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Claim Processor Jobs in Fresno, CA (NOW HIRING)

Adecco

Stop Loss Claim Specialist

Fresno, CA · On-site

$19 - $21/hr

Review and process stop loss claims for accuracy, completeness, and eligibility. * Analyze medical documentation and claims information to ensure proper claim determination. * Verify policy coverage ...

Adecco

Stop Loss Claim Specialist

Fresno, CA

$19 - $21/hr

Review and process stop loss claims for accuracy, completeness, and eligibility. * Analyze medical documentation and claims information to ensure proper claim determination. * Verify policy coverage ...

My Solar Claim

Be Seen First

Remote Sales Closer Warm Leads Provided Uncapped Commission

Fresno, CA · Remote

$1.0K - $10K/wk

About My Solar Claim Hundreds of thousands of homeowners were sold solar systems that never ... People who follow a process, take coaching, and hit numbers. Solar experience is not required.

Jobs for Humanity

Legal Processors

Madera, CA

... to claim jobs, map your stops, and track your pay. Who is ABC Legal? We are a premier legal ... What's the Key to Process Server Success? - Be organized - Plan your route - Go when people are ...

Deloitte

RCM Training and Quality Analyst

Fresno, CA · On-site +1

Lead onboarding training for new staff on account and claim processing procedures, systems, and SOPs. * Design and deliver ongoing refresher training for tenured staff to reinforce standards ...

Deloitte

Epic Denials Manager

Fresno, CA · Remote

Works closely with Manager of Billing and engagement leadership to resolve barriers to account and claim processing and identify and implement opportunity areas to remediate issues and improve ...

Deloitte

Epic Denials Management Operator

Fresno, CA · Remote

$17.75 - $23.75/hr

Experience analyzing billing workflows, claim issues, or operational data The wage range for this ... 277 processing) received from third party payers. Conduct Denial categorization and root cause ...

Kings View Corporation

Billing Manager (602)

Fresno, CA · On-site

$40.87 - $43.36/hr

... process improvements. * Prepare and maintain accurate and timely reports analyzing billing team performance, clean claim rates, denial trends, accounts receivable aging and write-offs, and other key ...

Grundfos

Service Technician

Fresno, CA · On-site

$26.77 - $38.96/hr

Knowledge of warranty claim processes and quality improvement reporting * Familiarity with health & safety regulations and risk assessment procedures in a workshop or field service setting The salary ...

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Claim Processor information

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How much do claim processor jobs pay per hour?

As of Sep 12, 2026, the average hourly pay for claim processor in Fresno, CA is $18.76, according to ZipRecruiter salary data. Most workers in this role earn between $16.01 and $20.24 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 cities near Fresno, CA are hiring for Claim Processor jobs?

Cities near Fresno, CA with the most Claim Processor job openings:

Claim Processor jobs near you
Infographic showing various Claim Processor job openings in Fresno, CA as of August 2026, with employment types broken down into 75% Full Time, 23% Part Time, and 2% Contract. Highlights an 81% Physical, 6% Hybrid, and 13% Remote job distribution, with an average salary of $39,581 per year, or $19 per hour.

Stop Loss Claim Specialist

Fresno, CA • On-site

Adecco
Recruiting and Staffing Services • 10K+ employees
Learn more about Adeccoexternal

$19 - $21/hr

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Posted 7 days ago

Job description

Stop Loss Claim Specialist

Pay: $19.00 - $21.00 per hour

About the Opportunity

Adecco is seeking a detail-oriented and analytical Stop Loss Claims Specialist to support a growing insurance administration team in Fresno, CA. The ideal candidate will have experience reviewing and processing health insurance claims, interpreting policy provisions, and working with medical coding and claims documentation.

This is an excellent opportunity for someone looking to grow their career in the healthcare insurance industry while working with a collaborative and professional team.

Key Responsibilities

  • Review and process stop loss claims for accuracy, completeness, and eligibility.

  • Analyze medical documentation and claims information to ensure proper claim determination.

  • Verify policy coverage, benefits, and claim requirements.

  • Research and resolve claim discrepancies while maintaining compliance standards.

  • Enter and maintain accurate claim records within internal systems.

  • Communicate effectively with internal departments, carriers, and other stakeholders regarding claim status and requirements.

  • Assist with claim audits, reporting, and ongoing process improvements.

Required Qualifications

  • Previous experience in health insurance, medical claims, benefits administration, or claims processing.

  • Knowledge of medical terminology and medical documentation.

  • Experience with Stop Loss claims preferred.

  • Understanding of CPT, HCPCS, and ICD-10/ICD-9 coding.

  • Strong attention to detail and organizational skills.

  • Proficiency with Microsoft Office and claims management systems.

  • Ability to manage multiple priorities in a fast-paced environment.

Preferred Qualifications

  • Experience reviewing medical records and claim adjudication.

  • Background in insurance verification or healthcare administration.

  • Knowledge of commercial health insurance plans and regulatory requirements.

  • Customer service experience within a healthcare or insurance environment.

Skills for Success

  • Analytical and problem-solving abilities

  • Strong written and verbal communication

  • Time management and prioritization

  • Accuracy and attention to detail

  • Ability to maintain confidentiality when handling protected information

  • Collaborative team mindset


Pay Details: $19.00 to $21.00 per hour
Benefit offerings available for our associates include medical, dental, vision, life insurance, short-term disability, additional voluntary benefits, EAP program, commuter benefits and a 401K plan. Our benefit offerings provide employees the flexibility to choose the type of coverage that meets their individual needs. In addition, our associates may be eligible for paid leave including Paid Sick Leave or any other paid leave required by Federal, State, or local law, as well as Holiday pay where applicable.
Equal Opportunity Employer/Veterans/Disabled
Military connected talent encouraged to apply
To read our Candidate Privacy Information Statement, which explains how we will use your information, please navigate to https://www.adecco.com/en-us/candidate-privacy
The Company will consider qualified applicants with arrest and conviction records in accordance with federal, state, and local laws and/or security clearance requirements, including, as applicable:
  • The California Fair Chance Act
  • Los Angeles City Fair Chance Ordinance
  • Los Angeles County Fair Chance Ordinance for Employers
  • San Francisco Fair Chance Ordinance

Massachusetts Candidates Only: It is unlawful in Massachusetts to require or administer a lie detector test as a condition of employment or continued employment. An employer who violates this law shall be subject to criminal penalties and civil liability.