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Claim Processor Jobs in California (NOW HIRING)

CCMSI

Workers' Compensation Claim Specialist

Irvine, CA · On-site

$85K - $95K/yr

We don't just process claims-we support people. As the largest privately owned Third Party Administrator (TPA), CCMSI delivers customized claim solutions that help our clients protect their employees ...

CCMSI

Workers' Compensation Claim Supervisor

Irvine, CA · On-site

$98K - $108K/yr

We don't just process claims-we support people. As the largest privately owned Third Party Administrator (TPA), CCMSI delivers customized claim solutions that help our clients protect their employees ...

CCMSI

Workers' Compensation Claim Supervisor

Irvine, CA · On-site

$98K - $108K/yr

We don't just process claims-we support people. As the largest privately owned Third Party Administrator (TPA), CCMSI delivers customized claim solutions that help our clients protect their employees ...

CCMSI

Workers' Compensation Claim Consultant

Irvine, CA · Remote

$80K - $95K/yr

We don't just process claims--we support people. As the largest privately owned Third Party Administrator (TPA), CCMSI delivers customized claim solutions that help our clients protect their ...

CCMSI

Workers' Compensation Claim Consultant

Irvine, CA · On-site

$80K - $95K/yr

We don't just process claims-we support people. As the largest privately owned Third Party Administrator (TPA), CCMSI delivers customized claim solutions that help our clients protect their employees ...

CCMSI

Workers' Compensation Claim Consultant

Irvine, CA · Remote

$80K - $95K/yr

We don't just process claims-we support people. As the largest privately owned Third Party Administrator (TPA), CCMSI delivers customized claim solutions that help our clients protect their employees ...

CCMSI

Workers' Compensation Claim Specialist

Irvine, CA · On-site +1

$85K - $95K/yr

We don't just process claims-we support people. As the largest privately owned Third Party Administrator (TPA), CCMSI delivers customized claim solutions that help our clients protect their employees ...

US Bank

Operations Processor

La Mirada, CA · On-site

$20 - $25.77/hr

Duties may include functions related to payment transactions or claim processing, data entry, archiving, researching, troubleshooting and vendor/client interaction. May have direct contact with 3rd ...

Chubb

Claim Technical Assistant

Los Angeles, CA · On-site

$73K/yr

Knowledge of bill processing is a plus but not required. * Knowledge of claim handling is a plus but not required. * If you do not already have one, you will be required to obtain an applicable ...

Chubb

Claim Technical Assistant

Los Angeles, CA · On-site

$73K/yr

Knowledge of bill processing is a plus but not required. * Knowledge of claim handling is a plus but not required. * If you do not already have one, you will be required to obtain an applicable ...

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Claim Processor information

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How much do claim processor jobs pay per hour?

As of Sep 9, 2026, the average hourly pay for claim processor in California is $18.91, according to ZipRecruiter salary data. Most workers in this role earn between $16.15 and $20.38 per hour, depending on experience, location, and employer.

What is a claim processor?

A Claim Processor is a professional who reviews and handles insurance claims submitted by policyholders or healthcare providers. Their main responsibilities include verifying the accuracy of claim information, ensuring all required documentation is provided, and determining whether a claim is valid under the policy terms. Claim Processors work with various types of insurance, such as health, auto, or property, and play a crucial role in ensuring timely and accurate payments. They may also communicate with customers, providers, and adjusters to resolve any discrepancies or additional information requests.

What are some typical challenges a claim processor might face in their daily work?

Claim Processors often handle high volumes of paperwork and data entry, which can be challenging when ensuring accuracy and meeting tight deadlines. They may also need to interpret complex policy details or resolve discrepancies in submitted claims, requiring strong attention to detail and problem-solving skills. Additionally, Claim Processors frequently interact with policyholders, healthcare providers, or other internal teams, so effective communication and the ability to manage stressful situations professionally are important for success.

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

To thrive as a Claim Processor, you need strong attention to detail, analytical skills, and a basic understanding of insurance policies, usually supported by a high school diploma or equivalent. Familiarity with claims management software, data entry systems, and sometimes certification such as AIC (Associate in Claims) is common. Excellent organizational skills, clear communication, and the ability to handle sensitive information with discretion help individuals excel in this role. These skills ensure accurate and timely processing of claims, minimize errors, and maintain customer satisfaction and regulatory compliance.

What is the difference between Claim Processor vs Claims Examiner?

AspectClaim ProcessorClaims Examiner
Required CredentialsHigh school diploma or equivalent; some roles may require insurance certificationsHigh school diploma; insurance certifications preferred
Work EnvironmentOffice settings, insurance companies, healthcare providersOffice settings, insurance companies, healthcare providers
Employer & Industry UsageInsurance companies, healthcare providers, third-party administratorsInsurance companies, third-party administrators, government agencies
Job FocusProcessing insurance claims, data entry, verifying informationReviewing claims for accuracy, compliance, and coverage decisions

While both Claim Processors and Claims Examiners work within the insurance industry handling claims, Claim Processors primarily focus on data entry and initial processing of claims. Claims Examiners review claims for accuracy and compliance, making decisions on claim approval or denial. The roles often overlap, but Claims Examiners typically require more experience or certifications and perform more in-depth analysis.

Is claim processing hard?

Claim processing is a detail-oriented job that requires strong organizational skills, attention to accuracy, and familiarity with insurance policies and claims systems. While it can involve repetitive tasks, many claim processors find it manageable with proper training and experience. The difficulty level varies depending on the complexity of claims and the work environment.

What do you need to be a claim processor?

To be a claim processor, you typically need a high school diploma or equivalent, strong attention to detail, and good organizational skills. Familiarity with claims processing software and basic knowledge of insurance policies are also important. Some positions may require prior experience in customer service or administrative roles.

What is a claims processing job?

A claims processing job involves reviewing, verifying, and managing insurance claims to determine their validity and appropriate payout. Claim processors use specialized software and follow company policies to ensure accurate and timely processing of claims, often requiring attention to detail and knowledge of insurance policies.

What are the most commonly searched types of Claim Processor jobs in California?

The most popular types of Claim Processor jobs in California are:

What cities in California are hiring for Claim Processor jobs?

Cities in California with the most Claim Processor job openings:

Claim Processor jobs near you
Infographic showing various Claim Processor job openings in California as of August 2026, with employment types broken down into 75% Full Time, 21% Part Time, and 4% Contract. Highlights an 81% Physical, 6% Hybrid, and 13% Remote job distribution, with an average salary of $39,341 per year, or $18.9 per hour.

Workers' Compensation Claim Specialist

Irvine, CA • On-site

CCMSI
Insurance Services • 1 - 5K employees
Learn more about CCMSIexternal

$85K - $95K/yr

Other

Medical, Dental, Vision, Life, Retirement, PTO

Re-posted 5 days ago

CCMSI rating

7.9

Company rating: 7.9 out of 10

Based on 16 frontline employees who took The Breakroom Quiz

Job description

Overview
Workers' Compensation Claim Specialist
Location: Irvine, CA (reporting remotely)
Schedule: Mon - Fri 8:00am - 4:30 pm (PST)
Salary Range: $85,000 - $95,000 (depending on experience)
Build Your Career With Purpose at CCMSI
At CCMSI, we partner with global clients to solve their most complex risk management challenges, delivering measurable results through advanced technology, collaborative problem-solving, and an unwavering commitment to their success.
We don't just process claims-we support people. As the largest privately owned Third Party Administrator (TPA), CCMSI delivers customized claim solutions that help our clients protect their employees, assets, and reputations. We are a certified Great Place to Work®, and our employee-owners are empowered to grow, collaborate, and make meaningful contributions every day.
Job Summary
We are seeking a driven and compassionate Workers' Compensation Claim Specialist to join our team and make a meaningful impact in the lives of injured workers. In this role, you will take ownership of a dedicated portfolio of claims within a single PEO client account, allowing you to develop strong client relationships, gain in-depth knowledge of the account's program, and deliver consistent, personalized claim management.
You will lead investigations, determine compensability, and guide each claim toward a fair and timely resolution while serving as a trusted partner to your client and injured workers.
This position offers the opportunity to grow your technical expertise and can serve as an advanced development path for future supervisory or management roles. As a Claim Specialist, you play a vital role in delivering the high-quality service our clients count on and upholding CCMSI's commitment to excellence.
Responsibilities
When we hire Workers' Compensation Adjusters at CCMSI, we look for detail-driven problem-solvers who balance empathy with sound judgment, navigate complex regulations with confidence, and deliver fair, timely outcomes that support injured workers and strengthen client trust.
  • Investigate, evaluate and adjust claims in accordance with established claim handling standards and laws.
  • Establish reserves and/or provide reserve recommendations within established reserve authority levels.
  • Review, approve or provide oversight of medical, legal, damage estimates and miscellaneous invoices to determine if reasonable and related to designated claims. Negotiate any disputed bills or invoices for resolution.
  • Authorize and make payments of claims in accordance with claim procedures utilizing a claim payment program in accordance with industry standards and within established payment authority.
  • Negotiate settlements in accordance within Corporate Claim Standards, client specific handling instructions and state laws, when appropriate.
  • Assist in the selection, referral and supervision of designated claim files sent to outside vendors. (i.e. legal, surveillance, case management, etc.)
  • Review and maintain personal diary on claim system.
  • Assess and monitor subrogation claims for resolution.
  • Compute disability rates in accordance with state laws.
  • Effective and timely coordination of communication with clients, claimants and other appropriate parties throughout the claim adjustment process.
  • Provide notices of qualifying claims to excess/reinsurance carriers.
  • Compliance with Corporate Claim Handling Standards and special client handling instructions as established.

Qualifications
Required:
  • 5+ years of Workers' Compensation claims handling experience, including full claim investigation, evaluation, and resolution.
  • Responsiveness to internal and external client needs.
  • Strong analytical and negotiation abilities.
  • Knowledge of all lower-level claim position responsibilities.
  • Adjuster's license may be required based on jurisdiction.

Nice to Have:
  • Bilingual (Spanish) proficiency - highly valued for communicating with claimants, employers, or vendors, but not required.
  • Bachelor's degree is preferred but not required
  • Professional designations such as AIC, ARM, or CPCU are preferred but not required

Why You'll Love Working Here
  • 4 weeks (Paid time off that accrues throughout the year in accordance with company policy) + 10 paid holidays in your first year
  • Comprehensive benefits: Medical, Dental, Vision, Life, and Disability Insurance
  • Retirement plans: 401(k) and Employee Stock Ownership Plan (ESOP)
  • Career growth: Internal training and advancement opportunities
  • Culture: A supportive, team-based work environment

How We Measure Success
At CCMSI, great adjusters stand out through ownership, accuracy, and impact. We measure success by:
  • Quality claim handling - thorough investigations, strong documentation, well-supported decisions
  • Compliance & audit performance - adherence to jurisdictional and client standards
  • Timeliness & accuracy - purposeful file movement and dependable execution
  • Client partnership - proactive communication and strong follow-through
  • Professional judgment - owning outcomes and solving problems with integrity
  • Cultural alignment - believing every claim represents a real person and acting accordingly

This is where we shine, and we hire adjusters who want to shine with us.
Compensation & Compliance
The posted salary reflects CCMSI's good-faith estimate in accordance with applicable pay transparency laws. Actual compensation will be based on qualifications, experience, geographic location, and internal equity. This role may also qualify for bonuses or additional forms of pay.
CCMSI offers comprehensive benefits including medical, dental, vision, life, and disability insurance. Paid time off accrues throughout the year in accordance with company policy, with paid holidays and eligibility for retirement programs in accordance with plan documents.
Visa Sponsorship: CCMSI does not provide visa sponsorship for this position.
ADA Accommodations: CCMSI is committed to providing reasonable accommodations throughout the application and hiring process.
Equal Opportunity Employer: CCMSI complies with all applicable employment laws, including pay transparency and fair chance hiring regulations.
Background checks, if required for the role, are conducted only after a conditional offer and in accordance with applicable fair chance hiring laws.
Our Core Values
At CCMSI, we believe in doing what's right-for our clients, our coworkers, and ourselves. We look for team members who:
  • Lead with transparency We build trust by being open and listening intently in every interaction.
  • Perform with integrity We choose the right path, even when it is hard.
  • Chase excellence We set the bar high and measure our success. What gets measured gets done.
  • Own the outcome Every employee is an owner, treating every claim, every decision, and every result as our own.
  • Win together Our greatest victories come when our clients succeed.

We don't just work together-we grow together. If that sounds like your kind of workplace, we'd love to meet you.
#EmployeeOwned #GreatPlaceToWorkCertified #CCMSICareers #ESOP #CaliforniaJobs #Career #IND123 #LI-Remote

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