, no problem! Let us help you on your career path as a Licensed Claims Adjuster. At MileHigh Adjusters Houston, we offer comprehensive training programs tailored to equip you w

As the hub of all claims, the coordinator is responsible for speaking with the customer, ongoing customer follow up, handling service complaints, logistics of dispatching field personnel to jobs while ensuring that the required deadlines are met.The Coordinator will be responsible for following up d

Independent Insurance Claims Adjusters Needed Now! Are you ready to embark on a dynamic and in-demand career as an Independent Insurance Claims Adjuster? This is your chance to join a thriving industry with endless opportunities for growth and advancement. Are you actively working as a Licensed Clai

Are you actively working as a Licensed Claims Adjuster with 100 claims or more under your belt?. If so, that's great! If not, no problem! Let us help you on your career path as a Licensed Claims Adjuster. At MileHigh Adjusters Houston, we offer comprehensive training programs tailored to equip you w

Work collaboratively and effectively with a team of underwriters, underwriting associates, customer service representatives, claims examiners, and loss control representatives. Senior Commercial Lines Life Sciences Underwriter. Chubb is seeking a highly motivated, results oriented Senior Commercial

The Major Claims Examiner is responsible for managing complex, high-value workers' compensation claims and ensuring timely, fair resolution in compliance with policy provisions while reducing financial exposure and supporting injured workers' recovery. This position manages assigned major loss claim

Manages claims by gathering information to determine exposure; assigns reserve values to claims, making claims payments as necessary, and settling claims up to designated authority level. To analyze claims to determine scope of damages; to ensure ongoing adjudication of claims within company standar

For associate claims examiners:/pulliParticipate in comprehensive training on workers compensation laws and claims handling. If youre ready to be part of a dynamic team and help shape the future of our organization, wed love to hear from you!/ppOur claims team manages workers compensation claims wit

Reviews and evaluates workers' compensation claims to determine compensability and benefits due on indemnity claims;. Workers' Compensation Claims Specialist. Responsible for reviewing, adjudicating and managing low- and mid-level workers' compensation claims in accordance with company guidelines, s

The Claims Specialist works within a Claims Team, using the latest technology to manage an assigned caseload of routine to moderately complex claims from the investigation of the claim through resolution. Knowledge of claims investigation techniques, medical terminology and legal aspects of claims.

Independent Insurance Claims Adjusters Needed Now! Are you ready to embark on a dynamic and in-demand career as an Independent Insurance Claims Adjuster? This is your chance to join a thriving industry with endless opportunities for growth and advancement. Are you actively working as a Licensed Clai

Under direct supervision, develops the knowledge and skills needed to conduct thorough investigations, make decisions about liability / compensability, evaluate losses, negotiate settlements and manage an inventory of commercial property/casualty and disability claims by participating in a comprehen

Requires a high degree of claims handling expertise, including at least five years managing medical professional liability cases, many with complex litigation or high potential value. This is a dynamic claims and account management position. To be the leading third-party administrator offering profe

Oversee proper handling of WC claims to protect the interests of the adjuster, client, and carrier. WC claims experience (California jurisdiction). Prior experience adjusting WC claims from start to resolution.

To analyze complex or technically difficult workers' compensation claims to determine benefits due; to work with high exposure claims involving litigation and rehabilitation; to ensure ongoing adjudication of claims within service expectations, industry best practices and specific client service req

To analyze complex or technically difficult general liability and auto liability claims to determine benefits due; to work with high exposure claims involving litigation and rehabilitation; to ensure ongoing adjudication of claims within service expectations, industry best practices, and specific cl

To analyze complex or technically difficult workers' compensation claims to determine benefits due; to work with high exposure claims involving litigation and rehabilitation; to ensure ongoing adjudication of claims within service expectations, industry best practices and specific client service req

Attendance and completion of designated claims professional training program. Adjusting various levels of workers' compensation claims under close supervision, which includes:. Thoroughly investigating new and existing claims by gathering relevant information including medical records, employer repo

The Senior Claims Specialist is responsible for managing the most complex, catastrophic commercial liability claims with a focus on providing the highest level of service for policyholders and ICW Group to independently bring claims to an equitable conclusion within company standards and best practi

You will be assigned a mentor and manager that will support and guide you on your career journey and be equipped with the foundational skills needed for a successful career in claims adjusting. Attendance and completion of designated claims professional training program. Adjusting various levels of

Job DescriptionBenefits: • 401(k), • Bonus based on performance

Job Description About Us At NewHaus Construction Inc., we’ve built our reputation as a trusted leader in roofing and exterior solutions by focusing on two things: uncompromising craftsmanship and a customer-first mindset. As we continue to grow, we’re looking for skilled Field Roofing Specialists who want more than just another job — they want a long-term career with real earning potential and opportunities to lead. The Role As a Field Roofing Specialist, you’ll be the expert on-site: inspecting roofs, assessing damage, documenting findings, and walking homeowners through the best solutions. You’ll work closely with our sales and project management teams to ensure every client receives accurate, professional, and timely service. What You’ll Do • Perform detailed roof inspections to identify damage, wear, and potential issues, • Capture accurate documentation with photos, measurements, and reports, • Explain inspection results to homeowners and recommend next steps, • Partner with sales staff to provide precise estimates and proposals, • Assist with storm damage evaluations, warranty inspections, and insurance claims, • Follow OSHA safety standards and company protocols at all times, • Experience in roofing, construction, or inspections preferred (not required), • Ability to safely climb and work on roofs of varying heights/pitches, • Strong communication skills with a customer-first approach, • Detail-oriented and able to deliver accurate reports, • Valid driver’s license and reliable transportation, • Uncapped earning potential: Top specialists earn $120K–$175K+ annually, • Performance bonuses & incentives that reward your hard work, • Clear career path: Grow into senior, lead, or management positions, • Leadership training & mentorship to support long-term development, • Company support: Paid training, safety gear, tools, and branded apparel provided, • Strong team culture: You’ll join a stable, growing company with a supportive crew Apply today by sending your resume and contact info to [application email/link], or call us directly: • 818-303-5437

Job Description SUMMARY OF POSITION: The Medical Billing Representative will be responsible for miscellaneous daily functions in the Revenue Cycle Management office. Reliability with high attention to detail and organizational skills is needed for this position. The ideal candidate is someone who takes pride in their everyday tasks, can function effectively as part of a team, as well as being able to work independently. PRIMARY DUTIES AND RESPONSIBILITIES: The primary job functions required of our Medical Billing Representative includes the following, but not limited to: • Thorough appropriate account review on billed claims, contact third-party payors for status and resolution, • Requests additional information from physician offices, patients, and others as needed to resolve payor requests, • Identify billing or coding issues and request re-bills, secondary billing, or corrected bills as needed, • Updates patient demographics as needed and correct plan IDs, • Posts appropriate follow-up notes/status to accounts, • Written appeals and corrections to third-party payors as needed, • Recognizes repetitive errors and delays with payors and escalates payment delays/ problems accounts timely to manager, • Perform collection efforts on delinquent patient accounts, • Perform special projects and other duties as needed, • Ensures compliance with State and Federal Laws Regulations, • Assist other Billing Representatives and Management with a variety of other daily tasks, • Respond to email, EHR messages/tasks throughout the day, • Be a team player: Identify how you might assist fellow team members, • Thorough understanding of the revenue cycle process for physician billing, • Possess intermediate skills in Microsoft Office (Word, Excel), • Ability to learn billing systems, • Ability to communicate in a clear and professional manner, • Must possess good oral and written skills, • Strong interpersonal skills, • Ability to make sound decisions, • Familiar with terms such as HMO, PPO, IPA and Capitation, • Understanding/ability to read an EOB, • Intermediate understanding of HCFA 1500 forms., • 2-3 years of medical claims and/or collections experience, • Full time (on-site), • Monday-Friday, • 7:30 am to 4:30 pm

Job Description We're looking for motivated, client-focused professionals to meet virtually with individuals who have requested information about supplemental benefit plans. These plans are designed to help protect families beyond what is typically offered by their employer. You will guide clients through available options, answer their questions, and assist them in selecting coverage that best meets their needs. Success in this position comes from building trust, providing clear explanations, and maintaining consistent follow-up. What You'll Do * Contact individuals who have expressed interest in learning about additional benefit coverage. * Schedule and conduct virtual meetings via Zoom to review plan details. * Recommend new coverage or update existing benefits based on each client's situation. * Maintain regular communication and long-term relationships with clients. * Provide benefit reviews, assist with claims, and handle policy changes as needed. * Deliver excellent customer service and ensure all records are accurate and up to date. Requirements * Must have a home office and reliable high-speed internet. * Strong communication and organization skills. * Comfortable working in a client-facing role, primarily through virtual meetings. * Ability to work independently and manage your schedule effectively. Compensation This is a commission-only position. Weekly pay is based on individual performance and sales results, with additional bonus opportunities available. First-year earnings for most representatives range between $62,000 and $69,500, depending on performance. There is no base salary. Benefits * Medical insurance * Dental, vision, and 401k matching * Company stock options * Paid training * Flexible schedule with remote work (office space available if preferred)

Job Category: Claims Description Are you looking for an opportunity to join a fast-growing company that consistently outpaces the industry in year-over-year growth? Liberty Mutual offers an exciting opening for a Workers Compensation Claims Specialist within the West Region! As a Workers Compensatio

As the hub of all claims, the coordinator is responsible for speaking with the customer, ongoing customer follow up, handling service complaints, logistics of dispatching field personnel to jobs while ensures that the required deadlines are met. Understanding of the claims flow process Contents, Fir

Job Category: Claims Description Under direct supervision, develops the knowledge and skills needed to conduct thorough investigations, make decisions about liability / compensability, evaluate losses, negotiate settlements and manage an inventory of commercial property/casualty and disability claim

The Claims Investigator should demonstrate proficiency in the following areas:.

Seeking an experienced investigator with multi-lines investigations to include W/C and P&C experience.SIU experience is also highly desired, but not required.We are seeking individuals who possess proven investigative skill sets within the industry, as well as honesty, integrity, self-reliance, reso

Claims Administrative Assistant. The purpose of this job is to oversee administrative processes within the Claims department. This position exists to alleviate the administrative responsibilities of the claims staff and to ensure that department inquiries are responded to in a timely manner.

Provides administrative assistance to the Claims team. Reviews medical bills for potential new losses, required corrections, and/or assigns to existing claims. Provides backup assistance to claims support teams.

The successful Claims Investigator should demonstrate proficiency in the following areas:. Are you a seasoned Claims Investigator with a knack for uncovering the truth? We are seeking an experienced professional equipped with a strong background in multi-line investigations, particularly in Workers'

The successful candidate will be responsible for managing senior claims professionals who handle the most severe casualty and commercial auto claims across the country. Applicants for the AVP, Complex Claims Manager position at the company should have 5-10 years of claims leadership and people manag

Sedgwick is the world's leading risk and claims administration partner, which helps clients thrive by navigating the unexpected. The company's expertise, combined with the most advanced AI-enabled technology available, sets the standard for solutions in claims administration, loss adjusting, benefit

We are looking for licensed claims adjusters with at least 100 claims under their belt. Independent Insurance Claims Adjuster in San Ysidro, California. Join MileHigh Adjusters Houston as an Independent Insurance Claims Adjuster in San Ysidro, California.

Generates new claim set up notifications/correspondence for incoming claims and for those claims identified for transfer from the Medical Claims Specialist Unit to Indemnity Unit. Berkshire Hathaway Homestate Companies, Workers Compensation Division, has an opening for a Claims Assistant in its San

The Claims Investigator should demonstrate proficiency in the following areas:.

Reviews and analyzes incoming workers' compensation claims to determine the severity of the claims, benefits owed, ensures medical treatment is communicated to the injured worker, and reviews the claims file for completeness and accuracy of details. This position is responsible for reviewing incomin

Experience in creating and delivering agentic AI solutions for Claims or other Operations functions. Lead initiatives to improve claims processing efficiency and accuracy, reducing operational costs and improving member satisfaction. Analyze claims workflows and identify bottlenecks or opportunities