• Claims Examiner

    Insight Global (Irvine, CA)
    …of medical terminology. Previous experience as a medical claims examiner or auditor preferred. Experience with claim investigation, quality assurance ... individual will be responsible for the investigation, determination, and reporting of claims processing through auditing billing processes, including pre and… more
    Insight Global (08/08/25)
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  • Medical Claims Adjudication - remote

    Cognizant (Sacramento, CA)
    …duties as assigned by management. **Qualifications:** + A minimum of 2 years' claims processing experience is required. + Knowledge of physician practice and ... stakeholders and other teams. **Primary Responsibilities** : + Review claim system data and verify against UB or HCFA...of Facets experience. + Experience in the analysis and processing of claims for payments, utilization review/quality… more
    Cognizant (08/01/25)
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  • Claims Examiner

    Kelly Services (Roseville, CA)
    …best practices and quality service standards **What's a typical day as a Claims Examiner? You'll be:** + Analyzing and processing complex workers' compensation ... + Identifying and pursuing recoveries, including subrogation and Second Injury Fund claims + Communicating claim status with claimants and clients, maintaining… more
    Kelly Services (08/13/25)
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  • Claims Examiner

    Kelly Services (San Diego, CA)
    …environment with growth potential **What's a typical day as a Workers' Compensation Claims Adjuster? You'll be:** + Analyzing and processing complex or ... where Kelly(R) comes in. We're seeking a **Workers' Compensation Claims Adjuster** to work with one of our top...managing reserves; ensuring adequacy throughout the life of the claim + Calculating and approving claim payments… more
    Kelly Services (08/19/25)
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  • Sr. Professional Liability Medical

    Providence (CA)
    …we must empower them.** **Providence is calling a Sr. Professional Liability Medical Claims Manager who will:** **Investigate, evaluate, and manage professional, ... issues. + 7 years of relevant general and professional liability claims processing or management experience **Preferred qualifications for this position… more
    Providence (07/15/25)
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  • Claims Specialsit

    Kelly Services (Orange, CA)
    … and litigation cases **What's a typical day as a Workers' Compensation Claims Adjuster? You'll be:** + Analyzing and processing complex workers' compensation ... within designated authority + Assigning and managing reserves throughout the life of claims + Approving and issuing timely claim payments and adjustments +… more
    Kelly Services (08/19/25)
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  • Workers Compensation | Claims Examiner…

    Sedgwick (Long Beach, CA)
    …. + Negotiating settlement of claims within designated authority. + Communicating claim activity and processing with the claimant and the client. + Reporting ... client service requirements. **ESSENTIAL RESPONSIBLITIES MAY INCLUDE** + Analyzing and processing claims through well-developed action plans to an appropriate… more
    Sedgwick (08/14/25)
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  • Claims Examiner

    TEKsystems (Northridge, CA)
    …documentation and workflow meet regulatory and internal standards. + Must-Have Skills + HMO Claims Processing + Claim Denials and Resubmissions + EZCap ... team in Northridge, CA. This role focuses on auditing and compliance within claims processing , including benefit analysis, system design, and managing special… more
    TEKsystems (08/16/25)
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  • Claims Representative Trainee | In-office…

    Sedgwick (Orange, CA)
    …under close supervision. + Documenting claims files and properly coding claim activity. + Communicating claim action/ processing with claimant and ... + Performs on-the-job training activities including: + Adjusting lost-time workers compensation claims under close supervision. May be assigned medical only … more
    Sedgwick (08/21/25)
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  • Industry Advancement Program | Workers…

    Sedgwick (Roseville, CA)
    …under close supervision. + Documenting claims files and properly coding claim activity. + Communicating claim action/ processing with claimant and ... + Performs on-the-job training activities including: + Adjusting lost-time workers compensation claims under close supervision. May be assigned medical only … more
    Sedgwick (08/20/25)
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