p>To learn more about our comprehensive benefit programs please visit http://careers.travelers.com/life-at-travelers/benefits/.
li>Be able to seamlessly transition between various methods of inspection, including video, or photo, to write a damage estimate: Knowledge and Skills: As a Property Claims Examiner 2, you will:
Technical Skills & Competencies: Preference for prior experience as MO Claim Examiner in workers' compensation as a lost time examiner, or similar examiner experience in short-term / long-term disability, auto personal injury protection / medical injury, or general liability claims. Prior workers' compensation claim handling experience or other similar type of claim handling experience is preferred (healthcare, short-term / long-term disability, auto personal injury protection / medical injury, or general liability).
This position requires the individual to access and inspect all areas of a dwelling or structure, which is physically demanding requiring the ability to carry, set up and climb a ladder weighing approximately 38 to 49 pounds, walk on roofs, and enter tight spaces (such as attic staircases and entries, crawl spaces, etc.). As an Associate Claim Rep, Outside Property, you will receive comprehensive training in claim handling, customer service, and policy interpretation while working alongside experienced claim professionals.
The Senior Claims Examiner will adjust workers’ compensation claims from inception through settlement and closure, ensuring timely processing of claims and payment of benefits, managing, and directing medical treatment, setting reserves, and negotiating settlements. Must possess a current Experienced Indemnity Claims Adjuster Designation, provided by an insurer, as defined in California Code of Regulations, Title 10, Chapter 5, Subchapter 3, Section 2592.01(f).
li>Directly investigate each claim through prompt and strategically-appropriate contact with appropriate parties such as policyholders, accounts, claimants, law enforcement agencies, witnesses, agents, medical providers and technical experts to determine the extent of liability, damages, and contribution potential.
p>Responsibilities: s tort laws as normally acquired through a bachelors degree (or equivalent training) plus 3 to 5 years directly related work experience.
ATHENS POSITION DETAILS Position Title:Senior Claims ExaminerDepartment:Workers’ Compensation CaliforniaReports To:Claims SupervisorFLSA Status:Non-ExemptJob Grade:12Career Ladder:Next step in progression could include Lead Senior Claims Examiner or Claims Supervisor ATHENS ADMINISTRATORSExplore the Athens Administrators difference: We have been dynamic, innovative leaders in claims administration since our founding in 1976. The Senior Claims Examiner will adjust police and fire 4850 workers’ compensation claims from inception through settlement and closure, ensuring timely processing of claims and payment of benefits, managing, and directing medical treatment, setting reserves, and negotiating settlements.
ATHENS POSITION DETAILS Position Title:Senior Claims ExaminerDepartment:Workers’ Compensation CaliforniaReports To:Claims SupervisorFLSA Status:Non-ExemptJob Grade:12Career Ladder:Next step in progression could include Lead Senior Claims Examiner or Claims Supervisor ATHENS ADMINISTRATORSExplore the Athens Administrators difference: We have been dynamic, innovative leaders in claims administration since our founding in 1976. POSITION SUMMARYAthens Administrators has an immediate need for a full-time Senior Claims Examiner to support our workers compensation offices and can be located anywhere in the state of California, however, employees who live less than 26 miles from the Concord, CA or Orange, CA offices are required to work once a week in the office on a day determined by their supervisor between Tuesday – Thursday.
ATHENS POSITION DETAILS Position Title:Senior Claims ExaminerDepartment:Workers’ Compensation CaliforniaReports To:Claims SupervisorFLSA Status:Non-ExemptJob Grade:12Career Ladder:Next step in progression could include Lead Senior Claims Examiner or Claims Supervisor ATHENS ADMINISTRATORSExplore the Athens Administrators difference: We have been dynamic, innovative leaders in claims administration since our founding in 1976. POSITION SUMMARYAthens Administrators has an immediate need for a full-time Senior Claims Examiner to support our workers compensation offices and can be located anywhere in the state of California, however, employees who live less than 26 miles from the Concord, CA or Orange, CA offices are required to work once a week in the office on a day determined by their supervisor between Tuesday – Thursday.
p>Performs a combination of duties in accordance with departmental guidelines:
Investigates each claim through prompt contact with appropriate parties such as policyholders, accounts, claimants, law enforcement agencies, witnesses, agents, medical providers and technical experts to determine the extent of liability, damages, and contribution potential. The actual salary for this position will be determined by a number of factors, including the scope, complexity and location of the role; the skills, education, training, credentials and experience of the candidate; and other conditions of employment.
Education/Course of Study: Work Experience: Analytical Thinking: Identifies current or future problems or opportunities; analyzes, synthesizes and compares information to understand issues; identifies cause/effect relationships; and explores alternative solutions that support sound decision-making. Independently handles assigned claims of low to moderate complexity where Wage loss and the expectation is a return to work to modified or full duty or obtain MMI with no RTW.
ul> To learn more about our comprehensive benefit programs please visit http://careers.travelers.com/life-at-travelers/benefits/.
As an Associate Claim Rep, Workers Compensation, you will receive comprehensive training in claim handling, customer service, and policy interpretation while working alongside experienced claim professionals. The Travelers Workers Compensation Claim team is committed to partnering with our business insurance customers to help their injured employees return to work as soon as medically appropriate.
Knowledge and Skills: As a Property Claims Field Adjuster 2, you will: Possess the ability to work independently with limited or no supervision over daily activities required to successfully investigate, evaluate, write damage estimates, negotiate, and resolve property claims. Be able to seamlessly transition between various methods of inspection, including physical, video, or photo, to write a damage estimate: o May include climbing ladders to inspect roofing or attic space and inspection of crawl spaces.
p>Responsibilities:
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Directly investigate each claim through prompt and strategically-appropriate contact with appropriate parties such as policyholders, accounts, claimants, law enforcement agencies, witnesses, agents, medical providers and technical experts to determine the extent of liability, damages, and contribution potential. Actively engage in the identification, selection and direction of appropriate internal and/or external resources for specific activities required to effectively evaluate claims, such as Subrogation, Risk Control, nurse consultants, and fire or fraud investigators, and other experts.
Silva-Lining HR is seeking a Fractional Customer Service (Claims) Manager for a client to oversee and optimize the end-to-end claims process, ensuring timely resolution, operational efficiency, and exceptional customer experience. Lead project management efforts for claims resolution, including task delegation and coordination with internal team members, vendor partners, shipping providers, and repair services.
The Auditor also helps maintain productive working relationships with delegated provider organizations by facilitating clear communication during the audit process, supporting the development of Corrective Action Plans, and verifying that corrective actions are completed in accordance with audit outcomes and regulatory requirements. Prior Medicare Managed Care claims experience related to delegation oversight and auditing.1-2 years minimum experience conducting oversight audits of delegated entities and/or ancillary providersDemonstrable detailed knowledge/experience with CMS claims compliance reporting - Part C, ODAG, Monthly Timeliness, etc.
Communicate professionally with members and providers to resolve inquiries, follow up on pended claims, and complete corrections or adjustments. This position is ideal for someone who enjoys problem‑solving, working with complex benefit plans, and collaborating with both internal teams and external partners.
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