Top 18 Claims examiner Jobs in Pleasant Hill, Ca

Claims Examiner Trainee
Berkshire Hathaway Homestate Companies —Walnut Creek, CA
- Hybrid work
- Spanish
- Writing skills
- Basic math
- Paid holidays
- Health insurance
Quick Apply
Claims Examiner II
Partnership HealthPlan of California —Fairfield, CA
- $31.45 - $37.74 an hour
- Research
- Mid-level
- Office
Claims Examiner III - Hybrid / Remote
TRISTAR RISK MANAGEMENT —Concord, CA
- $90,000 - $95,000 a year
- Full-time
- Hybrid work
- Spanish
- Microsoft Excel
- 5 years
- Paid holidays
- Health insurance
Quick Apply
Liability Claims Examiner
Sedgwick —Concord, CA
- Full-time
- Hybrid work
- Mid-level
- Bachelor's degree
- Travel
- Health savings account
- Disability insurance
6d
Workers Compensation Claims Examiner III (Hybrid)
TRISTAR RISK MANAGEMENT —Concord, CA
- $90,000 - $100,000 a year
- Full-time
- Spanish
- Microsoft Excel
- 5 years
Quick Apply
Claims Examiner/Senior Claims Examiner
Berkley —Walnut Creek, CA
- $65,000 - $115,000 a year
- Full-time
- Computer literacy
- Analysis skills
- Organizational skills
- Profit sharing
- Health insurance
Claims Examiner
Gallagher —Oakland, CA
- $79,500 - $113,500 a year
- Remote
- 5 years
- Writing skills
- Mid-level
Senior Claims Examiner - County Account
Athens Administrators —Concord, CA
- $50.29 - $55.87 an hour
- Urgently hiring
- Management
- Bachelor of Science
- Basic math
- Health savings account
- AD&D insurance
Quick Apply
4d
Claims Examiner - Workers Compensation (HYBRID - Concord, CA)
Sedgwick —Concord, CA
- Full-time
- 5 years
- Office
- High school diploma or GED
- Health savings account
- Disability insurance
Senior Claims Examiner, Complex General Liability
Gallagher —Oakland, CA
- $88,000 - $171,500 a year
- Remote
- 7 years
- Writing skills
- High school diploma or GED
Examiner
JT2 —Oakland, CA
- Full-time
- Computer literacy
- Mid-level
- Analysis skills

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Claims Processor 3
Zenith-American —San Francisco, CA
Generate correspondence and form letters. Write routine reports and correspondence. Maintain current knowledge of assigned Plan(s) and effectively apply this…
$27.81 an hour
Claims Processor 1
Zenith-American —San Francisco, CA
Consistent with the Americans with Disabilities Act (ADA) and other applicable federal and state law, it is the policy of Zenith American Solutions to provide…
$25.75 an hour

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Workers Compensation Claims Examiner | MI, KY, IN & OH Jurisdictions | MI, IN & KY Licensing Preferred
Sedgwick —Dublin, OH
Professional certification as applicable to line of business preferred. Mental: Clear and conceptual thinking ability; excellent judgment, troubleshooting,…

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claims examiner jobs near pleasant hill, ca

Claims Examiner Trainee

Berkshire Hathaway Homestate Companies -
Walnut Creek, CA

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Job Details

Benefits

Paid holidays
Health insurance
Dental insurance
Tuition reimbursement
Paid time off
Vision insurance
Opportunities for advancement

Qualifications

Customer communication
High school diploma or GED

Full Job Description

WHAT WE'RE LOOKING FOR

Are you searching for a unique opportunity that offers exceptional training and career growth with a dynamic and growing organization? Are you a Spanish speaker looking to apply those skills in a professional environment? Berkshire Hathaway Homestate Companies is searching for bright individuals looking to begin a challenging, yet rewarding career path as a Workers’ Compensation Claims Adjuster.

Upon successful completion of the Claims Training program, the Claims Adjuster Trainee will be responsible for management of a caseload of workers compensation claims from inception to resolution. Responsibilities include initial investigation and analysis, strategic planning, management of medical care and legal process, and client relations. This individual will continue to build on claims knowledge and claims will increase in number and complexity.

RESPONSIBILITIES

Completes classroom training introducing workers’ compensation claims handling strategies, medical terminology, and legal concepts.
Learns skills such as investigative and persuasive communication, negotiation, decision-making, and strategic planning. Learns to review and interpret medical records.
Conducts and directs the investigation of reported claims to determine coverage, compensability and severity and to gather all other relevant information, including making three-point contact telephone calls.
Calculates appropriate reserves for each claim and ensures that reserves are adjusted as needed per authority guidelines.
Develops and updates a plan of action for the successful resolution of each claim.
Assigns appropriate tasks to a Claims Assistant and/or Claims Clerical Assistant and ensures they are performed correctly and efficiently.
Reduces fraud through early identification and escalation.
Communicates effectively with individuals outside the company, including clients, medical providers, and injured workers.
Prepares timely and accurate settlement recommendations (within designated authority parameters) and effectively negotiates the settlement of claims.
Ensures that the actions of all other professionals involved in managing a claim, including attorneys, nurse case managers, and investigators, are coordinated to achieve a successful resolution of the claim.

WHAT YOU'D BRING TO THE ROLE

Minimum of High School Diploma or equivalent certificate required; Bachelor’s degree from four-year college or university is preferred
Ability to communicate effectively verbally and in writing; Spanish Fluency ability preferred
Exceptional interpersonal and customer service skills
Ability to manage and prioritize multiple assignments in a fast-paced environment
Strong organization skills to ensure tasks are completed within hard deadlines
Basic mathematical skills to calculate monetary reserves
To perform this job successfully, an individual should be proficient in the Microsoft Office Suite of applications and be proficient, or able to become proficient, on applicable databases, systems, and vendor software programs.

WHY YOU SHOULD APPLY

Unparalleled financial strength and stability
Fantastic growth and advancement opportunities
WFH Hybrid schedule
Free gym in building
Generous Paid Time Off and Holidays
Excellent Benefits (Medical, Dental, Vision, 401k, etc)
Health and Wellness Reimbursement
Tuition Assistance Reimbursement
Discounts across companies such as GEICO, See’s Candies, etc.

In accordance with the California Equal Pay Act, the starting hourly wage for this job is $33.6539. This hourly wage is what the employer reasonably expects to pay for the position based on potential employee qualifications, operational needs and other considerations consistent with applicable law. The pay scale applies only to this position and only if it is filled in California. The pay scale may be different for other positions or in other locations.

Quick Apply

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claims examiner jobs in pleasant hill, ca

Claims Examiner Trainee

Claims Examiner II

Claims Examiner III - Hybrid / Remote

Liability Claims Examiner

Workers Compensation Claims Examiner III (Hybrid)

Claims Examiner/Senior Claims Examiner

Claims Examiner

Senior Claims Examiner - County Account

Claims Examiner - Workers Compensation (HYBRID - Concord, CA)

Senior Claims Examiner, Complex General Liability

Examiner

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