Claims assistant Jobs in Anaheim, CA
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Claims assistant • anaheim ca
Claims Specialist
Talent MoversOrange, California, USA- Promoted
Claims Examiner I
Astiva Health, IncOrange County, CA, United States- Promoted
Claims Specialist - Legal
ScimaxconsultingOrange, CA, US- Promoted
Claims Reviewer
Axelon Services CorporationAnaheim, CA, US- Promoted
Claims Specialist
CorVelAnaheim, CA, US
Senior Claims Specialist-Permanent
estaffing IncOrange, California, USA- Promoted
Workers Compensation Claims Supervisor
AVONRISKOrange, CA, US- Promoted
Senior Claims Specialist
Gainful PlacementsAnaheim, CA, US- Promoted
Workers Compensation Claims Supervisor
Intercare InsuranceOrange, CA, US
Claims Assistant Team Lead
VirtualVocationsAnaheim, California, United States- Promoted
Claims Specialist (CAP Claims)
Authentic Group of CompaniesAnaheim, CA, US- Promoted
Claims Examiner - Workers Compensation
StaffingOrange, CA, US
Claims Specialist
NS IT SolutionsOrange, California, USA
Claims Specialist
MY HROrange, California, USA
Assistant Vice President, Complex Claims
CNABrea, CA, USA- Promoted
Assistant Claims Team Lead - Workers Compensation | Orange, CA
San Francisco StaffingOrange, CA, US
Claims Investigator - Experienced
Command InvestigationsOrange, CA, United States- Promoted
Sr. Claims Specialist
Cooperative of American Physicians, Inc.Orange County, CA, United States
Claims Specialist
AZAD Technology PartnersOrange, CA, USClaims Specialist
Talent MoversOrange, California, USA- Full-time
We are Hiring for Claims Specialist in Orange CA
Full Time
Job Description
Our client is seeking a Claims Specialist for their Orange County office. This role involves handling technical and administrative responsibilities related to managing assigned claim files and taking on a larger caseload of highly complex claims. The Senior Claims Specialist also plays an active role in the ongoing training and oversight of Claims Specialist I and II team members.
Roles & Responsibilities
Essential Duties and Responsibilities :
Manage medical malpractice claims including the assignment direction and control of defense counsel under supervision and in compliance with the Claims Technical Manual the Defense Attorney Guidelines and the MPT Agreement. Manage increasingly complex cases with larger financial exposure.
Investigate and evaluate claim files including complying with the standards of performance interviewing members reviewing medical records corresponding with plaintiff attorneys obtaining preliminary expert evaluation / opinions and preparing interview summaries.
Prepare case evaluation reports for publication and presentation to the CRC and CSC.
Prepare case evaluation reports for discretionary authority on selected cases.
Manage and participate in all litigation activity including discovery plan mediation MSC and negotiation under supervision as necessary.
Monitor trials and arbitrations including daily progress reports providing member and defense attorney with support.
Prepare claim file resolution documentation.
Timely update the claims database.
Document all important case developments under the chronology tab.
Code the claims file and update as relevant information is available.
Timely review and index documents to the On Base system.
Provide assistance to management as indicated on special project.
Identify investigate and follow-up on coverage issues.
Take Hotline calls as requested and as necessary and prepare hotlines.
Attend staff and department meetings as indicated.
Assist management in training of Claims Specialist I and IIs.
- Perform other duties as necessary.
Education and / or Experience :
Certificates Licenses Registrations :
Requirements
Other Skills and Abilities :
Key Skills
Corporate Paralegal,Baan,IT Sales and Marketing,Civil Quality Control,Activex,Jboss
Employment Type : Full Time
Experience : years
Vacancy : 1