Current jobs related to Claims Management Specialist - San Diego, California - Intercare Insurance
-
Claims Specialist
4 weeks ago
San Diego, California, United States CorVel Enterprise Comp, Inc. Full timeJob Title: Claims SpecialistCorVel Enterprise Comp, Inc. is seeking a skilled Claims Specialist to join our team. As a Claims Specialist, you will be responsible for managing workers' compensation claims within delegated authority to achieve the best possible outcome.Key Responsibilities:Receive and process claims, confirming policy coverage and...
-
Claims Specialist
4 weeks ago
San Diego, California, United States CorVel Corporation Full timeJob Title: Claims SpecialistCorVel Corporation is seeking a highly skilled Claims Specialist to join our team. As a Claims Specialist, you will be responsible for managing complex and non-complex Auto and General Liability claims, ensuring best possible outcomes for CorVel and our clients.Key Responsibilities:Receive and investigate claims, confirming policy...
-
Claims Specialist
4 weeks ago
San Diego, California, United States CorVel Enterprise Comp, Inc. Full timeJob Title: Claims SpecialistCorVel Enterprise Comp, Inc. is seeking a skilled Claims Specialist to join our team. As a Claims Specialist, you will be responsible for managing complex and non-complex Auto and General Liability claims, working within delegated authority to achieve the best possible outcomes for CorVel and our clients.Key...
-
Claims Specialist
4 weeks ago
San Diego, California, United States CorVel Corporation Full timeJob Title: Claims SpecialistThe Claims Specialist plays a crucial role in managing liability claims within the company's best practices, ensuring a best possible outcome under the direct supervision of a senior claims professional. This position supports the goals of the claims department and CorVel Corporation.This is a remote position that requires regular...
-
Claims Specialist
2 weeks ago
San Diego, California, United States CorVel Corporation Full timeJob SummaryThe Auto/PD Liability Claims Specialist is responsible for managing complex and non-complex Auto and General Liability claims within company best practices. This role requires strong analytical and problem-solving skills, as well as excellent communication and interpersonal skills.Key ResponsibilitiesReceives claims, confirms policy coverage, and...
-
Claims Specialist
2 weeks ago
San Diego, California, United States CorVel Corporation Full timeJob Title: Claims Specialist - Liability ManagementThe Claims Specialist - Liability Management role at CorVel Corporation involves managing lower-level, non-complex liability claims within delegated limited authority to achieve the best possible outcome. This position is under the direct supervision of a senior claims professional and supports the goals of...
-
Claims Specialist
1 week ago
San Diego, California, United States CorVel Corporation Full timeJob Title: Claims SpecialistThe Claims Specialist is responsible for managing lower-level, non-complex liability claims within delegated limited authority to achieve the best possible outcome. This role is under the direct supervision of a senior claims professional and supports the goals of the claims department and CorVel.This is a remote position that...
-
Claims Specialist
1 month ago
San Diego, California, United States CorVel Enterprise Comp, Inc. Full timeJob Title: Liability Claims SpecialistCorVel Enterprise Comp, Inc. is seeking a highly skilled Liability Claims Specialist to join our team. As a key member of our claims department, you will be responsible for managing lower-level, non-complex liability claims to achieve the best possible outcome.Key Responsibilities:Receive and process claims, confirming...
-
Claims Specialist
3 weeks ago
San Diego, California, United States CorVel Enterprise Comp, Inc. Full timeJob Title: Liability Claims SpecialistCorVel Enterprise Comp, Inc. is seeking a highly skilled Liability Claims Specialist to join our team. As a key member of our claims department, you will be responsible for managing lower-level, non-complex liability claims to achieve the best possible outcome.Key Responsibilities:Receive and process claims, confirming...
-
Claims Specialist
4 weeks ago
San Diego, California, United States CorVel Corporation Full timeJob Title: Claims SpecialistThe Claims Specialist plays a critical role in managing complex and non-complex Auto and General Liability claims, ensuring timely and effective resolution for CorVel and our clients.Key Responsibilities:Receive and process claims, verifying policy coverage and acknowledging receiptRender Liability determinations in accordance...
-
Medical Claims Specialist
1 week ago
San Diego, California, United States MASC Medical Full timeMedical Claims SpecialistWe are seeking a skilled Medical Claims Specialist to join our team at MASC Medical. As a Medical Claims Specialist, you will be responsible for processing medical billing claims for patients in a fast-paced environment.Responsibilities:Request prior authorizations for services.Address rejected claims efficiently.Maintain...
-
Senior Liability Claims Specialist
2 weeks ago
San Diego, California, United States CorVel Enterprise Comp, Inc. Full timeJob Title: Senior Liability Claims SpecialistCorVel Enterprise Comp, Inc. is seeking a highly skilled Senior Liability Claims Specialist to join our team. As a key member of our claims team, you will be responsible for managing complex and non-complex Auto and General Liability claims, ensuring timely and effective resolution for our clients.Key...
-
Loss Mitigation Claims Specialist
2 weeks ago
San Diego, California, United States Guild Mortgage Full timeJob SummaryWe are seeking a highly skilled Loss Mitigation Claims Specialist to join our team at Guild Mortgage Company. As a key member of our Loss Mitigation team, you will play a critical role in ensuring timely, accurate, and compliant processing of post-loss mitigation workouts.Key ResponsibilitiesMonitor filed claims to ensure acceptance and...
-
San Diego, California, United States alliant_commercial_realty_services Full timeJob Title: Claims Advocate Commercial PC InsuranceWe are seeking a skilled Claims Advocate to join our team at Alliant Insurance Services. As a Claims Advocate, you will play a critical role in providing exceptional customer service and supporting our producers in servicing existing accounts and soliciting new business.Key Responsibilities:Act as an advocate...
-
Claims Evaluation Specialist
4 days ago
San Diego, California, United States Vets Hired Full timeAbout the JobAt Vets Hired, we are seeking a skilled Claims Evaluation Specialist to join our team. The successful candidate will be responsible for evaluating residential and commercial contents inventories obtained by or submitted to VeriClaim on both a Replacement Cost and Actual Cash Value (ACV) basis.Key Responsibilities:* Evaluate contents inventories...
-
San Diego, California, United States alliant_commercial_realty_services Full timeJob Title: Claims Advocate Commercial PC InsuranceWe are seeking a highly skilled Claims Advocate to join our team at Alliant Insurance Services. As a Claims Advocate, you will be responsible for providing exceptional customer service and supporting our producers by servicing existing accounts and soliciting new business.Key Responsibilities:Act as an...
-
Medical Claims Specialist III
3 days ago
San Diego, California, United States University of California Full timeJob SummaryUC San Diego Health's Revenue Cycle department is seeking a highly skilled Medical Claims Specialist III to join our team. As a key member of our revenue cycle team, you will be responsible for the full range of billing duties within the revenue cycle from claim generation to final payment disposition.Key ResponsibilitiesMonitor, prioritize and...
-
San Diego, California, United States alliant_commercial_realty_services Full timeJob Title: Claims Advocate Commercial PC InsuranceWe are seeking a highly skilled Claims Advocate to join our team at Alliant Insurance Services. As a Claims Advocate, you will be responsible for providing exceptional customer service and supporting producers by servicing existing accounts and soliciting new business.Key Responsibilities:Act as an advocate...
-
San Diego, California, United States Halo Staffing Group Full timeAbout this role:Halo Staffing Group, a leading medical recruitment and staffing agency, is currently seeking an experienced Medical Biller and Insurance Claims Specialist to join our team. In this role, you will be responsible for managing all medical billing in a Reproductive Medical Group, working closely with patients, insurance companies, and staff to...
-
Workers Compensation Claims Adjuster
3 days ago
San Diego, California, United States Sedgwick Full timeJob SummarySedgwick is seeking a highly skilled Workers Compensation Claims Adjuster to join our team. As a Claims Professional, you will be responsible for analyzing and resolving workers compensation claims in a timely and efficient manner.Key ResponsibilitiesAnalyze and determine compensability and benefits due on long-term indemnity claimsDevelop and...
Claims Management Specialist
2 months ago
Position Summary: The Claims Management Specialist plays a crucial role in overseeing and resolving a portfolio of workers' compensation claims. This position reports directly to the Claims Supervisor and is responsible for managing complex cases while adhering to company policies and regulatory requirements.
Key Responsibilities:
- Conduct thorough outreach within 24 hours of claim receipt to gather essential information from the claimant, employer, and medical professionals.
- Maintain comprehensive documentation of case developments and relevant details necessary for determining compensability and managing disability payments.
- Develop and implement a strategic action plan for each indemnity claim to ensure timely resolution.
- Collaborate with medical case managers to facilitate early return-to-work opportunities, minimizing extended disability costs.
- Identify and refer potential fraud cases to the Special Investigations Unit.
- Pursue subrogation opportunities and manage contributions from multiple defendants when applicable.
- Ensure compliance with all relevant statutes and company guidelines throughout the claims process.
- Evaluate and approve vocational rehabilitation plans as needed.
- Monitor and adjust monetary reserves for cases in accordance with established authority levels.
- Review medical bills for accuracy before processing payments.
- Exhibit professionalism and maintain a supportive demeanor in all interactions.
- Respond to inquiries in a timely manner, ensuring effective communication.
- Possess a solid understanding of California's Labor Code related to workers' compensation claims.
- Manage litigation processes effectively, ensuring proper oversight and direction.
- Perform additional tasks as assigned by the Supervisor or Manager.
Qualifications:
To excel in this role, candidates must demonstrate proficiency in all essential duties. The following qualifications are necessary:
- A Bachelor's degree from an accredited institution.
- A minimum of seven years of relevant experience in claims management, with at least five years focused on indemnity cases.
- Possession of an SIP certificate is preferred.
Certifications:
Active pursuit of the IEA Certificate and Self-Insured Certificate, along with completion or active study of the WCCP designation or equivalent qualifications.
Powered by Intercare Insurance
