Role Description The Claims Examiner is responsible for liability claims and property damage claims to their conclusion in the most cost-effective way possible for the client. In addition, the Claims Examiner will be responsible for recognizing claims involving coverage issues and present them to the Claims and Coverage Committees for referral to counsel. - Review assigned claims within the PLCA guidelines. - Prepare appropriate response letter to Government Claims within the required timelines. - Assignment of Investigations. - Review investigative reports, evaluate damages and make recommendations to clients regarding assigned files. - Direct attorneys on litigated files and control defense costs. - Prepare timely Reports to Reinsurers. - Prepare appropriate write ups for JPA’s/ Superpools on a quarterly basis. - Monitor/adjust reserves when developments occur. - Review files for Subrogation potential and actively pursue subrogation. - Manage and respond to client inquiries. - Maintain accurate statistical data in computer. - Assist in client file reviews. - Attend Court ordered Mediations/MSC’s or any meeting required to facilitate settlement. - Bill at minimum 80% of the work day. - Other duties as assigned. Qualifications - Required: High school diploma and 5 years related claims experience required. - Appropriately licensed and/or certified in all states in which claims are being handled or able to obtain the licenses/certification per local requirements. - Extensive knowledge of accepted industry standards and practices. - Computer experience with related claims and business software. - Preferred: Bachelor's degree preferred. Requirements - Ability to think critically, solve problems, plan and organize activities, serve clients, negotiate, effectively communicate verbally and in writing and embrace new challenges. - Analytical skill necessary to make decisions and resolve complex issues inherent in handling losses. - Ability to successfully negotiate the settlement and disposition of serious claims including the ability to interpret related documentation. Benefits - Medical/dental/vision plans, which start from day one! - Life and accident insurance. - 401(K) and Roth options. - Tax-advantaged accounts (HSA, FSA). - Educational expense reimbursement. - Paid parental leave. - Digital mental health services (Talkspace). - Flexible work hours (availability varies by office and job function). - Training programs. - Gallagher Thrive program – elevating your health through challenges, workshops and digital fitness programs for your overall wellbeing. - Charitable matching gift program. - And more...

Role Description MedPOINT Management in Sherman Oaks, CA is looking for a detail-oriented Hospital Claims Adjuster to join our dynamic healthcare team. In this role, you'll play a critical part in reviewing and processing hospital claims with accuracy and efficiency. If you're passionate about healthcare operations and thrive in a fast-paced environment, we want to hear from you! Responsibilities: - Review, analyze, and adjudicate inpatient and outpatient hospital claims in accordance with plan guidelines - Verify patient eligibility, benefits, and coverage prior to claims processing - Identify and resolve claim discrepancies, denials, and underpayments - Apply ICD-10, CPT, and DRG coding knowledge to ensure accurate claim adjudication - Coordinate with providers, hospitals, and internal departments to resolve claim issues - Ensure compliance with state and federal healthcare regulations, including HIPAA - Maintain accurate documentation and meet productivity and quality benchmarks Qualifications - 2+ years of experience in hospital or medical claims adjudication - Proficiency in ICD-10, CPT, HCPCS, and DRG coding - Familiarity with managed care, HMO, PPO, and IPA claims processing - Strong knowledge of EOB preparation and explanation of benefits - Experience with claims management software and healthcare information systems - Excellent analytical, problem-solving, and organizational skills - Strong attention to detail with the ability to meet deadlines in a high-volume environment Requirements - 2+ years of experience in hospital or medical claims adjudication - Proficiency in ICD-10, CPT, HCPCS, and DRG coding - Familiarity with managed care, HMO, PPO, and IPA claims processing - Strong knowledge of EOB preparation and explanation of benefits - Experience with claims management software and healthcare information systems - Excellent analytical, problem-solving, and organizational skills - Strong attention to detail with the ability to meet deadlines in a high-volume environment Benefits - 401(k) - 401(k) matching - Bonus based on performance - Dental insurance - Employee discounts - Free food & snacks - Health insurance - Opportunity for advancement - Paid time off - Parental leave - Savings bank - Training & development - Vision insurance - Wellness resources

• Point of contact for technical warranty cases – handling customer contact by phone and in writing • Evaluate the plausibility of damage reports • Processing and monitoring of automated data imports • Managing external partners • Ensuring transparent cost control • Communication and information exchange with all stakeholders

Role Description At Gallagher Bassett, we're there when it matters most because helping people through challenging moments is more than just our job, it’s our purpose. Every day, we help clients navigate complexity, support recovery, and deliver outcomes that make a real difference in people’s lives. It takes empathy, precision, and a strong sense of partnership—and that’s exactly what you’ll find here. We’re a team of fast-paced fixers, empathetic experts, and outcomes drivers — people who care deeply about doing the right thing and doing it well. Whether you're managing claims, supporting clients, or improving processes, you’ll play a vital role in helping businesses and individuals move forward with confidence. Here, you’ll be supported by a culture that values teamwork, encourages curiosity, and celebrates the impact of your work. Because when you’re here, you’re part of something bigger. You’re part of a team that shows up, stands together, and leads with purpose. How you'll make an impact: - Apply claims management experience to execute decision-making to analyze claims exposure, plan the proper course of action, and appropriately resolve claims. - Interact extensively with various parties involved in the claim process to ensure effective communication and resolution. - Provide exceptional customer service to our claimants on behalf of our clients exhibiting empathy through each step of the claims process. - Handle claims consistent with clients' and corporate policies, procedures, and standard methodologies in accordance with statutory, regulatory, and ethics requirements. - Document and communicate claim activity timely and efficiently, supporting the outcome of the claim file. Qualifications - Claims Background: Commercial General Liability Bodily Injury and Litigation Management - Jurisdictional Experience: Any - Active Adjusters' licenses: TX, FL, NY preferred Requirements - High School Diploma. - Minimum of 5 years related claims experience. - Appropriately licensed and/or certified in all states in which claims are being handled. - Knowledge of accepted industry standards and practices. - Computer experience with related claims and business software. Benefits - Medical/dental/vision plans, which start from day one! - Life and accident insurance - 401(K) and Roth options - Tax-advantaged accounts (HSA, FSA) - Educational expense reimbursement - Paid parental leave - Digital mental health services (Talkspace) - Flexible work hours (availability varies by office and job function) - Training programs - Gallagher Thrive program – elevating your health through challenges, workshops and digital fitness programs for your overall wellbeing - Charitable matching gift program - And more...