UNKNOWN

FEED

Role Overview: Investigate, evaluate, and resolve advanced, large-loss, and complex workers compensation claims with a high degree of autonomy. We're looking for a Senior Claims Examiner- Workers Compensation (California) with a passion for claims management to join our team!

Based in Atlanta, Georgia, Crawford &amp; Company is the world's largest independent provider of claims management solutions to the risk management and insurance industry as well as self-insured entities, with an expansive global network serving clients in more than 70 countries. 

The Crawford System of Claims Solutions(SM) offers comprehensive, integrated claims services, business process outsourcing and consulting services for major product lines, including property and casualty claims management, workers compensation claims and medical management, and legal settlement administration 

The Company's shares are traded on the NYSE under the symbols CRDA and CRDB.

Crawford & Company

Sr Claim Examiner-Wc (Ca)

ea_via_bold

As Paychex and Paycor come together, we're combining innovative technology, data-driven insights, AI, and human expertise to help organizations work smarter, support their people, and achieve better business outcomes. Paychex is reimagining how businesses manage their workforce by bringing payroll, HR, benefits, and advisory services together into a single connected HCM platform.

HOUR

Paychex Inc

Litigation and Claims Analyst

linkup_via_bold

The Temporary UM Claims Examiner supports Utilization Management and Claims Operations by reviewing claims requiring UM intervention, validating authorization requirements, identifying continuity of care protections, researching claim discrepancies, and ensuring accurate routing and adjudication of claims. This role performs administrative and analytical review activities and escalates clinical determinations to licensed UM staff when appropriate.

We are a $125 Million, NMSDC-certified Minority & Woman owned Workforce Solutions Company headquartered in the DC metro area with presence across US with global presence - Canada, Mexico, India, UK, Malaysia, Indonasia, Hongkong, Singapore, UAE. We are specialized in providing Workforce Solutions, SOW project delivery, Engineering Solutions, Creative Services. We currently support 100+ Fortune companies globally and across multiple industry segments. We are currently supporting several massive programs across industry segment nationally/globally (Intel, Ally, AMD, QUALCOMM, Morgan Stanley, Kraft/ Mondelez, MNP, Amdocs, Dell, SanDisk, Medtronic, Becton Dickinson, GE, Lockheed Martin, UTC, L-3 Communications, Caterpillar, BMW, Mercedes Benz, National Grid, Dominion, Energy Future Holdings, PSEG, 3M, Fidelity, Aetna, Humana, Johnson & Johnson, Pfizer, Merck etc). 
All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender, identity, national origin, disability, or protected veteran status.

LanceSoft Inc

Claims Clerk I

jobdiva

house network, and a hard-wired internet connection capable of continuously supporting outstanding call quality and high-speed response rates. Previous experience in a medical office type setting, including some knowledge of insurance, claims, billing or coding, with an understanding of the different types of insurance (Medicare/Medicaid and/or Child Plus).

As a process transformation company, Sutherland rethinks and rebuilds processes for the digital age by combining the speed and insight of design thinking with the scale and accuracy of data analytics. We have been helping customers across industries from financial services to healthcare, achieve greater agility through transformed and automated customer experiences for over 30 years. 

Headquartered in Rochester, N.Y., Sutherland employs thousands of professionals spanning 19 countries around the world. To learn more, please visit us at www.sutherlandglobal.com.

Sutherland Global Services Inc

Health Claims Specialists

FULL_TIME

As a process transformation company, Sutherland rethinks and rebuilds processes for the digital age by combining the speed and insight of design thinking with the scale and accuracy of data analytics. We have been helping customers across industries from financial services to healthcare, achieve greater agility through transformed and automated customer experiences for over 30 years. 

Headquartered in Rochester, N.Y., Sutherland employs thousands of professionals spanning 19 countries around the world. To learn more, please visit us at www.sutherlandglobal.com.

Sutherland

SmartRecruiters_Organic_Non_Easy_Apply

Identify premature conclusions, missing investigative steps, unsupported valuations, improper communications, and failures to distinguish covered damage from excluded or unrelated loss. Experience handling claims in at least one area such as property, auto physical damage, bodily injury, general liability, commercial casualty, catastrophe, or specialty claims.

Mercor

Insurance Claims Specialist - Fully Remote

Manatal

Must possess a license from your domiciled (state you live in or designated home state) state and a minimum of one license in any of the following states: NY, TX or FL Additional State Adjuster License(s) may be required within 180 days. Relies on extensive experience and judgment to plan and accomplish goals with a minimum 8-10 years of complex/major claims experience including proficiency in investigation and resolution of severe to major casualty and general liability claims.

Elite

Senior Claims Adjuster – GL

sourcestack_via_bold

POSITION SUMMARY: Under general supervision, manages workers’ compensation indemnity claims of moderate to complex difficulty from inception through resolution within assigned authority limits and established company and client guidelines. QUALIFICATIONS REQUIRED: Education/Experience: Bachelor’s degree in related field (preferred); and three (3) to five (5) years related experience; or equivalent combination of education and experience.

Work Comp Claims Adjuster (Texas Jurisdiction)

Claims Examiner III Must have TEXAS workers' compensation license and seeking 5 years experience in lost time work comp claims for TEXAS jurisdiction. DUTIES AND RESPONSIBILITIES: Effectively manages a caseload of 110 to 160 workers’ compensation files, including very complex claims.*.

Senior Claims Adjuster_TEXAS WC License

Gainwell Technologies defines "wages" and "wage rates" to include "all forms of pay, including, but not limited to, salary, overtime pay, bonuses, stock, stock options, profit sharing and bonus plans, life insurance, vacation and holiday pay, cleaning or gasoline allowances, hotel accommodations, reimbursement for travel expenses, and benefits. Working under the direction of the Claims Appeals Supervisor, you will serve as a primary resource for Appeals Examiners, help coordinate daily workflow, provide training and guidance, monitor quality and performance, and assist with complex appeals and operational issues.

YEAR

Gainwell Technologies LLC

Claims Appeals Team Lead - Onsite - West Sacramento, CA

As part of our internship program you will receive: Targeted business training designed to help you refine your professional skills and acumen critical to the success of Westfield professionals; Technical training to deepen your skill level within your chosen discipline; and an understanding of the broader insurance industry; Access to additional training to compliment your professional development. An Claims Intern at Westfield Specialty works on a variety of projects to gain hands-on experience in the insurance industry and develop technical skills.

Westfield Insurance Co

2027 Summer Intern Program- Claims Intern, Berkeley Heights, NJ

Investigates claims, gathers and evaluates documentation, communicates with customers, claimants, clients, service providers, and field teams, and makes claim determinations and settlement decisions within assigned authority limits. Benefits : Comprehensive package including medical, dental, and vision coverage; prescription drug and telemedicine services; company-paid life and disability insurance; retirement savings with company match; paid time off, holidays, and parental leave; plus additional voluntary benefits and employee discounts.

CRST The Transportation Solution

Claims Representative

We utilize time-tested, proven, active methods of technician management developed from our long lasting experience. These elements are managed by a highly seasoned, cross-functional executive team that can support you in achieving your service program goals: offer development, demand generation, event fulfillment, customer experience validation, and more.
				
				We provide:
				<ul>
					<li>Ongoing service programs and offer development, including commercial programs</li>
					<li>Analysis of electronics complexity for simplicity of consumer use</li>
					<li>Creative demand enhancement/average order increases</li>
					<li>Measurement and reporting of consumer satisfaction</li>
					<li>GUARANTEED delivery of a complete, quality service event, every time</li>
				</ul>

Installs LLC

Manage litigated and non-litigated insurance coverage and bad faith claims on all lines of business (e.g., casualty, environmental, garage, construction defect, NYLL, inland marine, and WC/EL), utilizing the highest degree of technical and legal experience, and working closely with management and outside coverage counsel to resolve all such claims in the most successful manner possible. A deep knowledge of claims adjudication and focus on customer service typically achieved through: At least seven years’ experience handling insurance coverage issues and disputes, with exposure of $100,000 or more, for Commercial General Liability (including Bodily Injury and Property Damage), Construction Defect, New York Labor Law, Garage, Inland Marine, Excess, Property, and Environmental.

BP&C

Senior Technical Claims Specialist (Insurance Coverage Litigation)

Essential Responsibilities: Working with limited oversight under broad management direction, adjudicate highly complex claims and insurance coverage disputes mostly for our professional liability line of business, at the highest authority limits on assignments reflecting the highest degree of technical complexity and coordination in liability and litigated claims, potentially with major impact on departmental results. Qualifications / Experience Required: A deep knowledge of claims adjudication and focus on customer service typically achieved through: At least seven years' experience handling insurance coverage issues and disputes, with exposure of $100,000 or more, for Professional Liability claims.

Argo Group International Holdings Inc

Senior Technical Claims Specialist

Qualifications / Experience Required: A deep knowledge of claims adjudication and focus on customer service typically achieved through: At least seven years' experience handling insurance coverage issues and disputes, with exposure of $100,000 or more, for Commercial General Liability (including Bodily Injury and Property Damage), Construction Defect, New York Labor Law, Garage, Inland Marine, Excess, Property, and Environmental. Essential Responsibilities: Manage litigated and non-litigated insurance coverage and bad faith claims on all lines of business (e.g., casualty, environmental, garage, construction defect, NYLL, inland marine, and WC/EL), utilizing the highest degree of technical and legal experience, and working closely with management and outside coverage counsel to resolve all such claims in the most successful manner possible.

Argo Group International Holdings Ltd.

Managing litigation cases related to auto claims disputes, attending mediations, arbitrations, and court hearings as necessary, and communicating regularly with clients, claims adjusters, attorneys, and other stakeholders. Analyzing and reviewing auto insurance claims to identify areas of dispute, investigating and gathering all necessary information and documentation related to the claim, evaluating liability and damages related to the claim, and negotiating and settling claims with opposing parties or their insurance providers.

Reserv

Litigation Claims Adjuster, Trucking

PART_TIME

Indexing, organizing, and uploading correspondence, photos, reports, invoices, and legal documents while keeping file notes, diary dates, and claim data accurate, current, and compliant with company policies for PII, PHI, and other confidential data. Maintaining department tracking tools and logs, correcting incomplete, inconsistent, or miscoded claims found in exception reports, and preparing monthly, ad hoc, regulatory, and audit reports for claims management, finance, underwriting, and reinsurance.

Kinsale Management, Inc

Claims Operations Specialist

Working under technical direction and within significant limits and authority, adjudicate Garage Bodily Injury claims of higher technical complexity with a direct impact on departmental results. A practical knowledge of commercial claims, as well as an exceptional customer service focus typically achieved through: A minimum of two years' experience adjudicating first and third party commercial Garage Bodily Injury claims.

Garage Bodily Injury Claims Adjuster

Working under technical direction and within significant limits and authority, adjudicate Garage Property Damage claims of higher technical complexity with a direct impact on departmental results. Our Adjusters and Managers are empowered to exercise their independent discretion and, within broad limits and authority, be creative in developing solutions and treat each case as the unique situation it is.

Claims Examiner Jobs in the United States

Sr Claim Examiner-Wc (Ca) Crawford & Company

Litigation and Claims Analyst Paychex Inc

Claims Clerk I LanceSoft Inc

Health Claims Specialists Sutherland Global Services Inc

Health Claims Specialists Sutherland

Insurance Claims Specialist - Fully Remote Mercor

Senior Claims Adjuster – GL Elite

Work Comp Claims Adjuster (Texas Jurisdiction) Elite

Senior Claims Adjuster_TEXAS WC License Elite

Claims Appeals Team Lead - Onsite - West Sacramento, CA Gainwell Technologies LLC

2027 Summer Intern Program- Claims Intern, Berkeley Heights, NJ Westfield Insurance Co

Claims Representative CRST The Transportation Solution

Claims Representative Installs LLC

Senior Technical Claims Specialist (Insurance Coverage Litigation) BP&C

Senior Technical Claims Specialist Argo Group International Holdings Inc

Senior Technical Claims Specialist (Insurance Coverage Litigation) Argo Group International Holdings Ltd.

Litigation Claims Adjuster, Trucking Reserv

Claims Operations Specialist Kinsale Management, Inc

Garage Bodily Injury Claims Adjuster BP&C

Property Damage Claims Adjuster, Garage BP&C

Similar Job Searches

See More Jobs

Stand out to leading employers.