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The ideal candidate is confident navigating California-specific regulations, skilled in negotiation strategy, and comfortable collaborating with legal counsel and medical professionals to drive efficient and compliant claim resolution. This role requires deep technical expertise, sound judgment, and the ability to independently handle high-exposure and litigated matters while delivering strong claim outcomes and exceptional service.

King'S Insurance Staffing

California Workers' Compensation Claims Examiner | Remote

Manage negotiations with claimants, claimant's legal representatives or third parties by utilizing strong communication and negotiation skills in sharing investigative results and rationale, listening to claimant perspective and arguments, and influencing claimant perspective to achieve consensus on appropriate and final resolution of assigned claims. Qualifications: Minimum Qualifications: High School Diploma/GED with 1-2 years of experience in Auto/General Liability Claims, Insurance, or related field, or suitable combination of education, experience, and training AND/OR Demonstration of the following skills and abilities through education, certifications, military, or other experiences.

J.B. Hunt Transport, Inc. is a Fortune 300 company that specializes in freight shipping for customers of all sizes. Our mission is to drive long-term value for our people, customers and shareholders while staying focused on our vision to create the most efficient transportation network in North America.

J.B. Hunt Transport Services Inc

Casualty Claims Examiner I

Manage negotiations with claimants, claimant's legal representatives or third parties by utilizing strong communication and negotiation skills in sharing investigative results and rationale, listening to claimant perspective and arguments, and influencing claimant perspective to achieve consensus on appropriate and final resolution of assigned claims. This investigation includes analysis of state and federal laws, retaining services of field investigators, outside legal counsel to obtain a full picture of exposure and documentation of all findings for each claim within the claims matter management system for management review as well as internal and external audit processes.

J.B. Hunt

FULL_TIME

Reviews, researches, and resolves pended claims for Medi-Cal types: medical, hospital, ancillary, long term care, encounter data, other coverage, and batch claims within. The job duties, elements, responsibilities, skills, functions, experience, educational factors and the requirements and conditions listed in this job description are representative only and not exhaustive or definitive of the tasks that an employee may be required to perform.

HOUR

Partnership HealthPlan of California

Claims Examiner II

[AW]-iCims

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Selby Jennings Ltd

Causalty Claims Examiner

PRIMARY PURPOSE: 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 requirements; and to identify subrogation of claims and negotiate settlements. 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 requirements; and to identify subrogation of claims and negotiate settlements.

Ova Technologies

Claims Examiner

jobdiva

Our client is continuing to expand their Homeowner Property footprint and seeking to add an experienced Senior Inside Homeowners Property Claims Adjuster to join their growing team! Investigate and evaluate residential property losses, including reviewing coverage, damages, estimates, documentation, and supporting claim information.

Senior Inside Homeowner Property Claims Examiner | Remote

Volunteer opportunities to support our local communities - We have an adoration for helping others which is why we have worked hard to establish partnerships with organizations such as Children's Miracle Network and Habitat for Humanity that allow us to give back. Diversity, Equity and Inclusion - A diverse workforce allows us to achieve a dynamic business advantage where we can openly collaborate , thus bringing new ideas to the table that contribute to innovative and effective solutions.

Swift Transportation began operations on October 10th, 1966 transporting imported steel through the ports of Los Angeles to Arizona and Arizona cotton for export back through to Southern California.

Jerry Moyes, founder, began with the same entrepreneurial, can-do spirit that is one of Swift’s core values today. The original operation was conducted under the name of Common Market. Operating authority was purchased from a descendant of the Swift Meat Packing family, hence, today’s name of Swift Transportation. Jerry, with his father, brother and a partner, grew the business, with typical start up challenges, to a $25 million annual revenue in 1984. With the passing of Jerry’s father, Carl Moyes, Jerry became the sole owner. By 1990, Swift had grown to a $125 million carrier with 800 trucks. Swift’s significant revenue growth is attributable to internal growth with existing customers as well as acquisitions. Since 1988, Swift has acquired 13 different motor carriers. Today, Swift generates over $4 billion in revenue and operates nearly 20,000 trucks.

Swift’s terminal network has grown to over forty full service facilities in both the continental United States and Mexico. Swift owns 100% of Trans-Mex, a Nuevo Laredo, Mexico based carrier. Swift offers border crossing services at all major Mexican border crossings. Swift maintains a presence in every Canadian province each day. Swift is unquestionably the largest full-truckload motor carrier in North America.

Swift Transportation

Cargo Claims Examiner 1

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We're in search of highly motivated Injury Claims Examiners with prior casualty and bodily injury experience, in private passenger automotive liability claims, looking to help deliver world-class service to our clients. Negotiate claims settlements for evaluated damages with insureds, claimants and/or attorneys as assigned from letter of representation through settlement or verdict.

We know you know GEICO, but we want you to know that with us, you’ll find a rewarding career no matter which path you take. Our over 37,000 associates have been unexpectedly delighted to find that their jobs have turned into successful, illuminating careers. You know us for insurance. Get to know us for careers, too. Visit us at http://www.geico.jobs for more!

Geico Insurance

Injury Claims Examiner

OTHER

Highly complex medical claim reviewAdvance claim adjudicationAdvance claim history analysisReview medical record documentation to determine coding coverageComplex appeals and reconsiderationsEscalated claim resolutionComplex provider and payer issuesComplex duplicate claim investigationsPayer Audit-related claim reviewsComplex void and replace processingAdvance reprocessing resolutionResearch of system and adjudication issuesReview of recurring claim-processing problemsIdentify opportunities for process improvementAssist with system and workflow validationProvide subject-matter expertise to Levels 1 and 2Provide guidance and mentoring to Claims team membersAssist with training and knowledge transferSupport development and refinement of claims proceduresServe as a senior escalation and subject -matter resource for complex claim issues

Alivi TPA of Florida, LLC

Medical Claims Examiner

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POSITION SUMMARY/RESPONSIBILITIES Performs adjudication of medical (HCFA) or hospital (UB92) claims for Medicaid, Commercial, and CHIP (Childrens Health Insurance Program) according to departmental and regulatory requirements. Specific knowledge and experience in Medicaid, CHIP and commercial claim processing preferred.

University Health

Make decisions and resolve conflicts in such areas as application of coverages to submitted claims, application of laws of jurisdiction to investigatory facts, application of policy exclusions and exceptions as well as the ability to read and understand contracts, hold harmless and indemnity agreements. Volunteer opportunities to support our local communities - We have an adoration for helping others which is why we have worked hard to establish partnerships with organizations such as Children's Miracle Network and Habitat for Humanity that allow us to give back.

Senior Claims Examiner

Make decisions and resolve conflicts in such areas as application of coverages to submitted claims, application of laws of jurisdiction to investigatory facts, application of policy exclusions and exceptions as well as the ability to read and understand contracts, hold harmless and indemnity agreements. Volunteer opportunities to support our local communities- We have an adoration for helping others which is why we have worked hard to establish partnerships with organizations such as Children's Miracle Network and Habitat for Humanity that allow us to give back.

Swift Transportation Co LLC

Claims Examiner 5

Thorough knowledge of medical terminology, ICD-9/CPT4 Coding, and general managed care principles is required. POSITION SUMMARY/RESPONSIBILITIES Performs review, analysis, and adjudication of all claim types including coordination of benefits and DME claims.

With our employee-first focus, the Company is consistently recognized as a great place to work, earning multiple workplace and wellness awards, including the Great Place to Work® Award, Fortune 100 Best Companies to Work For, Fortune Best Workplaces for Parents, Fortune Best Workplaces for Millennials, and many others. Salary ranges are available for all positions at this location, taking into account roles with a comparable level of responsibility and impact in the relevant labor market and these salary ranges are regularly reviewed and adjusted in accordance with prevailing market conditions.

Crum & Forster

Claims Examiner, Medical Stop Loss, Remote

To determine the actual offer, Crawford considers a wide range of factors including the candidate's previous experience and education, market rates, minimum pay requirements for the applicable jurisdiction, business segment, supply/demand, and scheduled hours. Establish reserves, using independent judgment and expertise and authorizes payments within scope of authority, settling claims in the most cost effective manner and ensuring timely issuance of disbursements.

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 & Co

Sr Claim Examiner-WC (CA)

Establish reserves, using independent judgment and expertise and authorizes payments within scope of authority, settling claims in the most cost effective manner and ensuring timely issuance of disbursements. Reviews coverages, determines liability and compensability, secures information, arranges property damage appraisals and settles claims utilizing claims best practices.

Crawford & Company

Sr Claim Examiner- WC

This role is ideal for an experienced examiner who is confident working independently, thrives in an in-office setting, and understands the importance of accuracy, urgency, and strong communication. We’re looking for a seasoned Workers’ Compensation Claims Examiner III to step into a fast-paced, high-volume environment and take ownership of Texas loss-time claims from start to finish.

Cala Sourcing Solutions LLC

Worker's comp/Claims examiner III

WorkWolf

By applying for this job, you agree to receive calls, AI-generated calls, text messages, or emails from and its affiliates, and contracted partners. Enjoy a collaborative work environment in a vibrant city known for its community spirit and great quality of life.

Abacus Service Corporation

Investigate, evaluate, negotiate, and settle moderate difficulty type claims; takes appropriate action to achieve results that have a positive impact on profitability. Comprehensive claims investigations/settling experience with 1-3 years experience in Claims or similar organization.

Claims Examiner Jobs in the United States

California Workers' Compensation Claims Examiner | Remote King'S Insurance Staffing

Casualty Claims Examiner I J.B. Hunt Transport Services Inc

Casualty Claims Examiner I J.B. Hunt

Claims Examiner II Partnership HealthPlan of California

Causalty Claims Examiner Selby Jennings Ltd

Claims Examiner Ova Technologies

Senior Inside Homeowner Property Claims Examiner | Remote King'S Insurance Staffing

Cargo Claims Examiner 1 Swift Transportation

Injury Claims Examiner Geico Insurance

Medical Claims Examiner Alivi TPA of Florida, LLC

Claims Examiner University Health

Senior Claims Examiner Swift Transportation

Claims Examiner 5 Swift Transportation Co LLC

Senior Claims Examiner University Health

Claims Examiner, Medical Stop Loss, Remote Crum & Forster

Sr Claim Examiner-WC (CA) Crawford & Co

Sr Claim Examiner- WC Crawford & Company

Worker's comp/Claims examiner III Cala Sourcing Solutions LLC

Sr Claim Examiner- WC Abacus Service Corporation

Claim Examiner- WC Crawford & Co

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