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Claim Operator Jobs in California (NOW HIRING)

Tristar

Clerical Assistant (Hybrid)

Rancho Cordova, CA · On-site

$20 - $22/hr

Documents all work product and claim activity in the electronic claim file. * Prepares and prints ... EQUIPMENT OPERATED/USED: Computer, telephone, 10-key, fax machine, printers and other basic office ...

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CYNET SYSTEMS

Office Assistant

Orange, CA · On-site

$13 - $18/hr

Sets up, maintains and locates claim files. * Processes packets. * Conducts computer data entry and ... recruitment engine operating across North America and Asia--ensuring speed, quality, and ...

MMC Group

Reimbursement Counselor

San Bruno, CA · On-site

$19.50/hr

Researches and resolves any claim denials or underpayment of claims * Effectively utilizes various ... Exercises judgment within defined standard operating procedures to determine appropriate action

Aldridge Pite LLP

Bankruptcy Processor

San Diego, CA · On-site

Purpose The Proof of Claim Processor is responsible for the accurate preparation, processing, and ... Maintains compliance with all client guidelines, Standard Operating Procedures (SOPs), operational ...

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All JobsClaim Operator JobsClaim Operator Jobs in California

Claim Operator information

What are some common challenges a claim operator faces in managing insurance claims, and how can they be addressed?

Claim Operators often encounter challenges such as handling a high volume of claims, ensuring accuracy in documentation, and meeting strict deadlines. These challenges can be managed by developing strong organizational skills, utilizing claims management software efficiently, and maintaining clear communication with both clients and team members. Staying updated on regulatory changes and company policies also helps prevent errors and ensures compliance throughout the claims process.

What is the difference between Claim Operator vs Claims Adjuster?

AspectClaim OperatorClaims Adjuster
Required CredentialsHigh school diploma or equivalent; some roles may require insurance licensesHigh school diploma; licensing or certification often required
Work EnvironmentInsurance companies, claims processing centersFieldwork and office settings, inspecting damages
Employer & Industry UsageInsurance companies, third-party administratorsInsurance companies, independent adjusting firms
Common Search & ComparisonClaim OperatorClaims Adjuster

Claim Operators primarily handle the administrative processing of claims within insurance companies, focusing on data entry and documentation. Claims Adjusters, on the other hand, evaluate damages, inspect claims, and determine settlement amounts. While both roles require insurance knowledge and sometimes licensing, Claim Operators focus on processing, whereas Claims Adjusters are more involved in assessment and decision-making.

What are the key skills and qualifications needed to thrive as a claim operator, and why are they important?

To thrive as a Claim Operator, you need strong analytical skills, attention to detail, and a foundational understanding of insurance processes, often supported by a high school diploma or equivalent. Familiarity with claims management software, Microsoft Office Suite, and sometimes industry certifications like AIC (Associate in Claims) are typically required. Excellent communication, organization, and problem-solving abilities help in interacting with clients and resolving claims efficiently. These skills are crucial for accurately processing claims, ensuring customer satisfaction, and maintaining compliance with regulatory standards.

What does a claim operator do?

A Claim Operator is responsible for processing and managing insurance claims. They review claim submissions, verify documentation for accuracy, and determine the validity of claims according to company policies. Claim Operators may also communicate with clients, adjusters, and other stakeholders to gather additional information or resolve issues. Their role helps ensure that claims are handled efficiently and fairly, contributing to customer satisfaction and the integrity of the insurance process.

What are popular job titles related to Claim Operator jobs in California?

For Claim Operator jobs in California, the most frequently searched job titles are:

What job categories do people searching Claim Operator jobs in California look for?

The top searched job categories for Claim Operator jobs in California are:

What cities in California are hiring for Claim Operator jobs?

Cities in California with the most Claim Operator job openings:

Claim Operator jobs near you

Claims Manager, Medicare Advantage Plan (Flexible-Hybrid)

UCLA Outpatient Clinics

Los Angeles, CA • On-site

$95.40 - $208.30/hr

Other

Posted 9 days ago

Job description

Description

Play a vital role on our Claims leadership team, you will manage a team of claim examiners, auditors, and support staff toward operational excellence. The Claims Manager of the Medicare Advantage Plan will:

  • Implement and maintain efficient and streamlined claims adjudication processes that effectively utilize technology to automate business processes and maximize the accuracy of claims payments.
  • Foster a positive, high-performing team culture focused on quality and exceptional customer service
  • Identify opportunities to enhance workflows, resolve complex claim issues, and develop practical standard operating procedures
  • Empower the team to navigate challenging scenarios with confidence and consistency

Salary Range: $95,400 - $208,300/annually

Note: This position is flexible-hybrid.

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