Senior Claims Specialist

1 week ago

Riverside, California, United States AssuredPartners Full time

Position Overview:

Manage indemnity claims and address intricate claim challenges. Leverage extensive litigation management expertise, lien resolution skills, and exceptional customer service to resolve standard claims without the need for legal representation.

About AssuredPartners:
AssuredPartners is a prominent insurance brokerage and consulting firm dedicated to fulfilling the insurance requirements of various sectors, including healthcare, public entities, and educational institutions. Our firm excels in delivering consulting services across multiple domains such as employee benefits, workers' compensation, risk management, financial services, and property & liability.

Key Responsibilities:

  • Maintain an updated claims diary.
  • Identify, avert, and minimize potential penalties.
  • Document claim notes in the system promptly.
  • Ensure timely reporting of excess files to the Reinsurance Manager.
  • Report any suspected fraud or SIU cases.
  • Identify and pursue subrogation opportunities.
  • Complete necessary rehabilitation forms and benefit notices.
  • Refer PRIME deletions to the designated office personnel.
  • Update reserves within 30 days of receiving new information affecting a claim's financial exposure.
  • Prepare for and participate in file reviews.
  • Make decisions to accept or deny delayed claims within a 90-day timeframe.
  • Request settlement authorization within 30 days of a final report.
  • Complete necessary legal documentation.
  • Achieve a 100% closing ratio on active accounts and aim to reduce runoff accounts by 25% annually.
  • Prepare legal referrals and provide guidance to defense attorneys.
  • Respond to all inquiries within 24 hours.
  • Prepare instructional materials for support staff.
  • Review incoming mail daily.
  • Correct errors as reported on a daily basis.
  • Ensure client and claimant satisfaction.
  • Update Unit Stat forms as needed.
  • Oversee new setups, reserves, and instructional materials.
  • Draft cover letters for evaluations.
  • Negotiate outstanding liens effectively.
  • Conduct three-point contact.
  • File necessary legal documents.
  • Collaborate with case management nurses.
  • Perform additional duties as assigned.

Qualifications:

  • A minimum of five (5) years of experience as a Claims Examiner in California, along with a Self-Insurance Certificate or the ability to obtain one within one (1) year of employment. WCCP certification is preferred.
  • At least two (2) years of experience managing claims for public entities is preferred.
  • Strong verbal and written communication skills.
  • Proficient in Microsoft Office Suite, including Outlook, Excel, PowerPoint, and Word, with the ability to access business data online as needed.

Benefits:
We value our employees and offer a comprehensive benefits package, including:

  • Competitive base salary.
  • Generous paid time off policy, including over 30 days of comprehensive leave.
  • Health benefits tailored to your needs, including multiple medical plan options, dental coverage, and vision plans.
  • 401(k) plan with company matching.
  • Fitness and wellness support, including discounts at numerous gyms.
  • Access to mental health resources, including 24/7 therapy services.
  • Pet benefits and discounts.
  • Opportunities to engage with Employee Resource Groups (ERGs) that promote diversity and inclusion.

Compensation:
The anticipated salary range for this role is between $75,000 and $95,000 annually, with actual compensation determined by education, experience, skills, and internal equity. Remote work flexibility is available.

Join Us:
At AssuredPartners, we are committed to fostering an environment that encourages innovation and growth. We believe in the power of relationships and strive to provide customized solutions and exceptional service. Our diverse team is dedicated to supporting our clients and each other, creating a workplace where everyone can thrive.

  • Automotive Warranty Claims Specialist

    2 weeks ago

    Riverside, California, United States Walter's Audi Full time

    Join the Team at Walter's Audi of RiversideAbout Us:At Walter's Audi of Riverside, we are dedicated to providing exceptional service and support to our customers. We are currently seeking a skilled individual to fill the role of Warranty Claims Specialist.Position Overview:The Warranty Claims Specialist plays a crucial role in managing and processing...

  • Senior Claims Examiner

    24 hours ago

    Riverside, California, United States AssuredPartners Full time

    Job SummaryWe are seeking a highly skilled Senior Claims Examiner to join our team at AssuredPartners. As a Senior Claims Examiner, you will be responsible for administering indemnity claims and handling complex claim issues. You will utilize your strong litigation management experience, lien resolution abilities, and customer service skills to resolve...

  • Senior Accounting Specialist

    2 weeks ago

    Riverside, California, United States Tobias Solutions, LLC Full time

    Job Overview As a vital member of the finance team, the Senior Accounting Specialist will report directly to the Controller, ensuring the integrity of financial documentation and oversight of the organization’s fiscal activities, including assets, liabilities, revenues, tax responsibilities, and related concerns. Qualifications Essential Qualifications:...

  • Senior Physician Gastroenterology Specialist

    2 days ago

    Riverside, California, United States Apex Ventures Full time

    Job Opportunity at Apex VenturesWe are seeking a highly skilled Senior Physician Gastroenterology Specialist to join our team at Apex Ventures.About the RoleThe successful candidate will be responsible for providing high-quality medical care to patients with gastrointestinal disorders. This will involve:Diagnosing and treating a range of gastrointestinal...

  • Senior Substance Use Specialist

    2 weeks ago

    Riverside, California, United States Whiteside Manor Full time

    Position OverviewWe are seeking a qualified Senior Substance Use Specialist to join our dedicated team at a women's recovery program. The ideal candidate will possess a strong background in substance use counseling, with a preference for those who have experience in mental health.This role encompasses a variety of responsibilities, including:Managing client...

  • Human Resources Specialist

    2 weeks ago

    Riverside, California, United States 2020 Plumbing & Heating, Inc. Full time

    Job OverviewAt 20/20 Plumbing & Heating, Inc., we pride ourselves on being Employee Owners committed to enhancing our communities. Our organization has established itself as a frontrunner in the HVAC and plumbing sectors across California and Nevada. We provide dependable, cutting-edge services for various projects, including residential, commercial, and...

  • Senior Personnel Specialist

    3 days ago

    Riverside, California, United States Department of Forestry & Fire Protection Full time

    Job SummaryThe Department of Forestry & Fire Protection is seeking a highly skilled Senior Personnel Specialist to join our team. As a key member of our human resources department, you will be responsible for a variety of tasks related to personnel management, including recruitment, selection, and onboarding.Key ResponsibilitiesRecruit and select candidates...

  • Senior Geotechnical Specialist

    5 days ago

    Riverside, California, United States Vets Hired Full time

    About the RoleVets Hired is seeking a highly skilled Senior Geotechnical Specialist to join our team. As a key member of our organization, you will play a critical role in ensuring the safety and integrity of our projects.Key ResponsibilitiesSeismic Safety and Hazard Mitigation: Update and revise seismic safety and hazard mitigation plans for various...

  • Meal Service Specialist

    2 weeks ago

    Riverside, California, United States MBK Senior Living Full time

    Dining Services AttendantJoin a dedicated team at MBK Senior Living, where your role as a Dining Services Attendant will play a vital part in enhancing the dining experience for our residents. This position is part-time and is located in a supportive environment focused on enriching the lives of seniors.Key Responsibilities:Deliver exceptional customer...

  • Accounts Receivable Specialist

    2 weeks ago

    Riverside, California, United States Advantage Ambulance Full time

    Accounts Receivable Specialist at Advantage AmbulanceAdvantage Ambulance, a prominent provider of Basic Life Support (BLS) and Critical Care Transport (CCT) services, is on the lookout for a talented Accounts Receivable Specialist to enhance their operations. This organization is committed to delivering exceptional care and positively influencing the...

  • Senior Chief Physician Orthopedics Specialist

    2 days ago

    Riverside, California, United States FusionWorks Full time

    About the RoleWe are seeking a highly skilled and experienced Senior Chief Physician Orthopedics Specialist to join our team at FusionWorks.The successful candidate will be responsible for leading our maximum care EndoProthetikZentrum, providing expert care to patients and mentoring junior staff members.Key Responsibilities:Develop and implement effective...

  • Returns Processing Specialist

    2 weeks ago

    Riverside, California, United States LINKSWELL INC Full time

    Job OverviewThe Returns Processing Specialist plays a crucial role in overseeing the return and warranty operations. This position involves maintaining inventory, conducting inspections, managing data entry, and providing customer support to ensure efficient handling of returns and warranty claims. The ideal candidate will be a proactive self-starter, highly...

  • Senior Benefits Analyst

    2 weeks ago

    Riverside, California, United States HUB International Full time

    ABOUT HUB: In an ever-evolving landscape, HUB provides guidance to businesses and individuals on preparing for unforeseen circumstances. As one of the largest insurance brokerage firms globally, our commitment lies in ensuring our clients have peace of mind, safeguarding what matters most through dedicated advocacy and customized insurance solutions that...

  • Accounts Receivable Specialist

    2 weeks ago

    Riverside, California, United States Advantage Ambulance Full time

    Advantage Ambulance stands as a premier provider of Basic Life Support (BLS) and Critical Care Transport (CCT) services. Our mission is to offer exceptional care while positively influencing the communities we serve. Our dedication to quality has earned us elite recognition from the Commission on Accreditation of Ambulance Services (CAAS), a distinction held...

  • Senior Provider Relations Liaison

    14 hours ago

    Riverside, California, United States UnitedHealth Group Full time

    About the RoleWe are seeking a highly skilled and experienced Senior Provider Relations Liaison to join our team at UnitedHealth Group. As a key member of our organization, you will play a critical role in building and maintaining strong relationships with our affiliated physicians and their staff.Key ResponsibilitiesProvider Relations: Serve as a...

  • Broadcast Operations Specialist

    1 week ago

    Riverside, California, United States Defense Media Activity Full time

    Position OverviewThis role is integral to the Defense Media Activity.Key ResponsibilitiesAs a Broadcast Operations Specialist, your primary duties will include:Managing source transitions and live edits through the operation of sophisticated broadcasting equipment, adhering strictly to established broadcast schedules, which enables seamless switching between...

  • Commission Accounting Specialist

    3 days ago

    Riverside, California, United States Gallagher Full time

    About the RoleWe are seeking a highly skilled Commission Accounting Specialist to join our team at Gallagher. As a Commission Accounting Specialist, you will play a critical role in ensuring the accuracy and efficiency of our commission payment processes.Key ResponsibilitiesReconcile commission payments received with commission statements to calculate and...

  • IT Support Specialist

    4 days ago

    Riverside, California, United States K2 Staffing Full time

    Job SummaryWe are seeking a highly skilled IT Support Specialist to join our team at K2 Staffing. As a Help Desk Technician, you will be responsible for providing top-notch technical support to our clients.Key ResponsibilitiesProvide front-line technical support to clients via phone, email, or in-personAssist clients with troubleshooting and resolving...

  • Returns Operations Specialist

    2 weeks ago

    Riverside, California, United States LINKSWELL INC Full time

    Job OverviewThe Returns Processor plays a crucial role in the management of product returns and warranty claims. This position involves meticulous handling of returned merchandise, ensuring accurate data entry, and providing exceptional customer service to facilitate a seamless returns process.Key Responsibilities:Conduct thorough inspections of returned...

  • Medical Collections Specialist

    1 week ago

    Riverside, California, United States Advantage Ambulance Full time

    About Advantage AmbulanceAdvantage Ambulance is a leading provider of Basic Life Support (BLS) and Critical Care Transport (CCT) ambulance services in Riverside, California. Our commitment to excellence has led us to achieve elite status with the Commission on Accreditation of Ambulance Services (CAAS), a recognition attained by only 1% of ambulance...