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Liability Claims Examiner - Auto & GL

Liability Claims Examiner - Auto & GL

Sedgwick Claims Management Services, Inc.Orange, CA, United States
[job_card.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][last_updated.last_updated_variable_days]
Liability Claims Examiner - Auto & GL

Liability Claims Examiner - Auto & GL

SedgwickOrange, CA
[job_card.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][last_updated.last_updated_variable_days]
  • [promoted]
Claims Specialist

Claims Specialist

Elite SourcingCosta Mesa, CA, US
[job_card.full_time]
Property Damage Claims Specialist.Elite Sourcing is seeking an experienced Property Damage Claim Specialist to join a well-known Law Firm in Costa Mesa, CA. You will be responsible for investigating...[show_more][last_updated.last_updated_30]
  • [promoted]
Claims Specialist

Claims Specialist

Talent MoversOrange, California, USA
[job_card.full_time]
We are Hiring for Claims Specialist in Orange CA.Our client is seeking a Claims Specialist for their Orange County office. This role involves handling technical and administrative responsibilities ...[show_more][last_updated.last_updated_variable_days]
  • [promoted]
Remote Residential Title Examiner (FL)

Remote Residential Title Examiner (FL)

Insight GlobalSanta Ana, CA, US
[filters.remote]
[job_card.full_time]
Remote Residential Title Examiner.Insight Global is looking for a Remote Residential Title Examiner to work at an industry-leading title company. This employee will be responsible for searching publ...[show_more][last_updated.last_updated_30]
Experienced Claims Examiner

Experienced Claims Examiner

VirtualVocationsCosta Mesa, California, United States
[job_card.full_time]
A company is looking for an Experienced Claims Examiner - Remote.Key Responsibilities Review and adjudicate medical claims, ensuring accurate coding and data entry Verify patient eligibility and...[show_more][last_updated.last_updated_30]
  • [promoted]
Claims Examiner I

Claims Examiner I

Astiva Health, IncOrange County, CA, US
[job_card.full_time]
Orange, CA is a premier healthcare provider specializing in Medicare and HMO services.With a focus on delivering comprehensive care tailored to the needs of our diverse community, we prioritize acc...[show_more][last_updated.last_updated_variable_days]
Commercial Auto Claims Adjuster / Examiner - REMOTE

Commercial Auto Claims Adjuster / Examiner - REMOTE

Work At Home Vintage ExpertsAnaheim, CA, US
[filters.remote]
[job_card.full_time] +2
[filters_job_card.quick_apply]
Put your Insurance Experience to work – FROM HOME!.Our unique platform provides you with.WHAT YOU’LL LOVE ABOUT WAHVE.We created a welcoming place to work with friendly and professional...[show_more][last_updated.last_updated_variable_days]
  • [promoted]
Commercial Title Examiner

Commercial Title Examiner

StewartIrvine, California, USA
[job_card.full_time]
At Stewart we know that success begins with great people.As a Stewart employee youll be joining a company that was named a 2024-2025 Best Company to Work For by U. News & World Report and a 2025...[show_more][last_updated.last_updated_variable_days]
  • [promoted]
Claims Specialist

Claims Specialist

CorVelAnaheim, CA, US
[job_card.full_time]
The Claims Specialist manages within company best practices lower-level, non-complex and non-problematic workers' compensation claims within delegated limited authority to best possible outcome, un...[show_more][last_updated.last_updated_30]
  • [promoted]
MEP Plans Examiner

MEP Plans Examiner

Willdan Group, Inc.Yorba Linda, CA, United States
[job_card.full_time]
At Willdan, we believe the future is now.Through our subsidiary Public Agency Resources (PARS), we are proud to be "Envisioning the Future" of Building & Safety-partnering with cities, buildings, a...[show_more][last_updated.last_updated_30]
MEP Plans Examiner

MEP Plans Examiner

WilldanYorba Linda, CA, Yorba Linda, CA, US
[job_card.full_time]
Envision the future with us! At Willdan, we believe the future is now.Through our subsidiary Public Agency Resources (PARS), we are proud to be “Envisioning the Future” of Building & Safety—partner...[show_more][last_updated.last_updated_30]
  • [promoted]
Claims Examiner - Workers Compensation

Claims Examiner - Workers Compensation

StaffingOrange, CA, US
[job_card.full_time]
Manager's Note : Workers Compensation Claims Examiner.Preferred SIP Certification Medical facilities.PRIMARY PURPOSE : To analyze complex or technically difficult workers' compensation claims to dete...[show_more][last_updated.last_updated_30]
Claims Examiner - Workers Compensation

Claims Examiner - Workers Compensation

Rose InternationalOrange, CA, USA
[job_card.full_time]
Only qualified Workers' Compensation candidates located in California are eligible to be considered for this role • • •.Candidates must be located in the state of California.High School Diploma or equ...[show_more][last_updated.last_updated_30]
  • [promoted]
Claims Specialist (CAP Claims)

Claims Specialist (CAP Claims)

Authentic Group of CompaniesAnaheim, CA, US
[job_card.full_time]
Essential Duties and Responsibilities : .Manage medical malpractice claims, including the assignment, direction, and control of defense counsel, under supervision and in compliance with the Claims Te...[show_more][last_updated.last_updated_1_day]
  • [promoted]
Claims Examiner III

Claims Examiner III

Verda Healthcare IncHuntington Beach, CA, US
[job_card.full_time]
Center of Medicaid and Medicare Services (CMS) and a state license with the Texas Department of Insurance for a Medicare Advantage Prescription Drug (MAPD) plan. We are committed to the idea that he...[show_more][last_updated.last_updated_30]
Lead Claims Examiner I, CA

Lead Claims Examiner I, CA

AmTrust FinancialIrvine, CA, US
[job_card.full_time]
Amtrust Financial Services, a fast growing commercial insurance company, has an immediate need for a .This role will be located in our Irvine, CA office. The adjuster is responsible for the prompt a...[show_more][last_updated.last_updated_30]
  • [promoted]
Claims Specialist

Claims Specialist

NS IT SolutionsOrange, California, USA
[job_card.full_time]
Job Description - Claims Specialist.Location : Orange CA United States 92859.Our client is seeking a Claims Specialist for their Orange County office. This role involves handling technical and admini...[show_more][last_updated.last_updated_variable_days]
  • [promoted]
Claims Specialist

Claims Specialist

MY HROrange, California, USA
[job_card.full_time] +1
Manage med-mal claims end-to-end; larger / complex caseload; guide defense counsel; CRC / CSC reports; discovery / mediation / trial monitoring. mentor CS I / II.BA / BS; 5 years med-mal claims (or WC / Bodily I...[show_more][last_updated.last_updated_variable_days]
Liability Claims Examiner - Auto & GL

Liability Claims Examiner - Auto & GL

Sedgwick Claims Management Services, Inc.Orange, CA, United States
[job_card.variable_days_ago]
[job_preview.job_type]
  • [job_card.full_time]
[job_card.job_description]

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 career with us, experience our caring culture, and enjoy work-life balance. Here, there's no limit to what you can achieve.

Newsweek Recognizes Sedgwick as America's Greatest Workplaces National Top Companies

Certified as a Great Place to Work

Fortune Best Workplaces in Financial Services & Insurance

Liability Claims Examiner - Auto & GL

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 brands?

  • Apply your knowledge and experience to adjudicate complex customer claims in the context of an energetic culture.
  • Deliver innovative customer-facing solutions to clients who represent virtually every industry and comprise some of the world's most respected organizations.
  • Be a part of a rapidly growing, industry-leading global company known for its excellence and customer service.
  • Leverage Sedgwick's broad, global network of experts to both learn from and to share your insights.
  • Take advantage of a variety of professional development opportunities that help you perform your best work and grow your career.
  • Enjoy flexibility and autonomy in your daily work, your location, and your career path.
  • Access diverse and comprehensive benefits to take care of your mental, physical, financial and professional needs.

ARE YOU AN IDEAL CANDIDATE? We are looking for driven individuals that embody our caring counts model and core values that include empathy, accountability, collaboration, growth, and inclusion.

OFFICE LOCATIONS

Hybrid (2 Days In-Office)

PRIMARY PURPOSE : To analyze complex or technically difficult general liability and auto liability 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 general liability and auto liability 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.
  • Assesses liability and resolves claims within evaluation.
  • 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 clams within designated authority level.
  • Prepares necessary state fillings 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.
  • 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 & Knowledge

  • 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
  • TAKING CARE OF YOU

  • Flexible work schedule.
  • Referral incentive program.
  • Career development and promotional growth opportunities.
  • A diverse and comprehensive benefits offering including medical, dental vision, 401K on day one.
  • As required by law, Sedgwick provides a reasonable range of compensation for roles that may be hired in jurisdictions requiring pay transparency in job postings. Actual compensation is influenced by a wide range of factors including but not limited to skill set, level of experience, and cost of specific location. For the jurisdiction noted in this job posting only, the range of starting pay for this role is $80,000 - $100,000. A comprehensive benefits package is offered including but not limited to, medical, dental, vision, 401k and matching, PTO, disability and life insurance, employee assistance, flexible spending or health savings account, and other additional voluntary benefits.

    #Claims #ClaimsExaminer #Hybrid #LI-Hybrid #LI-Remote #LI-AM1

    Qualified applicants with arrest or conviction records will be considered for employment in accordance with the Los Angeles County Fair Chance Ordinance for Employers, the City of Los Angeles' Fair Chance Initiative for Hiring Ordinance, the San Diego Fair Chance Ordinance, the San Francisco Fair Chance Ordinance, the California Fair Chance Act, and all other applicable laws.

    Sedgwick is an Equal Opportunity Employer and a Drug-Free Workplace.

    If you're excited about this role but your experience doesn't align perfectly with every qualification in the job description, consider applying for it anyway! Sedgwick is building a diverse, equitable, and inclusive workplace and recognizes that each person possesses a unique combination of skills, knowledge, and experience. You may be just the right candidate for this or other roles.