293 claims processor jobs found

Title:   Claims Processor 1   Department:   Claims Bargaining Unit:   OPEIU 29   Grade:   16 Position Type:   Non-Exempt   Hours per Week:   40 Position   Summary The Claims Processor provides customer service and processes routine health and welfare claims on assigned accounts according to plan guidelines and adhering to Company policies and regulatory requirements. "Has minimum necessary access to Protected Health Information (PHI) and Personally Identifiable Information (PII) by Job Description/Role." Key   Duties   and   Responsibilities Maintains current knowledge of assigned Plan(s) and effectively applies that knowledge in the payment of claims. Processes routine claims which could include medical, dental, vision, prescription, death, Life and AD&D, Workers' Compensation, or disability. May provide customer service by responding to and documenting telephone, written, electronic, or in-person inquiries....

Title: Customer Service Claims Processor                                 Department: Customer Service Union: OPEIU 29                                                                               Grade: 17 Position Summary The Customer Service Claims Processor is focused on providing customer service via call handling to participants, beneficiaries, union locals and providers regarding eligibility, benefits and claims status in conjunction with claims processing as business needs dictate. "Has minimum necessary access to Protected Health Information (PHI) and Personally Identifiable Information (PII) by Job Description/Role." Key Duties and Responsibilities Provides written, verbal or face-to-face customer service to members by responding to and documenting telephone and written inquiries in accordance with various Plan(s) benefits. Resolves customer inquiries and complaints in a timely and accurate manner. Escalates issues as appropriate....

Title: Customer Service Claims Processor                                 Department: Customer Service Union: OPEIU 29                                                                               Grade: 17 Position Summary The Customer Service Claims Processor is focused on providing customer service via call handling to participants, beneficiaries, union locals and providers regarding eligibility, benefits and claims status in conjunction with claims processing as business needs dictate. "Has minimum necessary access to Protected Health Information (PHI) and Personally Identifiable Information (PII) by Job Description/Role." Key Duties and Responsibilities Provides written, verbal or face-to-face customer service to members by responding to and documenting telephone and written inquiries in accordance with various Plan(s) benefits. Resolves customer inquiries and complaints in a timely and accurate manner. Escalates issues as appropriate. Processes routine...

Independently processes medical, dental and/or hospital claims, including more difficult or complex claims, provides customer service, and handles special projects and complex functions, including subrogation; acts as a “lead” and resource for other claims processing positions. "Has minimum necessary access to Protected Health Information (PHI) and Personally Identifiable Information (PII) by Job Description/Role." Key Duties and Responsibilities Processes medical, dental and/or hospital claims; processes complex claims independently.  Provides customer service by responding to and documenting telephone and/or written inquiries. Meets quantity and quality claims processing standards.  Performs pre-authorizations, audits files, requests check tracers and stop payments, and assists with researching and preparing appeals, as applicable.   Maintains current knowledge of assigned Plan(s) and effectively applies knowledge in the payment of claims, customer service and...

Overview Responsible for oversight and management of the overall operation of the in-house defense attorneys including all staff counsel personnel within assigned territory. Establish and monitor procedures to ensure the delivery of legal services meets performance standards, complies with best practices, and supports business strategy. Identify opportunities for streamlining operational efficiency through process improvement initiatives and oversee change implementation. Collaborate within Claim department and contribute to shared initiatives. Responsibilities Staff Counsel Operations Direct the overall operations of the Staff Counsel Office to ensure efficient performance. Assess and manage personnel to maximize resource allocation. Review and monitor performance metrics, staffing model and claim trends. Own all aspects of the hiring process including interviewing, onboarding and training. Leadership and...

Crum & Forster Company Overview Crum & Forster (C&F) , with a proud history dating to 1822, provides specialty and standard commercial lines insurance products through our admitted and surplus lines insurance companies. C&F enjoys a financial strength rating of "A+" (Superior) by AM Best and is proud of our superior customer service platform. Our claims and risk engineering services are recognized as among the best in the industry.   Our most valuable asset is our people: more than 2000 employees in locations throughout the United States. The company is increasingly winning recognition as a great place to work, earning several workplace and wellness awards, including the 2025 Great Place to Work ® Award for our employee-first focus and our steadfast commitment to diversity, equity and Inclusion.   C&F is part of Fairfax Financial Holdings, a global, billion dollar organization.  For more information about Crum & Forster,...

Crum & Forster Company Overview Crum & Forster (C&F) , with a proud history dating to 1822, provides specialty and standard commercial lines insurance products through our admitted and surplus lines insurance companies. C&F enjoys a financial strength rating of "A+" (Superior) by AM Best and is proud of our superior customer service platform. Our claims and risk engineering services are recognized as among the best in the industry.   Our most valuable asset is our people: more than 2000 employees in locations throughout the United States. The company is increasingly winning recognition as a great place to work, earning several workplace and wellness awards, including the 2025 Great Place to Work ® Award for our employee-first focus and our steadfast commitment to diversity, equity and Inclusion.   C&F is part of Fairfax Financial Holdings, a global, billion dollar organization.  For more information about Crum & Forster,...

If you're passionate about being part of a diverse organization that enables a company with nearly $70 billion in annual sales to deliver innovative business solutions with excellence, then Nationwide's Legal team could be the place for you! At Nationwide®, “on your side” goes beyond just words. Our customers are at the center of everything we do and we’re looking for associates who are passionate about delivering extraordinary care. No billable hours! The preferred candidate will have insurance defense experience including both personal lines and commercial lines cases. This position can be located in Northern CA, or in the Los Angeles Area. #LI-CP1 Job Description Summary Would you thrive in an environment where you can deliver top-quality legal services to support the mission of a Fortune 100 insurance company’ to protect people, businesses and futures with extraordinary care? If you possess the academic credentials, strong analytical skills and legal...

Who Are We? Taking care of our customers, our communities and each other. That’s the Travelers Promise. By honoring this commitment, we have maintained our reputation as one of the best property casualty insurers in the industry for over 170 years. Join us to discover a culture that is rooted in innovation and thrives on collaboration. Imagine loving what you do and where you do it. Job Category Underwriting Compensation Overview The hourly salary range provided for this position is a nationwide market range and represents a broad range of salaries for this role across the country. The actual hourly rate for this position will be determined by a number of factors, including the scope, complexity and location of the role; the skills, education, training, credentials and experience of the candidate; and other conditions of employment. As part of our comprehensive compensation and benefits program,...

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 Worker Compensation Team Lead | Hybrid (Orange, CA) 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...

At Cotality, we are driven by a single mission—to make the property industry faster, smarter, and more people-centric. Cotality is the trusted source for property intelligence, with unmatched precision, depth, breadth, and insights across the entire ecosystem. Our talented team of 5,000 employees globally uses our network, scale, connectivity and technology to drive the largest asset class in the world. Join us as we work toward our vision of fueling a thriving global property ecosystem and a more resilient society. Cotality is committed to cultivating a diverse and inclusive work culture that inspires innovation and bold thinking; it's a place where you can collaborate, feel valued, develop skills and directly impact the real estate economy. We know our people are our greatest asset. At Cotality, you can be yourself, lift people up and make an impact. By putting clients first and continuously innovating, we're working together to set the pace for unlocking new possibilities...

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 Adjuster PRIMARY PURPOSE :   To handle losses and claims for property and casualty insurers. ESSENTIAL FUNCTIONS and RESPONSIBILITIES Examines insurance policies and other records to determine insurance coverage. Interviews, telephones, and/or corresponds with claimant and witnesses regarding claim. Consults police and hospital records and inspects property damage to determine extent of company's liability and varying methods of investigation according to type...

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 Workers Compensation Claims Examiner | West Hills, CA (Remote 2 Days) 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...

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 Leave of Absence Coordinator Leave of Absence Coordinator Our teams thrive together! We collaborate in person and embrace a flexible hybrid work style. To join us, you’ll need to live near one of our dynamic Centers of Excellence West Hills, CA. 8521 Fallbrook Ave. Suite 250, West Hills, CA ✨ What we offer: A stable, consistent work environment —both in-office and virtual A comprehensive training program to help you support...

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 Claims Assistant | In-office (Ontario, California) Are you looking for an impactful job requiring no prior experience that offers an opportunity to develop a professional career? A stable and consistent work environment in an office setting A training program to learn how to help employees and customers from some of the world’s most reputable brands An assigned mentor and manager who will guide you on your career journey Career...

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 Workers Compensation Claims Associate | West Hills, CA (In-office) Are you looking for an impactful job requiring no prior experience that offers an opportunity to develop a professional career? A stable and consistent work environment in an office and/or virtual setting A training program to learn how to help employees and customers from some of the world’s most reputable brands An assigned mentor and manager who will guide you on your career journey...

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 Concierge/Performance Assosicate PRIMARY PURPOSE:   To assist Property Repair Solutions customers (homeowners, contractors, carriers) with any questions or concerns they may have and/or the work being done by the program contractors; to ensure that all customer expectations are met and/or exceeded to the best of our ability. ESSENTIAL FUNCTIONS and RESPONSIBILITIES ·          Receives, reviews and dispatches new jobs to contractors based on job...

Job Type: Permanent Build a brilliant future with Hiscox   Position: Senior Software Engineer  Reporting to: Engineering Manager    Location: LA, Atlanta, Boston, Chicago The Role: This Senior Software Engineer role focuses on building and maintaining the APIs that power Hiscox’s insurance platform. You’ll design and implement OpenAPI-based services within a microservice architecture, contributing to the infrastructure that enables launching and managing new insurance products at an industry-leading pace. You’ll be responsible for shaping key technical decisions that directly impact the company’s ability to scale and innovate. The Team: The Carrier Platform team owns the APIs and systems that power policy underwriting, issuance, and management. As part of Hiscox’s engineering organization, the team plays a central role in enabling business growth through faster product delivery and stronger service reliability. You’ll collaborate closely with...

Job Type: Permanent Build a brilliant future with Hiscox   Product Manager – Insurance Enablement   Build a Brilliant Future with Corix, a Hiscox Company   The Product Manager – Insurance Enablement role at Corix, a Hiscox Company is responsible for the strategy, development, and execution of product features, enhancements, and integrations that support insurance product development, business growth, and product distribution. This role focuses on improving technology and tooling to make the creation and maintenance of insurance products easier, faster, and more efficient.   Core responsibilities include partnering with Insurance Product Implementation teams to drive enhancements to existing products and enable the launch of new ones, refining underwriting rules and risk assessment s, and coordinating with internal and external stakeholders to deliver operationally efficient and scalable solutions.   This position...

Job Type: Permanent Build a brilliant future with Hiscox   Product Manager – Insurance Platforms   Build a Brilliant Future with Corix, a Hiscox Company     The Product Manager – Insurance Platforms role at Corix, a Hiscox Company, is responsible for the strategy, development, and execution of platform features, enhancements, and integrations that power the end-to-end insurance lifecycle. This role focuses on improving the systems and tools used to manage and sell insurance policies, ensuring seamless support for underwriting, policy servicing, billing, renewals, endorsements, and claims.   Core responsibilities include partnering with Insurance, Operations, Administrators, and Underwriting teams to drive roadmap priorities, enhance platform usability, and deliver scalable, efficient workflows. Th is role will define requirements, coordinate with design and engineering, and ensure integrations with platforms and internal systems...