12 ca senior claims specialist jobs found in Folsom, CA

The Senior Claims Specialist manages within company standards and best practices complex and problematic, high visibility workers' compensation claims within delegated limited authority to determine benefits due; work closely with case managers and attorneys; manage subrogation and negotiate settlements to ensure specific customer service requirement to achieve the best possible outcome in the claim, supporting the goals of claims department and of CorVel. This is a remote position.   ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Receives claim, confirms policy coverage and acknowledgement of the claim Determines validity and compensability of the claim by investigating and gathering information regarding the claim and files necessary documentation with state agencies Establishes reserves and authorizes payments within reserving authority limits Develops and manages well documented action plans with the case manager and outcomes manager to reduce overall cost of the...

The Senior Claims Specialist manages within company standards and best practices complex and problematic, high visibility workers' compensation claims within delegated limited authority to determine benefits due; work closely with case managers and attorneys; manage subrogation and negotiate settlements to ensure specific customer service requirement to achieve the best possible outcome in the claim, supporting the goals of claims department and of CorVel. This is a remote position.   ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Receives claim, confirms policy coverage and acknowledgement of the claim Determines validity and compensability of the claim by investigating and gathering information regarding the claim and files necessary documentation with state agencies Establishes reserves and authorizes payments within reserving authority limits Develops and manages well documented action plans with the case manager and outcomes manager to reduce overall cost of the...

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, under the direct supervision of a senior claims professional, supporting the goals of claims department and of CorVel.  This is a remote opportunity. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Receives claims, confirms policy coverage and acknowledgment of the claim Determines validity and compensability of the claim Establishes reserves and authorizes payments within reserving authority limits Manages non-complex and non-problematic medical only claims and minor lost-time workers’ compensation claims under close supervision Communicates claim status with the customer, claimant and client Adheres to client and carrier guidelines and participates in claims review as needed Assists other claims professionals with more complex or problematic claims as...

The Regulatory Compliance Specialist is responsible for ensuring compliance with all jurisdictional regulations within the designated department, mitigating potential legal and other company cost exposure. This position is solely responsible for recommending and helping implement process and internal policy changes based on state regulation changes. This position acts as an independent, positive and professional representative of our CorVel family, interacting with national and state officials, clients, claims, providers and all levels of internal management. May function as a member of the bill review department leadership team, the national network team, provider relations and/or specialized teams, ensuring optimum quality performance by providing regulatory guidance and assistance to achieve the organizational goals. This is a remote position. ESSENTIAL FUNCTIONS & RESPONSIBILITIES:   Provide technical and jurisdictional guidance to management, clients,...

The Claims Specialist manages within company best practices lower-level, non-complex and non-problematic indemnity claims within delegated limited authority to best possible outcome, under the direct supervision of a senior claims professional, supporting the goals of claims department and of CorVel. This is a remote opportunity.    ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Receives claims, confirms policy coverage and acknowledgment of the claim Determines validity and compensability of the claim Establishes reserves and authorizes payments within reserving authority limits Manages non-complex and non-problematic indemnity claims under close supervision Communicates claim status with the customer, claimant and client Adheres to client and carrier guidelines and participates in claims review as needed Assists other claims professionals with more complex or problematic claims as necessary Requires regular and consistent attendance...

The Medical Only Claims Specialist manages non-complex and non-problematic, medical only claims and minor lost-time workers’ compensation claims under close supervision, supporting the goals of claims department and of CorVel. This is a remote job opportunity.   ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Receives claims, confirms policy coverage and acknowledgement of the claim. Determines the validity and compensability of the claim. Establishes reserves and authorizes payments within established reserving authority limits. Communicates claim status with the customer, claimant and client. Adheres to client and carrier guidelines and participates in claims review as needed. Assists other claims professionals with more complex or problematic claims as necessary. Additional projects and duties as assigned.   KNOWLEDGE & SKILLS: Excellent Customer Service Skills. Excellent written and verbal communication skills. Ability to learn rapidly to...

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, under the direct supervision of a senior claims professional, supporting the goals of claims department and of CorVel.  This is a remote opportunity. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Receives claims, confirms policy coverage and acknowledgment of the claim Determines validity and compensability of the claim Establishes reserves and authorizes payments within reserving authority limits Manages non-complex and non-problematic medical only claims and minor lost-time workers’ compensation claims under close supervision Communicates claim status with the customer, claimant and client Adheres to client and carrier guidelines and participates in claims review as needed Assists other claims professionals with more complex or problematic claims as...

This role is eligible to participate in Zenith’s hybrid work schedule which provides the flexibility to work from home on select days of the week according to the in-office schedule established by regional executive leadership.  Selected candidate must be able to report into the Roseville, California office on a weekly basis. Job Posting At Zenith Agribusiness Solutions (ZAS), we specialize in providing P&C insurance products and services to California agricultural businesses. From dairies to berries, from almonds to wine, from vegetables to cattle ranches, we recognize the importance of agriculture and the effort it takes to compete in the global agriculture industry. That’s why we employ talented insurance professionals who are eager to get to know our policyholders, understand their operations, and help protect their businesses. Values such as collaboration, work-life balance, and integrity are placed at the center of all our operations. In addition, ZAS supports...

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 160 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 Claim, Legal Compensation Overview The annual base 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 salary for this position will be determined by a number of factors, including the scope,...

If you're passionate about being part of a diverse organization that enables a Fortune 100 company 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.   This position will cover various counties throughout Northern California, including San Francisco and the Bay Area.   The position can be a remote work from home opportunity .   This position will specialize in Large Loss Complex Case s. Other cases might include Bodily Injury Auto, Bodily Injury Commercial, Bodily Injury Homeowners, Commercial Auto, Commercial Property, Complex Commercial, Premises Liability, Products Liability, Property Damage, Trucking Defense, Uninsured & Underinsured Motorist, Wrongful...

Be Here. Be Great. Working for a leader in the insurance industry means opportunity for you. Great American Insurance Group’s member companies are subsidiaries of American Financial Group. We combine a "small company" culture where your ideas will be heard with "big company" expertise to help you succeed. With over 35 specialty property and casualty operations, there are always opportunities here to learn and grow. We value diversity and recognize the benefits gained when people from different cultures, backgrounds and experiences work collaboratively to achieve business results. We are intentionally focused on fostering an inclusive culture and know valuing diversity is an essential leadership quality. Our goal is to create a workplace where all employees feel included, empowered, and enabled to perform at their best. Join our team in Northern California at Republic Indemnity! For over 50 years , Republic Indemnity has been a trusted partner for businesses...

Be Here. Be Great. Working for a leader in the insurance industry means opportunity for you. Great American Insurance Group’s member companies are subsidiaries of American Financial Group. We combine a "small company" culture where your ideas will be heard with "big company" expertise to help you succeed. With over 35 specialty property and casualty operations, there are always opportunities here to learn and grow. We value diversity and recognize the benefits gained when people from different cultures, backgrounds and experiences work collaboratively to achieve business results. We are intentionally focused on fostering an inclusive culture and know valuing diversity is an essential leadership quality. Our goal is to create a workplace where all employees feel included, empowered, and enabled to perform at their best. Join our team in Northern California at Republic Indemnity! For over 50 years , Republic Indemnity has been a trusted partner for businesses...