Claims Adjuster

2 weeks ago


Long Beach, United States Synectics Inc Full time
Job DescriptionJob Description

Description:

  • To analyze mid- and higher-level workers compensation claims to determine benefits due; to ensure ongoing adjudication of claims within company standards and industry best practices; and to identify subrogation of claims and negotiate settlements.

  • Manages workers compensation claims determining compensability and benefits due on long term indemnity claims, monitors reserve accuracy, and files necessary documentation with state agency.

  • Develops and manages workers compensation claims' action plans to resolution, coordinates return-to-work efforts, and approves claim payments.

  • Approves and processes assigned claims, determines benefits due, and manages action plan pursuant to the claim or client contract.

  • Manages subrogation of claims and negotiates settlements.

  • Communicates claim action with claimant and client.

  • Ensures claim files are properly documented and claims coding is correct.

  • May process complex lifetime medical and/or defined period medical claims which include state and physician filings and decisions on appropriate treatments recommended by utilization review.

  • Maintains professional client relationships.

  • Performs other duties as assigned.

  • Supports the organization's quality program(s).

  • Travels as required.

Qualifications:

  • SIP preferred but not required

  • Years of experience: prefer 2 or more

  • WC Claims Examiner



  • Long Beach, United States TheBest Claims Solutions Full time

    Our client, is in need of a Temporary Workers' Compensation Claims Examiner for their Long Beach Office to work on a remote basis. The ideal candidate will have 3+ years of California Workers Compensation Experience.Required Qualifications:3+ years of experience handling Workers' Compensation claims in California.Ability to negotiate settlement of claims...


  • Long Beach, United States TheBest Claims Solutions Full time $40 - $45

    Our client, is in need of a Temporary Workers' Compensation Claims Examiner for their Long Beach Office to work on a remote basis. The ideal candidate will have 3+ years of California Workers Compensation Experience.Is this your next job Read the full description below to find out, and do not hesitate to make an application.Required Qualifications:3+ years...


  • Long Beach, California, United States American Automobile Association Full time

    Job SummaryAs a Property Claims Adjuster with the American Automobile Association, you will play a vital role in providing an outstanding experience for our members by using your investigative, negotiation, and communication skills to help them through the claim process and recover from the unexpected.Key Responsibilities Investigate, evaluate, and determine...


  • Long Beach, United States Automobile Club of Southern California Full time

    Claims Casualty AdjusterJob SummaryThe Claims Casualty Adjuster handles low to moderate-complexity claims involving material damage, property, and/or liability lines of insurance written by the Interinsurance Exchange in compliance with all regulatory and statutory requirements. The primary functions include liability investigation, coverage evaluation and...


  • Long Beach, United States Automobile Club of Southern California Full time

    Claims Senior Auto AdjusterJob SummaryThe Claims Senior Auto Adjuster supports the Auto Claims Operation by providing service pursuant to the policy by handling claims of material damage, property damage, and/or liability lines of insurance written by the Interinsurance Exchange in compliance with all regulatory and statutory requirements. The primary...


  • Long Beach, California, United States Automobile Club of Southern California Full time

    Claims Casualty Adjuster Job SummaryThe Claims Casualty Adjuster role involves handling low to moderate-complexity claims related to material damage, property, and liability lines of insurance, ensuring compliance with regulatory and statutory requirements.Key Responsibilities:Communicate and interact with various individuals, explaining benefits, coverages,...

  • Claims Adjuster

    3 weeks ago


    Virginia Beach, Virginia, United States Sedgwick Full time

    Role SummarySedgwick is seeking a Claims Adjuster to analyze and process low to mid-level auto and transportation claims. As a Claims Adjuster, you will assess damage, make payments, and ensure claim files are properly documented and correctly coded based on the policy.Key ResponsibilitiesProcess auto property damage and lower level injury claimsDevelop and...


  • Juno Beach, United States IntePros Full time

    About the Company - IntePros is seeking a Senior Property Claims Adjuster who will be able to investigate, evaluate, and manage to resolution assigned Property claims of varying monetary exposures and/or complexity. This position will require both direct claim handling and Third-Party Administrator (“TPA”) oversight and supervision. The position will...


  • juno beach, United States IntePros Full time

    About the Company - IntePros is seeking a Senior Property Claims Adjuster who will be able to investigate, evaluate, and manage to resolution assigned Property claims of varying monetary exposures and/or complexity. This position will require both direct claim handling and Third-Party Administrator (“TPA”) oversight and supervision. The position will...


  • Juno Beach, United States IntePros Full time

    About the Company - IntePros is seeking a Senior Property Claims Adjuster who will be able to investigate, evaluate, and manage to resolution assigned Property claims of varying monetary exposures and/or complexity. This position will require both direct claim handling and Third-Party Administrator (“TPA”) oversight and supervision. The position will...


  • Juno Beach, Florida, United States IntePros Full time

    IntePros is seeking a highly skilled Senior Property Claims Adjuster to manage property claims from first notice of loss to final resolution. This role involves investigation, coverage analysis, litigation management, payment processing, reserving, and auditing for an assigned caseload.Key Responsibilities:Investigate and evaluate assigned property claims,...


  • Juno Beach, FL, United States IntePros Full time

    About the Company - IntePros is seeking a Senior Property Claims Adjuster who will be able to investigate, evaluate, and manage to resolution assigned Property claims of varying monetary exposures and/or complexity. This position will require both direct claim handling and Third-Party Administrator (“TPA”) oversight and supervision. The position will...


  • Juno Beach, Florida, United States IntePros Full time

    IntePros is seeking a Senior Property Claims Adjuster to manage property claims from first notice of loss to final resolution. This role involves investigation, coverage analysis, litigation management, payment processing, reserving, and auditing for an assigned caseload.Key Responsibilities:Investigate and evaluate assigned property claims, adhering to the...


  • Juno Beach, United States IntePros Full time

    IntePros is seeking a Senior Property Claims Adjuster to join our client in Juno Beach, FL. The ideal candidate will manage property claims from the first notice of loss to final resolution. This role involves investigation, coverage analysis, litigation management, payment processing, reserving, and auditing for an assigned caseload.Key...


  • Juno Beach, United States IntePros Full time

    IntePros is seeking a Senior Property Claims Adjuster to join our client in Juno Beach, FL. The ideal candidate will manage property claims from the first notice of loss to final resolution. This role involves investigation, coverage analysis, litigation management, payment processing, reserving, and auditing for an assigned caseload.Key...


  • juno beach, United States IntePros Full time

    IntePros is seeking a Senior Property Claims Adjuster to join our client in Juno Beach, FL. The ideal candidate will manage property claims from the first notice of loss to final resolution. This role involves investigation, coverage analysis, litigation management, payment processing, reserving, and auditing for an assigned caseload.Key...


  • Juno Beach, FL, United States IntePros Full time

    IntePros is seeking a Senior Property Claims Adjuster to join our client in Juno Beach, FL. The ideal candidate will manage property claims from the first notice of loss to final resolution. This role involves investigation, coverage analysis, litigation management, payment processing, reserving, and auditing for an assigned caseload.Key...


  • Long Beach, California, United States Mary Kraft HR Full time

    Job Title: Workers Compensation Claims ExaminerMary Kraft HR is seeking an experienced Workers Compensation Claims Examiner to join our team. As a key member of our claims team, you will be responsible for analyzing and managing complex workers' compensation claims, including indemnity claims, to determine benefits due.Key Responsibilities:Analyze and...


  • Long Beach, California, United States Morgan Stephens Full time

    Job Title: Medicare Claims Appeals ClerkMorgan Stephens is seeking a highly skilled Medicare Claims Appeals Clerk to join our team.Job SummaryThe Medicare Claims Appeals Clerk is responsible for reviewing and resolving member and provider complaints, and communicating resolutions to members and providers (or authorized representatives) in accordance with...

  • Claims Examiner

    4 weeks ago


    Long Beach, California, United States Mary Kraft HR Full time

    Job Title: Claims Examiner - Workers CompensationMary Kraft HR is seeking an experienced Claims Examiner to analyze and process complex workers' compensation claims. The ideal candidate will have a strong understanding of California Workers' Compensation laws and claim procedures.Key Responsibilities:Analyze and process complex workers' compensation claims...