Top 16 Claims examiner Jobs in Riverside, Ca

Workers' Compensation Claims Examiner
JT2 Integrated Resources —California
- From $90,000 a year
- Full-time
- Mid-level
- 3 years
- Analysis skills
- Health insurance
- Dental insurance
Quick Apply
EXAMINER, CLAIMS
Pomona Valley Hospital Medical Center —Pomona, CA
- $24.43 - $34.38 an hour
- Full-time
- Hospital
- High school diploma or GED
- 1 year
10d
Claims Examiner
LSMA Management Inc —San Bernardino, CA
- $28.85 - $33.65 an hour
- Extended hours
- Hybrid work
- Google Workspace
- Customer service
- Writing skills
Xcelys Medical Claims Examiner-REMOTE
NTT DATA —Ontario, CA
- $20 an hour
- Contract
- Remote
- High school diploma or GED
- Analysis skills
- Continuous improvement
Quick Apply
14d
Examiner Physician Assistant - Travel
Loyal Source Government Services —California
- $133,120 - $163,120 a year
- Microsoft Word
- Microsoft Outlook
- Military
Quick Apply
Workers Compensation Claims Examiner | Ontario, California
Sedgwick —Ontario, CA
- Full-time
- Hybrid work
- Customer service
- 5 years
- Office
- Health savings account
- Disability insurance
Claims Examiner
TechOneIT —Pomona, CA
- $25 - $30 an hour
- Temporary
- Customer service
- Mid-level
- High school diploma or GED
Quick Apply
4d
Claims Examiner - Workers Compensation (On-Site Ontario, California or REMOTE in California)
Sedgwick —Ontario, CA
- Full-time
- Hybrid work
- Mid-level
- 3 years
- High school diploma or GED
- Health savings account
- Disability insurance
Workers Compensation - Claims Examiner | HYBRID | Riverside, CA
Sedgwick —Riverside, CA
- Full-time
- Hybrid work
- Customer service
- 5 years
- Office
- Health savings account
- Disability insurance
Workers Compensation Claims Examiner III _ Temp
TRISTAR RISK MANAGEMENT —Chino Hills, CA
- $93,600 - $104,000 a year
- Temporary
- Remote
- Microsoft Word
- Writing skills
- Basic math
- Paid holidays
- Disability insurance
Quick Apply
Senior Claims Examiner, Workers' Compensation
Gallagher —Corona, CA
- $71,500 - $102,000 a year
- Remote
- 5 years
- High school diploma or GED
- Bachelor's degree

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Certified Medical Billing Reconciliation Specialist
Transgender Health & Wellness Center —Palm Springs, CA
Certified Professional Biller (CPB) or equivalent certification. Reconcile approximately *60–80 payment transactions per hour*, depending on claim complexity.
$20 - $22 an hour
Quick Apply
4d
Medical Case Manager- CA
Broadspire Services, Inc. —Los Angeles, CA
Must maintain a valid driver's license in state of residence. A registered nurse (RN) license. Active RN home state licensure in good standing without…
Quick Apply

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claims examiner jobs near riverside, ca

Workers' Compensation Claims Examiner

JT2 Integrated Resources -
California

Quick Apply

Job Details

Full-time
From $90,000 a year

Benefits

Health insurance
Dental insurance
401(k)
Flexible spending account
Paid time off
Vision insurance

Qualifications

Customer communication
Caseload management

Full Job Description

Claims Examiner - Workers Compensation, JT2 Integrated Resources

JT2 has over two decades of experience in claims administration and has delivered consistent cost savings to clients while providing quality care to claimants. We partner with our clients to provide fully customized and innovative solutions that integrate claims administration with risk control solutions.

We are searching for a highly motivated Claims Examiner to join our team! Under supervision of the Claims Supervisor, the Claims Examiner will manage claims from inception to conclusion. The position requires an individual that adheres to best practices and State of California statutes to work directly with clients, injured workers, agents, vendors, and attorneys to resolve workers compensation claims.

Minimum Requirements

Three (3) years of claims management experience
Bachelor's degree from an accredited college or university preferred.
Possession of a current Self-Insurance Plan (SIP) Certificate and insurance-related course work: CPCU, WCCA, WCCP, ARM.
Must be able to administer any type of indemnity claim within the assigned caseload including those involving lost time, those likely to involve permanent disability residuals, and future medical claims.

Duties and Responsibilities

Ensure proper handling of claims from inception to conclusion per client service agreements and JT2 service standards.
Prepare accurate and timely issuance of benefits notices and required reports within statutory limits.
Reserve files in compliance with injury type, identify potential costs of medical care investigation and indemnity benefits.
Ensure timely payment of benefits, bills and appropriate caseload and performance goals.
Negotiate and prepare claims for settlement, provide manager/supervisor with complete and accurate settlement data.
Monitor, report, and assign claims for fraud potential and subrogation possibilities.
Monitor claims for pre-established criteria for case-management and vocational rehabilitation in accordance with State laws.
Prepare and present claims summaries to clients during file reviews.
Train and direct Claims Assistants to meet goals and deadlines.
Review and approve priority payments and other documents from Claims Assistants.
Performs other duties as assigned.

Knowledge, Skills, and Abilities

Strong knowledge of workers" compensation policy, concepts and terminology and benefit provisions.
Strong knowledge of adjusting workers" compensation claims for municipalities and administering LC 4850 benefits.
Strong skills with use of general office administration technology, including Microsoft Office Suite and related software.
Excellent verbal and written communication skills.
Excellent interpersonal and conflict resolution skills.
Excellent organizational skills and attention to detail.
Excellent interpersonal, negotiation, and conflict resolution skills.
Strong analytical and problem-solving skills.
Ability to act with integrity, professionalism, and confidentiality, at all times.
Remote work is acceptable.

The above statements are intended to describe the general nature and level of work being performed by people assigned to this classification. They are not to be construed as an exhaustive list of all responsibilities, duties, and skills required of personnel so classified. All personnel may be required to perform duties outside of their normal responsibilities from time to time, as needed.

JT2 Integrated Resources provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.

Job Type: Full-time

Pay: From $90,000.00 per year

Benefits:

401(k)
Dental insurance
Flexible spending account
Health insurance
Paid time off
Vision insurance

Work Location: Remote

Quick Apply

Refine Your Search

claims examiner jobs in riverside, ca

Workers' Compensation Claims Examiner

EXAMINER, CLAIMS

Claims Examiner

Xcelys Medical Claims Examiner-REMOTE

Examiner Physician Assistant - Travel

Workers Compensation Claims Examiner | Ontario, California

Claims Examiner

Claims Examiner - Workers Compensation (On-Site Ontario, California or REMOTE in California)

Workers Compensation - Claims Examiner | HYBRID | Riverside, CA

Workers Compensation Claims Examiner III _ Temp

Senior Claims Examiner, Workers' Compensation

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