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Claim adjuster Jobs in Rancho Cucamonga, CA

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Claim adjuster • rancho cucamonga ca

Last updated: 8 days ago

Claims Adjuster - Workers Compensation

MindlanceOntario, CA, United States
Full-time

Claims Adjuster - Workers Compensation.PRIMARY PURPOSE: To analyze complex or technically difficult workers' compensation claims to determine benefits due; to work with high exposure claims involvi... Show more

Property Claims Specialist Field I

Mercury GeneralRancho Cucamonga, CA, United States
$63,410.00 yearly
Full-time

Property Claims Field Adjuster.If you're passionate about helping people restore their lives when the unexpected happens to their homes and providing the best customer experience, then our Mercury ... Show more

Junior/Intermediate Field Property Adjuster- Sudbury, ON

SedgwickOntario, Telecommute, CA
Full-time

By joining Sedgwick, you'll be part of something truly meaningful.It’s what our 33,000 colleagues do every day for people around the world who are facing the unexpected.We invite you to grow your c... Show more

Remote Intellectual Property Expert - AI Trainer ($90-$100 per hour)

MercorChino, California, US
$90.00 hourly
Remote
Full-time

Role Overview** - Mercor is seeking senior intellectual property professionals to build evaluation tasks for AI systems operating in patent prosecution, licensing, and IP enforcement contexts.The w... Show more

Welsh-Speaking JSON & Coding Experts for Audio Evaluations

Lifted, an Upwork CompanyOntario, California, United States
Remote
Full-time

Participating in live, real-time conversational scenarios with AI systems.Reviewing and labeling conversation transcripts.Evaluating AI-generated responses using structured rubrics and providing wr... Show more

Workers Compensation Claims Adjuster | Ontario, California

SedgwickOntario, CA, United States
$70,000.00 yearly
Full-time

Workers Compensation Claims Adjuster.Are you looking for an opportunity to join a global industry leader where you can bring your big ideas to help solve problems for some of the world's best brand... Show more

Account Representative - State Farm Agent Team Member

Michael Barraza - State Farm AgentOntario, CA, US
$45,000.00 yearly
Full-time

Michael Barraza State Farm Agency is seeking an organized and efficient specialist to fulfill administrative duties and support insurance agents in gaining and keeping customers.As Account Associat... Show more

Insurance & Risk Program Specialist

IntelliPro GroupChino, CA, United States
Full-time

Insurance & Risk Program Specialist.Industry: Logistics / Transportation / Last-mile Delivery.We are looking for an Insurance & Risk Program Specialist to support the development and management of ... Show more

Workers Compensation Risk Consultant

EPIC BrokersOntario, CA, United States
$100,000.00 yearly
Full-time

Workers Compensation Risk Consultant.Fairly Group, a division of EPIC Insurance Brokers, specializing in risk management and insuring clients in the sports and entertainment industries.We are seeki... Show more

Remote Medical Billing Manager - AI Trainer ($80-$80 per hour)

MercorRancho Cucamonga, California, US
$80.00 hourly
Remote
Full-time

Mercor is working with a leading AI research lab to improve the capabilities of next-generation AI systems.We are seeking experienced Billing and Claims Managers to support the evaluation of AI too... Show more

CA Senior Claims Specialist

CorVelRancho Cucamonga, CA, United States
$29.35 hourly
Full-time

The WC Senior Claims Specialist handles complex and high-profile Workers' Compensation claims following company standards.This role works closely with case managers and attorneys, manages subrogati... Show more

CA Claims Specialist - Bilingual (Spanish)

CorVel CorporationRancho Cucamonga, CA, USA
$25.48 hourly
Full-time

The Workers’ CompensationClaims Specialist manages within company best practices lower-level, non-complex and non-problematic workers’ compensation claims within delegated limited authority to best... Show more

Adjuster- Lifestyle Claims

SedgwickOntario, Telecommute, CA
$50,000.00 yearly
Full-time

By joining Sedgwick, you'll be part of something truly meaningful.It’s what our 33,000 colleagues do every day for people around the world who are facing the unexpected.We invite you to grow your c... Show more

Senior Claims Adjuster

Trean CorporationOntario, CA, United States
Full-time

The Senior Claims Adjuster is responsible for managing complex workers compensation claims and assisting the process of determining benefits due the injured worker, ensure ongoing adjudication of c... Show more

Claims Examiner - Workers Compensation

IconmaRancho Cucamonga, CA, United States
Full-time

Claims Examiner - Workers Compensation.Our client, a Business Solutions company, is looking for a Claims Examiner - Workers Compensation for their Rancho Cucamonga, CA/ Remote within CA location.To... Show more

Remote Intellectual Property Expert - AI Trainer ($90-$100 per hour)

MercorOntario, California, US
$90.00 hourly
Remote
Full-time

Role Overview** - Mercor is seeking senior intellectual property professionals to build evaluation tasks for AI systems operating in patent prosecution, licensing, and IP enforcement contexts.The w... Show more

Adjuster- Accident Benefits

SedgwickOntario, Telecommute, CA
$70,000.00 yearly
Full-time

By joining Sedgwick, you'll be part of something truly meaningful.It’s what our 33,000 colleagues do every day for people around the world who are facing the unexpected.We invite you to grow your c... Show more

Insurance & Risk Program Specialist

IntelliPro Group Inc.Chino, CA, US
Full-time
Quick Apply

Insurance & Risk Program Specialist Location: Chino, CA Job Type: Full-time, On-site Industry: Logistics / Transportation / Last-mile Delivery About the Role We are looking for an Insurance &am... Show more

Quality Program Coordinator

Azul VisionChino, CA, United States
Full-time

Azul Vision is the largest eye care practice in Orange County, Inland Empire, and the Los Angeles area, with Twenty-Five locations and our newest location is Palm Desert to serve you conveniently a... Show more

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Claims Adjuster - Workers Compensation

Claims Adjuster - Workers Compensation

MindlanceOntario, CA, United States
30+ days ago
Job type
  • Full-time
Job description

Claims Adjuster - Workers Compensation

PRIMARY PURPOSE: To analyze complex or technically difficult workers' compensation claims to determine benefits due; to work with high exposure claims involving litigation and rehabilitation; to ensure ongoing adjudication of claims within service expectations, industry best practices and specific client service requirements; and to identify subrogation of claims and negotiate settlements.

ESSENTIAL FUNCTIONS AND RESPONSIBILITIES:

  • Analyzes and processes complex or technically difficult workers' compensation claims by investigating and gathering information to determine the exposure on the claim; manages claims through well-developed action plans to an appropriate and timely resolution.
  • Negotiates settlement of claims within designated authority.
  • Calculates and assigns timely and appropriate reserves to claims; manages reserve adequacy throughout the life of the claim.
  • Calculates and pays benefits due; approves and makes timely claim payments and adjustments; and settles claims within designated authority level.
  • Prepares necessary state filings within statutory limits.
  • Manages the litigation process; ensures timely and cost effective claims resolution.
  • Coordinates vendor referrals for additional investigation and/or litigation management.
  • Uses appropriate cost containment techniques including strategic vendor partnerships to reduce overall cost of claims for our clients.
  • Manages claim recoveries, including but not limited to: subrogation, Second Injury Fund excess recoveries and Social Security and Medicare offsets.
  • Reports claims to the excess carrier; responds to requests of directions in a professional and timely manner.
  • Communicates claim activity and processing with the claimant and the client; maintains professional client relationships.
  • Ensures claim files are properly documented and claims coding is correct.
  • Refers cases as appropriate to supervisor and management.

ADDITIONAL FUNCTIONS AND RESPONSIBILITIES:

  • Performs other duties as assigned.
  • Supports the organization's quality program(s).
  • Travels as required.

QUALIFICATION:

Education & Licensing: Bachelor's degree from an accredited college or university preferred. Professional certification as applicable to line of business preferred.

Experience: Five (5) years of claims management experience or equivalent combination of education and experience required.

Skills: Subject matter expert of appropriate insurance principles and laws for line-of-business handled, recoveries offsets and deductions, claim and disability duration, cost containment principles including medical management practices and Social Security and Medicare application procedures as applicable to line-of-business. Excellent oral and written communication, including presentation skills PC literate, including Microsoft Office products Analytical and interpretive skills Strong organizational skills Good interpersonal skills Excellent negotiation skills Ability to work in a team environment Ability to meet or exceed Service Expectations

WORK ENVIRONMENT:

When applicable and appropriate, consideration will be given to reasonable accommodations. Mental: Clear and conceptual thinking ability; excellent judgment, troubleshooting, problem solving, analysis, and discretion; ability to handle work-related stress; ability to handle multiple priorities simultaneously; and ability to meet deadlines Physical: Computer keyboarding, travel as required Auditory/Visual: Hearing, vision and talking

NOTE: Credit security clearance, confirmed via a background credit check, is required for this position.