141 claims jobs found in Rancho Cucamonga, CA

Gallagher Bassett is the premier provider of global claims services, dedicated to exceptional customer service and demonstrably superior outcomes. GB helps people, teams and businesses overcome adversity and loss through the guiding expertise of over 5,000 claims professionals, all committed to going beyond expectations in the continuous pursuit of a better way. Position Summary: Investigates, evaluates, disposes and settles the most complex claims and highest exposures with minimal supervision. Includes the investigation, determination and evaluation of coverage, liability and damages, and the setting of proper reserves. Incumbents at this level typically hold claims reserve and settlement authority of up to $10,000 liability and/or $25,000 workers compensation or greater. Essential Duties & Responsibilities: Exercises proper judgment and decision making to analyze the claims exposure, to determine the proper course of action and to appropriately settle the...

Gallagher Bassett is the premier provider of global claims services, dedicated to exceptional customer service and demonstrably superior outcomes. GB helps people, teams and businesses overcome adversity and loss through the guiding expertise of over 5,000 claims professionals, all committed to going beyond expectations in the continuous pursuit of a better way. Position Summary: Investigates, evaluates, disposes and settles the most complex claims and highest exposures with minimal supervision. Includes the investigation, determination and evaluation of coverage, liability and damages, and the setting of proper reserves. Incumbents at this level typically hold claims reserve and settlement authority of up to $10,000 liability and/or $25,000 workers compensation or greater. Essential Duties & Responsibilities: Exercises proper judgment and decision making to analyze the claims exposure, to determine the proper course of action and to appropriately settle the...

Gallagher Bassett is the premier provider of global claims services, dedicated to exceptional customer service and demonstrably superior outcomes. GB helps people, teams and businesses overcome adversity and loss through the guiding expertise of over 5,000 claims professionals, all committed to going beyond expectations in the continuous pursuit of a better way. Position Summary: Investigates, evaluates, disposes and settles the most complex claims and highest exposures with minimal supervision. Includes the investigation, determination and evaluation of coverage, liability and damages, and the setting of proper reserves. Incumbents at this level typically hold claims reserve and settlement authority of up to $10,000 liability and/or $25,000 workers compensation or greater. Essential Duties & Responsibilities: Exercises proper judgment and decision making to analyze the claims exposure, to determine the proper course of action and to appropriately settle the...

Gallagher Bassett is the premier provider of global claims services, dedicated to exceptional customer service and demonstrably superior outcomes. GB helps people, teams and businesses overcome adversity and loss through the guiding expertise of over 5,000 claims professionals, all committed to going beyond expectations in the continuous pursuit of a better way. Position Summary: Investigates, evaluates, disposes and settles the most complex claims and highest exposures with minimal supervision. Includes the investigation, determination and evaluation of coverage, liability and damages, and the setting of proper reserves. Incumbents at this level typically hold claims reserve and settlement authority of up to $10,000 liability and/or $25,000 workers compensation or greater. Essential Duties & Responsibilities: Exercises proper judgment and decision making to analyze the claims exposure, to determine the proper course of action and to appropriately settle the...

Gallagher Bassett is the premier provider of global claims services, dedicated to exceptional customer service and demonstrably superior outcomes. GB helps people, teams and businesses overcome adversity and loss through the guiding expertise of over 5,000 claims professionals, all committed to going beyond expectations in the continuous pursuit of a better way. CA based candidates only. Position Summary: Investigates, evaluates, disposes and settles the most complex claims and highest exposures with minimal supervision. Includes the investigation, determination and evaluation of coverage, liability and damages, and the setting of proper reserves. Incumbents at this level typically hold claims reserve and settlement authority of up to $10,000 liability and/or $25,000 workers compensation or greater. Essential Duties & Responsibilities: Exercises proper judgment and decision making to analyze the claims exposure, to determine the proper course of action and to...

Combine two of the fastest-growing fields on the planet with a culture of performance, collaboration and opportunity and this is what you get. Leading edge technology in an industry that's improving the lives of millions. Here, innovation isn't about another gadget, it's about making health care data available wherever and whenever people need it, safely and reliably. There's no room for error. Join us and start doing your life's best work.(sm) Primary Responsibilities: Accurately process professional claims Analyze and adjudicate claims to ensure accurate payment Interpret Fee for Service (FFS) and capitated provider contracts Review held claims on a periodic basis Meet Department Quality and Accuracy Standards Interfaces with other departments to obtain necessary information required for resolution of claims Advise management of any claim issues or inappropriate and/or incorrect billing Other duties assigned by management You’ll be rewarded and recognized...

Combine two of the fastest-growing fields on the planet with a culture of performance, collaboration and opportunity and this is what you get. Leading edge technology in an industry that's improving the lives of millions. Here, innovation isn't about another gadget, it's about making health care data available wherever and whenever people need it, safely and reliably. There's no room for error. Join us and start doing  your life's best work.(sm) Primary Responsibilities: Analyze professional claims to determine claims payment Apply claim reductions and denials as based on industry standard guidelines utilizing information displayed on each claim through CES review Apply proper benefit application based on service rendered Review authorizations Determine where capitated payment applies versus fee for service Monitor Error Queues and Denial queues for error corrections Seek assistance with claim questions through the Claims Trainer, Team Lead and Team Supervisor...

Job Summary: Responsible for investigating and confirming the facts of loss for basic to advanced automobile accidents. Determines coverage, liability, damages and otherwise adjusts and negotiates claims within limit of authority. Key Responsibilities: Handles investigation regarding all aspects of auto claims (coverage, damages, subrogation) with the exercise of discretion and independence within increased level of authority Applies intermediate understanding of insurance policies written by the company, the industry, and organizational relationships within the company and department Determines subrogation or fraud potential and how to handle Identifies customer needs and works to meet those needs using appropriate customer service skills Recognizes and identifies bodily injuries and works to settle claims within given authority. For claims involving fraud or subrogation, partners with assigned reps from those areas to achieve best outcome Supervisory...

Job Summary: This role utilizes analytical skills to create a comprehensive estimate of damages for 1st and 3rd party material damage claims leading to the proper disposition. Key Responsibilities: Exhibits proficient estimating fundamentals in order to create estimates of damages on 1st and 3rd party material damage losses Processes a deep understanding of the content of all policy types written by the company Negotiates settlements, makes settlement payments and documents all activities in the file within escalated authority limits Applies thorough understanding of regulatory compliance and fair claims practices Builds established relationships with both internal and external customers Supervisory Responsibilities: This job does not have supervisory duties Preferred Qualifications: Education and Experience Bachelor's degree preferred or equivalent experience 2 or more years of related experience Certificates, Licenses, Registrations Ability to...

Gallagher Bassett is the premier provider of global claims services, dedicated to exceptional customer service and demonstrably superior outcomes. GB helps people, teams and businesses overcome adversity and loss through the guiding expertise of over 5,000 claims professionals, all committed to going beyond expectations in the continuous pursuit of a better way. Position Summary: Investigates, evaluates, disposes and settles less complex claims with moderate supervision and includes the investigation, determination and evaluation of coverage, liability and damages and the setting of proper reserves. Incumbents at this level typically hold claims reserve and settlement authority of up to $5,000 liability and/or $10,000 workers compensation or greater. Essential Duties & Responsibilities: Exercises proper judgment and decision making to analyze the claims exposure to determine the proper course of action and to appropriately settle the claim. Interacts...

Gallagher Bassett is the premier provider of global claims services, dedicated to exceptional customer service and demonstrably superior outcomes. GB helps people, teams and businesses overcome adversity and loss through the guiding expertise of over 5,000 claims professionals, all committed to going beyond expectations in the continuous pursuit of a better way. Position Summary: Investigates, evaluates, disposes and settles the most complex claims and highest exposures with minimal supervision. Includes the investigation, determination and evaluation of coverage, liability and damages, and the setting of proper reserves. Incumbents at this level typically hold claims reserve and settlement authority of up to $10,000 liability and/or $25,000 workers compensation or greater. Essential Duties & Responsibilities: Exercises proper judgment and decision making to analyze the claims exposure, to determine the proper course of action and to appropriately settle the...

Insurance Company has an immediate need for a Remote Casualty General Liability Adjuster, 15% are in litigation. Public Entity experience is preferred. Licenses is not required. Must live in CA Temporary position - Pay rate: $35/hour RESPONSIBILITIES Conduct investigations, establish the facts of the loss, coverage analysis, compensability/liability/negligence determination, investigate possible application of risk transfer, litigation management, appropriate use of vendors, apply policy contract and insurance laws to properly assess and negotiate (settle, authorize or deny payment) to the conclusion of the claim within authority limits. Timely and appropriate reserve analysis and report completion. Handle litigated cases and attend mediation on assigned files. Prepare reports and Present claims in a round-table setting or at a claim review. Determine if subrogation opportunity exists and initiates recovery efforts. Some travel may be required. REQUIREMENTS...

Combine two of the fastest-growing fields on the planet with a culture of performance, collaboration and opportunity and this is what you get. Leading edge technology in an industry that is improving the lives of millions. Here, innovation is not about another gadget; it is about making health care data available wherever and whenever people need it, safely and reliably. There is no room for error. If you are looking for a better place to use your passion and your desire to drive change, this is the place to be. It's an opportunity to do your life's best work.(sm) You’ll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges. Primary Responsibilities: Facilitate end to end management of external and internal client audits of pharmacy benefits and pricing Gather PBM plan documentation from internal teams to provide to external audit firm  Read and interpret plan design documents and PBM service agreements  Research...

Gallagher Bassett is the premier provider of global claims services, dedicated to exceptional customer service and demonstrably superior outcomes. GB helps people, teams and businesses overcome adversity and loss through the guiding expertise of over 5,000 claims professionals, all committed to going beyond expectations in the continuous pursuit of a better way. Position Summary: Investigates, evaluates, disposes and settles less complex claims with moderate supervision and includes the investigation, determination and evaluation of coverage, liability and damages and the setting of proper reserves. Incumbents at this level typically hold claims reserve and settlement authority of up to $5,000 liability and/or $10,000 workers compensation or greater. Essential Duties & Responsibilities: Exercises proper judgment and decision making to analyze the claims exposure to determine the proper course of action and to appropriately settle the claim. Interacts...

Combine two of the fastest-growing fields on the planet with a culture of performance, collaboration and opportunity and this is what you get. Leading edge technology in an industry that's improving the lives of millions. Here, innovation isn't about another gadget, it's about making health care data available wherever and whenever people need it, safely and reliably. There's no room for error. Join us and start doing your life's best work.(sm) Join the Claims team as a Software Engineer focusing on Full Stack. The team is responsible for developing, maintaining, enhancing and setting a high-quality bar for web and mobile apps which assists end users in taking control of their healthcare claims and benefits. The team has a strong and integrated relationship with the product team based on strong collaboration, trust and partnership.  Goals for the team are focused on creating meaningful positive impact for our customers through clear and measurable metrics analysis....

Combine two of the fastest-growing fields on the planet with a culture of performance, collaboration and opportunity and this is what you get. Leading edge technology in an industry that is improving the lives of millions. Here, innovation is not about another gadget; it is about making health care data available wherever and whenever people need it, safely and reliably. There is no room for error. If you are looking for a better place to use your passion and your desire to drive change, this is the place to be. It's an opportunity to do your life's best work.(sm) You’ll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges. Primary Responsibilities: Facilitate end to end management of external and internal client audits of pharmacy benefits and pricing Gather PBM plan documentation from internal teams to provide to external audit firm  Read and interpret plan design documents and PBM service agreements...

Combine two of the fastest-growing fields on the planet with a culture of performance, collaboration and opportunity and this is what you get. Leading edge technology in an industry that's improving the lives of millions. Here, innovation isn't about another gadget, it's about making health care data available wherever and whenever people need it, safely and reliably. There's no room for error. Join us and start doing your life's best work.(sm)   Join the Claims team as a Software Engineer focusing on Backend. The team is responsible for developing, maintaining, enhancing and setting a high-quality bar for web and mobile apps which assists end users in taking control of their healthcare claims and benefits. The team has a strong and integrated relationship with the product team based on strong collaboration, trust and partnership.  Goals for the team are focused on creating meaningful positive impact for our customers through clear and measurable metrics analysis. As a...

You’ll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges. Welcome to one of the toughest and most fulfilling ways to help people, including yourself. We offer the latest tools, most intensive training program in the industry and nearly limitless opportunities for advancement. Join us and start doing  your life's best work.SM As member of the C&S UAT/Test Team, the Claims Business Process Technician will develop enhanced automation test opportunities and create & maintain test suites utilizing test automation applications.  You will work closely with our test team, technology & business partners to flawlessly deliver on test plans, & quality expectations, as it relates to the Claims End to End process on CSP Facets & surrounding systems.  This role should have a strong understanding of claims end to end system functionality as well as the up and down stream applications. These roles include, but...

Combine two of the fastest-growing fields on the planet with a culture of performance, collaboration and opportunity and this is what you get. Leading edge technology in an industry that is improving the lives of millions. Here, innovation is not about another gadget; it is about making health care data available wherever and whenever people need it, safely and reliably. There is no room for error. If you are looking for a better place to use your passion and your desire to drive change, this is the place to be. It's an opportunity to do your life's best work.(sm) This position is responsible for the testing of system changes as it relates to claim processing, fee schedule updates, contract modifications, enrollment, premium billing, employer group, reconciliation and fulfillment within the Facets system. This position may be involved in day-to-day work as it relates to creating and executing test cases and on large scale initiatives. You’ll enjoy the flexibility to...

Do you have compassion and a passion to help others? Transforming healthcare and millions of lives as a result starts with the values you embrace and the passion you bring to achieve  your life’s best work.(sm) This is an opportunity that's all about where you've been. Your experience. Your potential. Your skills. Because on the team at UnitedHealth Group, your potential and your impact can be career changing. No company has put together better teams of passionate, energetic and all out brilliant Claims Representatives. This is where you come in. We'll look for your experience and expertise to help keep our service levels and accuracy extremely high. We'll also look for your ideas on how to constantly evolve our claims processes. We'll back you with the great training, support and opportunities you'd expect from a Fortune 5 leader. You’ll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges.  Primary...