- Travelers Insurance Company (Diamond Bar, CA)
- …time to conclusion and negotiate settlements where appropriate to resolve claims . Coordinate medical and indemnity position of the claim with a Medical ... is no longer available. IW is receiving Vocational Rehabilitation. Claims that have been reopened for additional medical...issues). Achieve a positive end result by returning injured party to work and coordinating the appropriate medical… more
- Travelers Insurance Company (Rancho Cordova, CA)
- …for quality claim handling including investigating, evaluating, negotiating, and resolving claims on losses of lesser value and complexity and provide claim ... if a claim is compensable under Workers Compensation including evaluating claims for potential fraud. + Achieve a positive result by returning an injured… more
- Robert Half Accountemps (Los Angeles, CA)
- …thorough investigations to gather facts, obtain statements, and assess compensability of claims . * Administer statutory medical and indemnity benefits promptly ... and reporting. * Exceptional organizational and time management abilities to handle multiple claims simultaneously. Robert Half is the world's first and largest… more
- Stanford Health Care (Palo Alto, CA)
- …Health. The Claims Manager acts as the primary liaison with the third- party administrator (TPA) to ensure proper claims handling and with internal partners ... hope and innovation, we encourage you to take the first step and explore our current job openings. Your...the applicable service agreement. Review reserves, settlement activity, and claims costs. Participate in periodic claim reviews… more
- Sedgwick (Sacramento, CA)
- …! If you are an agile auto claims examiner with 5+ years of experience handling first party and third- party liability claims , we want to talk to you! ... FUNCTIONS and RESPONSIBILITIES** + Processes complex auto commercial and personal line claims , including bodily injury and ensures claim files are properly… more
- Sedgwick (Sacramento, CA)
- …assess Property Damage estimates, total loss evaluations, and related expenses to effectively negotiate first and third party claims . + Knowledge of total ... FUNCTIONS and RESPONSIBILITIES** + Processes auto property damage and lower-level injury claims ; assesses damage, makes payments, and ensures claim files are… more
- Philadelphia Insurance Companies (Mission Viejo, CA)
- …team! Summary: Investigate, evaluate and settle more complex first and third party commercial auto insurance claims . A typical day will include the ... communication as well as results of investigation. Evaluates each claim in light of facts; Affirm or deny coverage;...Companies, Tokio Marine America, Inc., TMNA Services, LLC, TM Claims Service, Inc. and First Insurance Company… more
- Highmark Health (Sacramento, CA)
- …requests, and drug claim edits/prior authorizations. By reviewing member claims history, clearly defines the medical necessity of non-formulary and ... ensures effective and efficient delivery of Pharmacy call center services. Serves as first line reviewer in monitoring and ensuring adherence to the health plan's… more
- Kemper (Chatsworth, CA)
- …preferred + 3 plus years of claims adjusting experience handling complex and severe first party and bodily injury claims with high exposures + Must be ... position focuses solely on the analysis & negotiation of bodily injury claims that are ordinarily assigned after the initial coverage determination, property damage… more
- City and County of San Francisco (San Francisco, CA)
- … processing, and/or collecting healthcare service reimbursements or medical claims from Medi-Cal (Medicaid), Medicare, insurance, third party payors, and ... to charge errors, claims submission volume, denials and trends based on claim type and/or payer, including unbilled inventory to ensure the team is prioritizing… more