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Claim specialist • fullerton ca

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Senior Claim Adjuster

Senior Claim Adjuster

DaviesSanta Ana, CA, US
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Imagine being part of a team that's not just shaping the future but actively driving it.At Davies North America, we're at the forefront of innovation and excellence, blending cutting-edge technolog...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30
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Network Management Specialist (Contract Specialist)

Network Management Specialist (Contract Specialist)

Magellan HealthAnaheim, CA, US
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The Network Contract Specialist will be responsible for creating and maintaining behavioral health provider contracts across the New Mexico territory for Presbyterian Health Plan with Medicaid, Med...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_variable_days
Payroll Specialist

Payroll Specialist

OurStaff, LLCSanta Ana, CA, US
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This role is responsible for processing semi-monthly payroll on time, accurately, and in compliance with government regulations, and all related activities. The ideal individual will have payroll ex...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_variable_days
Accounting Specialist

Accounting Specialist

AppleOneAnaheim, CA, US
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N Orange County, CA : Some of the outlined job duties include : .Full Cycle Accounts Payables (match, batch, and code).Track Lien Releases for all projects assigned. Create and submit AIA billing to su...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_variable_days
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Payroll Specialist

Payroll Specialist

Vaco by HighspringWestminster, California, United States
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Payroll Specialist who will be responsible time keeping records of employees’ hours worked as well as any deductions or withholdings required to comply with state and federal laws in all of our mar...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30
Claim Specialist - Property Field Inspection

Claim Specialist - Property Field Inspection

State FarmWhittier, California, US
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Being good neighbors – helping people, investing in our communities, and making the world a better place – is who we are at State Farm. It is at the core of how we operate and the reason for our suc...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30
Claim Professional Development Program Internship - Diamond Bar, CA (91765)

Claim Professional Development Program Internship - Diamond Bar, CA (91765)

Travelers InsuranceDiamond Bar, California
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Who Are We? Taking care of our customers, our communities and each other.By honoring this commitment, we have maintained our reputation as one of the best property casualty insurers in the indust...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30
Insurance Claim Specialist

Insurance Claim Specialist

VirtualVocationsNorwalk, California, United States
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A company is looking for an Insurance Claim Specialist HB.Key Responsibilities Submits accurate and timely claims to third party payers Resolves claim edits and account errors prior to claim sub...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30
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Culinary Specialist

Culinary Specialist

U.S. NavyPlacentia, CA, United States
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ABOUT Culinary Specialists (CSs) operate and manage Navy messes and living quarters to provide meals and accommodations for Navy personnel. They prepare menus, manage food inventories, maintain fina...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_variable_days
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Client Specialist

Client Specialist

ManpowerSanta Ana, CA, US
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Our client, a leading organization in the legal support industry, is seeking a dedicated and proactive Client Specialist to join their team. As a Client Specialist, you will be an essential part of ...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_variable_days
Claim Representative Jobs - Hiring Immediately

Claim Representative Jobs - Hiring Immediately

MyJobResourceAnaheim, CA, United States
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We are currently looking for individuals to fulfill Part-Time and Full-Time Claim Representative positions.No experience is required to apply for the position. Training is provided through former ex...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30
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Specialist, Contracts

Specialist, Contracts

Clearance JobsAnaheim, CA, US
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L3Harris Space and Sensors in Mason, OH is seeking an experienced Contracts Manager.The successful candidate must have a demonstrable record of achievement in the contracting career field and will ...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30
Housing Specialist

Housing Specialist

Volunteers of America Los AngelesGarden Grove, CA, US
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Helping Our Most Vulnerable Change Their Life Stories.Volunteers of America is a non-profit human services organization committed to serving people in need, strengthening families, and building com...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30
Import Specialist

Import Specialist

Activate TalentAnaheim, CA, United States
serp_jobs.job_card.full_time
We are seeking an experienced and detail-oriented Import Specialist to join our logistics team.In this role, you will oversee the management of imports, ensuring compliance with international trade...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_variable_days
Sr Claim Examiner-WC (CA)

Sr Claim Examiner-WC (CA)

Crawford & CompanyBrea, CA, United States
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Investigate and settle advanced, large loss, complex claims promptly and equitably under minimal supervision.Works within established authority on moderate-to-difficult claims.Reviews coverages, de...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30
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Parts Specialist

Parts Specialist

O'Reilly AutomotiveSanta Ana, CA, US
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Parts Specialist Position at Store 06266 Santa Ana CA.The actual hourly rate will equal or exceed the required minimum wage applicable to the job location. Additional compensation may include annual...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30
Leasing Specialist

Leasing Specialist

AvanathAnaheim, CA, US
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Avanath is proud to be named one of the top property management companies to provide affordable housing for the workforce. Cultivating the American Dream.At Avanath, every day is an opportunity to m...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30
Senior Claim Adjuster

Senior Claim Adjuster

DaviesSanta Ana, CA, US
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Senior Claim Adjuster

Imagine being part of a team that's not just shaping the future but actively driving it. At Davies North America, we're at the forefront of innovation and excellence, blending cutting-edge technology with top-tier professional services. As a vital part of the global Davies Group, we help businesses navigate risk, optimize operations, and spearhead transformation in the insurance and regulated sectors.

As a Claim Adjuster, you will play a crucial role in the insurance industry by evaluating and processing insurance claims. You will be responsible for investigating claims, assessing damages, determining coverage, and negotiating settlements. Your attention to detail, analytical skills, and ability to communicate effectively with clients and other stakeholders will be vital in ensuring fair and efficient resolution of claims. This position requires a strong understanding of insurance policies, regulations, and industry standards, and you must complete investigations and claims adjusting in full compliance with any relevant Department of Insurance regulations. All tasks must be done in accordance with authority granted to the company and you, making sure to obtain carrier or management authority when needed.

Key Responsibilities

  • Investigate and evaluate insurance claims to determine coverage, liability, and potential damages.
  • Review policy terms and issued clear coverage position letters, including reservation of rights or denials.
  • Conduct thorough investigations, gathered evidence, and negotiated fair settlements within company and legal guidelines.
  • Deliver exceptional customer service by maintaining proactive, professional communication with claimants and stakeholders.
  • Collaborate with internal teams and carriers on strategy, presenting claim findings and recommendations.
  • Maintain accurate, compliant digital claim files and documentation throughout the claim lifecycle.
  • Interpret complex policy language and advised insureds on rights, obligations, and claim outcomes.
  • Stay current on industry trends, regulations, and procedures to ensure best practices in claims handling.

Skills, Knowledge & Expertise

  • Bachelor's degree (or equivalent work experience) Juris Doctor and admittance to a relevant State Bar and remain in good standing.
  • Proven experience as a Claim Adjuster or in a similar role within the insurance industry.
  • In-depth knowledge of insurance policies, coverage, and claims procedures.
  • Familiarity with legal and regulatory requirements pertaining to claims handling.
  • Strong analytical and problem-solving skills, with attention to detail.
  • Excellent verbal and written communication skills.
  • Ability to negotiate and resolve conflicts effectively.
  • Proficient in using claim management software and digital tools.
  • Demonstrated ability to work independently and meet deadlines.
  • Relevant certifications (e.g., claims adjuster licenses) and willingness to obtain additional licenses, if needed.
  • Benefits

    At Davies North America, we are dedicated to supporting the well-being and future of our qualifying employees. Our comprehensive benefits package includes :

  • Medical, dental, and vision plans to ensure your health and that of your family.
  • A 401k plan with employer matching to help you build a secure financial future.
  • Our time-off policies, including Discretionary Time Off for exempt employees and Paid Time Off (PTO) package for non-exempt employees, reflect our commitment to promoting a healthy work environment.
  • Paid holidays.
  • Life insurance and both short-term and long-term disability plans, providing essential financial protection for you and your loved ones.
  • Diversity and Inclusion

    Davies is dedicated to fostering a diverse and inclusive workplace that embraces a wide range of perspectives and experiences. We believe that diversity of thought is essential for innovation and creativity, and we actively promote an environment where all voices are valued and heard.

    About Davies

    We are a specialist professional services and technology firm, working in partnership with leading insurance, highly regulated and global businesses. We help our clients to manage risk, operate their core business processes, transform and grow. We deliver professional services and technology solutions across the risk and insurance value chain, including excellence in claims, underwriting, distribution, regulation & risk, customer experience, human capital, digital transformation & change management. Our global team of more than 8,000 professionals operate across ten countries, including the UK & the U.S. Over the past ten years Davies has grown its annual revenues more than 20-fold, investing heavily in research & development, innovation & automation, colleague development, and client service. Today the group serves more than 1,500 insurance, financial services, public sector, and other highly regulated clients.