- TEKsystems (Fresno, CA)
- …(1)year experience as a Claims Examiner for medical, dental claims and vision, subrogation , and accident claims * Ability to interpret Plan Documents or Summary Plan ... Descriptions (SPD) for the purpose of accurate claim adjudication and/or benefit determination * Basic knowledge of medical terminology. Familiar with UB-04 and HCFA 1500 forms (837/5010 format), ICD10, CPT, and HCPCS codes. * Good verbal and written… more
- Sedgwick (Roseville, CA)
- …practices and specific client service requirements; and to identify subrogation of claims and negotiate settlements. **ESSENTIAL FUNCTIONS and RESPONSIBILITIES** ... + Analyzes and processes complex or technically difficult workers' compensation claims by investigating and gathering information to determine the exposure on the claim; manages claims through well-developed action plans to an appropriate and timely… more
- Sedgwick (Sacramento, CA)
- …cost for our clients. + Identifies and investigates for possible fraud, subrogation , contribution, recovery, and case management opportunities to reduce total claim ... cost. + Represents Company in depositions, mediations, and trial monitoring as needed. + Communicates claim activity and processing with the client; maintains professional client relationships. + Ensures claim files are properly documented and claims coding is… more
- Sedgwick (Concord, CA)
- …the file towards prompt and appropriate resolution. + Identifies and pursues subrogation and risk transfer opportunities; secures and disposes of salvage. + ... Communicates claim action/processing with insured, client, and agent or broker when appropriate. **ADDITIONAL FUNCTIONS and RESPONSIBILITIES** + Performs other duties as assigned. + Supports the organization's quality program(s). + Travels as required.… more
- Sedgwick (Sacramento, CA)
- …file towards prompt and appropriate resolution. + Identifies and pursues subrogation opportunities; secures and disposes of salvage. + Communicates claim ... action/processing with insured, client, and agent or broker when appropriate. + Maintains professional client relations. + Performs coverage, liability, and damage analysis on all claims assignments. **ADDITIONAL FUNCTIONS and RESPONSIBILITIES** + Performs… more
- USAA (Los Angeles, CA)
- …resources. May identify and resolve potential discrepancies and identifies subrogation potential resulting from unusual characteristics. + Identifies coverage ... concerns, reviews prior loss history, determines and creates Special Investigation Unit (SIU) referrals, when appropriate. Determines coverage through analyzing information involving complex policy terms and contingencies. + Determines and negotiates complex… more
- Travelers Insurance Company (Irvine, CA)
- …resources for specific activities required to effectively evaluate claims, such as Subrogation , Risk Control, nurse consultants, and fire or fraud investigators, and ... other experts. + Verifies the nature and extent of injury or property damage by obtaining and reviewing appropriate records and damage documentation. + Maintains claim files and documents claim file activities in accordance with established procedures. +… more
- Travelers Insurance Company (San Francisco, CA)
- …+ Recognizes when to refer claims to Travelers Special Investigations Unit and/or Subrogation Unit. + Identifies and refers claims with Major Case Unit exposure to ... the manager. + Performs administrative functions such as expense accounts, time off reporting, etc. as required. + Provides multi-line assistance in response to workforce management needs; including but not limited to claim handling for Auto, Workers… more
- Kelly Services (Brea, CA)
- …litigation and coordinating with attorneys and vendors + Identifying subrogation opportunities and managing claim recoveries + Communicating effectively with ... claimants, clients, and medical providers + Maintaining accurate claim documentation and professional client relationships + Supporting internal quality programs and team collaboration **This job might be an outstanding fit if you have:** + **5+ years of… more
- Robert Half Legal (Los Angeles, CA)
- …of civil litigation experience. This attorney will focus on sophisticated subrogation and catastrophic insurance litigation. This litigation attorney position is ... ideal for someone who wants to focus on research, legal analysis, and drafting. The firm is willing to consider attorneys with experience in any civil litigation practice area. The ideal attorney will have experience with discovery, drafting motions, making… more