<p>We are looking for an experienced Insurance Claims Examiner to join our team on a contract basis in Oakland, California. In this role, you will analyze and process medical claims, ensuring accuracy and compliance with healthcare regulations. Ideal candidates will have a strong background in insurance claims management and coding, along with the ability to work independently in a fast-paced environment.</p><p><br></p><p>Responsibilities:</p><p>• Review and adjudicate medical claims for accuracy and compliance with Medi-Cal, Medicare, and other healthcare regulations.</p><p>• Research and resolve claim discrepancies, ensuring proper payment and documentation.</p><p>• Utilize coding systems such as ICD-10, CPT, and HCPCS to verify claim accuracy.</p><p>• Maintain confidentiality while handling sensitive participant and family information.</p><p>• Follow organizational policies and procedures to ensure compliance and attention to detail.</p><p>• Exhibit consistent attendance and punctuality while meeting deadlines.</p><p>• Communicate effectively with internal teams and external stakeholders to address claim issues.</p><p>• Input accurate data into various computer systems and software programs.</p><p>• Provide courteous and detail-oriented customer service to all stakeholders.</p><p>• Perform additional duties as assigned to support claims processing activities.</p><p><br></p><p>If you are interested in this role please apply now and call us at (510) 470-7450, it is an urgent need for our client. </p>
<p>Job Posting: Claims Adjuster – Remote</p><p>Join our team to support a leading pet insurance organization as a Claims Adjuster. This is a fully remote role offering the opportunity to help pet parents by efficiently managing, adjudicating, and finalizing insurance claims. We are looking for detail-oriented individuals who value accuracy, organization, and clear communication.</p><p><br></p><p>Key Responsibilities:</p><ul><li>Adjudicate insurance claims in a timely and compliant manner, adhering to standard operating procedures.</li><li>Consistently meet or exceed daily claims targets.</li><li>Provide guidance, oversight, and final approval authority to non-licensed claims processors (GenPact, AdStrat, or Healthy Paws).</li><li>Maintain active adjuster licenses as required by state and municipal regulations.</li><li>Identify and recommend process improvements to enhance the claims workflow.</li><li>Ensure all claims are processed according to compliance and quality standards.</li></ul><p><br></p>
<p>We are looking for a dedicated Personal Injury Claims Representative to join our team in the Lawrenceville, New Jersey area. In this role, you will manage complex personal injury protection claims, ensuring compliance with company policies and regulatory requirements. This position requires a detail-oriented individual with strong analytical skills and a commitment to delivering high-quality service.</p><p><br></p><p>Salary is 58,240 - 76,960.</p><p><br></p><p>Benefits include medical, dental, vision insurance, PTO, life insurance, and 401k. </p><p><br></p><p>Responsibilities:</p><p>• Investigate assigned claims, confirm coverage, verify eligibility, and determine the appropriate course of action.</p><p>• Evaluate gathered information to assess claim validity, injury extent, and potential exposure.</p><p>• Establish and maintain accurate reserves for each claim based on exposure estimates.</p><p>• Coordinate medical case reviews, independent medical examinations, or expert consultations when necessary.</p><p>• Respond to inquiries and concerns from subscribers, claimants, attorneys, and healthcare providers.</p><p>• Document claim files comprehensively and maintain an organized follow-up system for timely reporting.</p><p>• Ensure claims are managed in alignment with the organization's Decision Point Review Plan.</p><p>• Collaborate with internal departments and external specialists to optimize claim outcomes.</p><p>• Oversee loss adjustment expenses and manage vendor activities to ensure efficient and necessary work completion.</p><p>• Adhere to guidelines outlined in the Unfair Claim Practices Acts and other relevant regulations.</p>
<p>Our client is looking for a dedicated Bodily Injury Claims Representative in the Lawrenceville, NJ area to manage non-litigation auto insurance claims, including uninsured and underinsured motorist cases. This role requires a strong understanding of insurance policies and the ability to assess claims effectively. </p><p><br></p><p>Salary is 60,000 - 79,000. </p><p><br></p><p>Benefits include medical, dental, and vision coverage, PTO, life insurance, and 401k. </p><p><br></p><p>Responsibilities:</p><p>• Investigate claims thoroughly to validate their authenticity, assess policy coverages, and determine if special investigations are necessary.</p><p>• Set appropriate reserves based on claim details and adjust them as new information becomes available.</p><p>• Negotiate settlements with claimants, attorneys, and other involved parties while adhering to company policies.</p><p>• Issue accurate payments promptly and ensure all transactions align with regulatory standards.</p><p>• Recognize potential fraud or questionable claims and escalate them to the special investigation unit when required.</p><p>• Maintain organized records and follow up regularly to ensure claims are resolved in a timely manner.</p><p>• Ensure compliance with state and local regulations, including NJ, PA, and Michigan Unfair Claims Practices guidelines.</p><p>• Complete other assigned duties as needed to support the claims process.</p>
We are looking for a dedicated Claims Adjustor to join our team on a contract basis in Des Moines, Iowa. In this role, you will handle medical-only workers' compensation claims, ensuring accuracy and prompt processing. This position requires excellent customer service skills and attention to detail to effectively manage a low volume of daily calls and claims.<br><br>Responsibilities:<br>• Review workers' compensation claims to ensure compliance with medical and insurance standards.<br>• Process medical-only claims accurately and in a timely manner.<br>• Communicate with customers to address inquiries and provide exceptional service.<br>• Collaborate with team members to maintain organized and efficient claim workflows.<br>• Handle medical billing and insurance claim documentation with precision.<br>• Monitor and manage medical denials and appeals to resolve issues.<br>• Support hospital billing processes and ensure proper claim handling.<br>• Maintain detailed records for claims and related communications.<br>• Identify discrepancies in claim submissions and take corrective actions.<br>• Provide regular updates and reports on claim processing activities.
We are looking for a detail-oriented Claims Admin Support Specialist to join our team in Maitland, Florida. In this long-term contract role, you will perform a variety of clerical and administrative tasks to ensure smooth office operations. This position requires strong organizational skills and the ability to handle routine inquiries while supporting broader office functions.<br><br>Responsibilities:<br>• Manage and maintain office supplies, ensuring stock levels are adequate and replenished as needed.<br>• Operate and oversee the maintenance of office equipment, including printers, copiers, and fax machines.<br>• Coordinate document shredding services with designated vendors.<br>• Handle document organization by creating, retrieving, and delivering files, as well as copying and scanning documents.<br>• Compose basic correspondence and assist with routine communication tasks.<br>• Greet visitors, direct them appropriately, and address general inquiries.<br>• Open, sort, and distribute incoming mail and deliveries, including FedEx packages.<br>• Assist in setting up meetings and coordinating record retention processes.<br>• Perform additional research and reporting tasks as requested by leadership.<br>• Occasionally travel for work-related tasks or meetings.
<p>Robert Half is looking for a skilled Liability Claims Coordinator to join our client in Santa Ana, California. In this long-term contract position, you will play a vital role in managing liability claims, ensuring accurate documentation, and providing essential administrative support. This position is fully on-site with a unique schedule of 6am-3pm. </p><p><br></p><p>Responsibilities:</p><p>• Manage liability claims efficiently, ensuring proper documentation and timely processing.</p><p>• Perform detailed data entry to maintain accurate records and track case progress.</p><p>• Collaborate with internal teams to support auto defense and workers compensation claims.</p><p>• Conduct intake calls and gather information from clients.</p><p>• Monitor claim statuses and follow up as needed to ensure resolution.</p><p>• Analyze claims data to identify trends and improve processes.</p><p>• Maintain compliance with legal and organizational standards throughout the claims process.</p>
<p>Our team is looking for a dedicated Insurance Authorization Specialist to support our growing healthcare organization in Carmel, IN. In this role, you will be responsible for verifying patient insurance coverage, obtaining pre-authorizations for medical services, and serving as a key liaison between our office, patients, and insurance providers. Your efforts will ensure a smooth billing process and timely patient care.</p><p><br></p><p>Schedule: Monday – Friday, 8:00 a.m. – 5:00 p.m.</p><p><br></p><p>Key Responsibilities:</p><ul><li>Confirm patient insurance eligibility and benefits prior to scheduled appointments and procedures.</li><li>Request and monitor prior authorizations for a variety of medical services.</li><li>Accurately document all exchanges with insurance carriers, payers, and patients.</li><li>Provide clear updates and information to providers, billing teams, and patients regarding authorization status and coverage issues.</li><li>Work collaboratively to address denied authorizations or appeal situations promptly.</li><li>Stay informed on current insurance policies, pre-authorization requirements, and payer protocols.</li><li>Maintain strict compliance with HIPAA regulations and safeguard patient privacy at all times.</li></ul><p><br></p>
<p>We are looking for an experienced attorney to join our client's well-respected law firm on their General Liability team in Philadelphia, Pennsylvania. This role offers an exciting opportunity for a mid-level lawyer to handle a variety of insurance defense and liability litigation matters. The ideal candidate will bring strong analytical skills, legal expertise, and a commitment to delivering excellent results.</p><p><br></p><p>Responsibilities:</p><p>• Manage a diverse range of general liability litigation cases from inception to resolution.</p><p>• Draft and file legal pleadings, motions, and briefs with precision and attention to detail.</p><p>• Conduct thorough discovery processes, including reviewing documents and preparing responses.</p><p>• Take depositions to gather essential case information and build effective legal strategies.</p><p>• Represent clients in arbitrations, trials, and other legal proceedings.</p><p>• Provide expert advice on insurance defense matters, ensuring compliance with relevant laws and regulations.</p><p>• Collaborate with senior attorneys and legal teams to develop case strategies and solutions.</p><p>• Maintain clear and consistent communication with clients regarding case progress and legal options.</p><p>• Stay updated on legal trends and changes in liability and insurance defense laws.</p><p>• Contribute to the firm's growth by mentoring less experienced team members and sharing expertise.</p>
<p>A personal injury law firm is looking for a dedicated Case Manager to join their team for an estimate of 1 month on a contract basis in West Los Angeles. This role involves managing case-related tasks with a focus on ordering medical records and providing administrative support.</p><p><br></p><p><strong>Responsibilities</strong>:</p><p>• Coordinate and manage the process of ordering medical records for legal cases.</p><p>• Provide comprehensive administrative support to ensure the efficient handling of case-related matters.</p><p>• Organize and maintain accurate records, including electronic filing of legal documents.</p><p>• Assist in abstracting medical records and compiling relevant data for case analysis.</p><p>• Collaborate with legal professionals to ensure cases are prepared and managed effectively.</p>
We are looking for a skilled Case Manager to join our team in Encino, California. In this role, you will oversee multiple pre-litigation cases, ensuring prompt and effective resolution while providing exceptional support to clients. This is an onsite position that offers a dynamic work environment and opportunities for growth.<br><br>Responsibilities:<br>• Manage multiple pre-litigation cases, ensuring timely and effective resolution.<br>• Supervise and guide entry-level case managers in their daily tasks and responsibilities.<br>• Facilitate claims processing with insurance carriers, including health insurance, Medicare, and Medi-Cal.<br>• Coordinate property damage and loss of use claims, ensuring proper resolution.<br>• Identify healthcare providers and schedule medical appointments for injury treatment.<br>• Advocate for clients by monitoring their medical treatment and arranging necessary care based on provider recommendations.<br>• Review, analyze, and interpret medical records, surgical reports, and medical bills.<br>• Prepare case files and documentation for submission to the demands department.<br>• Communicate effectively with clients, healthcare providers, and internal staff to maintain a high level of service.
We are looking for an experienced Insurance Defense Associate to join our dynamic legal team in Philadelphia, Pennsylvania. This role is ideal for a dedicated individual who is eager to work in a collaborative yet fast-paced environment, managing complex litigation cases and providing exceptional legal support. If you have a passion for insurance defense and a commitment to delivering high-quality legal services, we encourage you to apply.<br><br>Responsibilities:<br>• Analyze new case files to formulate strategic action plans and provide recommendations.<br>• Draft and review pleadings, motions, and other legal documents, ensuring accuracy and adherence to procedural requirements.<br>• Oversee discovery processes, including preparing responses and managing document production.<br>• Represent clients in depositions, hearings, and other litigation events, delivering comprehensive updates and reports.<br>• Negotiate settlements effectively and obtain necessary approvals while preparing cases for trial when required.<br>• Collaborate closely with paralegals and legal assistants to ensure seamless case management.<br>• Conduct legal research to support case strategies and arguments.<br>• Maintain consistent communication with clients to provide updates and address inquiries.<br>• Monitor case progress and deadlines to ensure timely execution of all legal tasks.
We are looking for a dedicated and organized Paralegal to join our team in Sacramento, California. In this role, you will manage legal cases, ensuring smooth communication and coordination between clients, neutrals, and internal teams. Your expertise will contribute to the efficient handling of mediation, arbitration, and private judging cases from initiation to resolution.<br><br>Responsibilities:<br>• Oversee case files for mediation, arbitration, and private judging, ensuring timely progress and resolution.<br>• Coordinate schedules and communication with neutrals to facilitate smooth legal proceedings.<br>• Apply legal terminology and processes effectively to maintain accuracy and compliance.<br>• Handle billing, retainer assessments, and client communications with attention to detail.<br>• Identify and resolve issues as they arise, collaborating with team leaders and consultants.<br>• Uphold internal service standards and best practices in all case management activities.<br>• Participate in team training sessions, check-ins, and meetings to stay informed and aligned with organizational goals.
