Senior Workers Compensation Claims Adjuster

The Claims Specialist at CorVel Corporation manages workers' compensation claims within company best practices, ensuring a best possible outcome under the direct supervision of a senior claims professional. This is a remote position.Key Responsibilities:Receives claims, confirms policy coverage, and acknowledges the claimDetermines validity and...

About the RoleWe are seeking a skilled Claims Representative Workers Compensation to join our team at Sedgwick. As a key member of our team, you will be responsible for processing low-level workers compensation claims, determining benefits due, and ensuring ongoing adjudication of claims within company standards and industry best practices.Key...

Job DescriptionThe Senior Claims Specialist at CorVel Enterprise Comp, Inc. plays a crucial role in managing complex and problematic workers' compensation claims. This position requires strong analytical and problem-solving skills to determine benefits due and work closely with case managers and attorneys to achieve the best possible outcome.This is a remote...

Job DetailsJob Title: Claims Examiner IIIJob Location: Sacramento - Rancho Cordova, CARemote Type: HybridPosition Type: Full TimeEducation Level: High School Diploma or GEDSalary Range:$85,000.00 - $95,000.00Travel Percentage: NoneJob Shift: DayJob Category: InsuranceJob SummaryAt Tristar Insurance Services LLC, we are seeking an experienced Claims Examiner...

Job DescriptionThe Claims Manager is responsible for overseeing the overall operation of a designated office. This role involves formulating and administering company best practices, developing long-range goals and objectives, analyzing costs, activities, and operations, and supporting the goals of the claims department and CorVel. This is a remote...

Job SummaryWe are seeking a highly organized and detail-oriented Benefits and Leave Specialist to support the administration of employee benefits programs and leave of absences processes.Key ResponsibilitiesAssist the Benefits Manager in the administration of employee benefits programs, including health insurance, disability insurance, life insurance,...

Job SummaryThe Claims Specialist is responsible for managing workers' compensation claims within delegated authority to achieve the best possible outcome. This role supports the goals of the claims department and CorVel Corporation.Key ResponsibilitiesReceive and confirm claims, verifying policy coverage and acknowledging the claimant.Determine the validity...

Job SummaryThe Claims Supervisor is a key role within the CorVel Enterprise Comp, Inc. team, responsible for overseeing a team of claims staff and ensuring the delivery of high-quality services to clients. This position requires strong leadership and management skills, as well as the ability to communicate effectively with stakeholders.Key...

About the Role:The Senior FEP Social Worker will be part of a multidisciplinary team that determines, develops, and implements a plan of care based on accurate and comprehensive assessment of the member's needs.Key Responsibilities:Collaborate with case managers and other team members to complete member assessments related to social and resource needs to...

About the RoleBlue Shield of California is seeking a Senior FEP Social Worker to join our team. In this role, you will be part of a multidisciplinary team that determines, develops, and implements a plan of care based on accurate and comprehensive assessment of the member's needs.Key ResponsibilitiesCollaborate with case managers and other team members to...

Job Summary:Aspire General Insurance is seeking a detail-oriented and customer-focused Claims Adjuster to investigate, evaluate, and settle insurance claims in a fair and timely manner.Key Responsibilities:Review and analyze insurance policies to determine coverageInvestigate claims by interviewing claimants, witnesses, and medical expertsEvaluate evidence,...

Job SummaryBlue Shield of California is seeking a skilled Senior Clinical Review Nurse to join our Commercial Post Service Review team. As a key member of our team, you will be responsible for clinically reviewing claims that are the result of either a preservice or claim denial.Key ResponsibilitiesPerform accurate and timely clinical review of post service...

Job Title: Insurance Claims SpecialistIntegrated Resources is seeking an experienced Insurance Claims Specialist to join our team. As an Insurance Claims Specialist, you will be responsible for managing new accounts, processing claims, and ensuring timely resolution of all accounts as instructed by management.Key Responsibilities:Manage new accounts, on a...

As a Claims Assistant at CorVel Corporation, you will play a vital role in supporting the claims staff in the setup and administration of workers' compensation claims and case management. This is a hybrid work arrangement that offers a unique blend of flexibility and collaboration.Key Responsibilities:Set up new claims and manage the claims process from...

About the RoleThe Utilization Management Nurse, Senior will play a critical role in ensuring the quality and cost-effectiveness of healthcare services for our members.Key ResponsibilitiesConduct prospective, concurrent, and retrospective utilization reviews to determine medical necessity and ensure compliance with nationally recognized clinical...

Job SummaryWe are seeking a highly skilled Senior Vice President of Government Relations to promote the mission, vision, values, and strategic objectives of CommonSpirit Health through the development and integration of a comprehensive government relations program.This position leads all government relations efforts for CommonSpirit Health at both state and...

Job SummaryThe Senior Vice President of Government Relations at CommonSpirit Health is responsible for promoting the mission, vision, and values of the organization through the development and integration of a comprehensive government relations program.This position leads all government relations efforts for CommonSpirit Health at both state and federal...

About the RoleBlue Shield of California is seeking a highly skilled Senior Care Manager to join our team. As a key member of our Care Management team, you will play a critical role in supporting the mission of our department, which is to provide exceptional care and support to patients in the outpatient setting.Key Responsibilities:Develop and implement...

Job SummaryThe Senior Utilization Management Nurse will be responsible for performing first-level determination approvals for members using BSC evidenced-based guidelines, policies, and nationally recognized clinical criteria across lines of business or for a specific line of business such as Medicare. This role requires a strong clinical judgment and...

Your RoleThe Commercial Post Service Review team at Blue Shield of California is responsible for clinically reviewing claims that are the result of either a preservice or claim denial. As a Senior Clinical Reviewer, you will report to the Manager, Post Service, and perform accurate and timely clinical review of post service claims for the CalPERS...