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Claims Examiner Jobs in Riverside, CA (NOW HIRING)

Senior Claims Examiner

Anaheim, CA · On-site

$69K - $89K/yr

Claims Adjuster, Public Entity DEPARTMENT: Claims Services REPORTS TO: Claims Manager / Director of Claims FLSA STATUS: Exempt COMPANY OVERVIEW Venbrook Claims Services is the claims business group ...

Senior Claims Examiner

Anaheim, CA · On-site

$69K - $89K/yr

Claims Adjuster, Public Entity DEPARTMENT: Claims Services REPORTS TO: Claims Manager / Director of Claims FLSA STATUS: Exempt COMPANY OVERVIEW Venbrook Claims Services is the claims business group ...

Sr Claim Examiner-WC (CA)

Brea, CA · On-site

$25.65 - $46.91/hr

Senior Claims Examiner - Workers Compensation (California) This is an exciting opportunity to join a global leader in claims management and make a meaningful impact through your expertise. ✅ Why ...

Sr Claim Examiner-WC (CA)

Brea, CA · On-site

$25.65 - $46.91/hr

Senior Claims Examiner - Workers Compensation (California) This is an exciting opportunity to join a global leader in claims management and make a meaningful impact through your expertise. ✅ Why ...

Sr Claim Examiner-WC (CA)

Brea, CA · On-site

$25.65 - $46.91/hr

Senior Claims Examiner - Workers Compensation (California) This is an exciting opportunity to join a global leader in claims management and make a meaningful impact through your expertise. ✅ Why ...

Senior Claims Examiner Commercial GL

Anaheim, CA · On-site

$34.25 - $46.50/hr

Claims Adjuster, Public Entity DEPARTMENT: Claims Services EFFECTIVE DATE: COMPANY OVERVIEW: Carl Warren & Company is a leading nationwide Third-Party Administrator (TPA) founded in 1944. Carl Warren ...

Senior Claims Examiner Commercial GL

Anaheim, CA · On-site

$34.25 - $46.50/hr

Claims Adjuster, Public Entity DEPARTMENT: Claims Services EFFECTIVE DATE: COMPANY OVERVIEW: Carl Warren & Company is a leading nationwide Third-Party Administrator (TPA) founded in 1944. Carl Warren ...

Showing results 21-40

Claims Examiner information

See Riverside, CA salary details

$16

$30

$47

How much do claims examiner jobs pay per hour?

As of Sep 5, 2026, the average hourly pay for claims examiner in Riverside, CA is $30.67, according to ZipRecruiter salary data. Most workers in this role earn between $23.32 and $36.63 per hour, depending on experience, location, and employer.

What is a claims examiner?

A claims examiner evaluates claim files that have been submitted by an insurance adjuster. They decide whether to authorize or deny payments and refer suspicious or complicated claims to insurance investigators. This job is a risk management position. In health insurance, examiners may have to decide if medical procedures are worth the patient’s prognosis, if someone's cause of death warrants incidental fees, or if witness interviews waive the insurance company’s liability.

What does a claims examiner do?

A Claims Examiner is responsible for reviewing insurance claims to determine their validity and whether they should be approved or denied. They carefully examine claim forms, supporting documents, and sometimes conduct interviews to gather additional information. Claims Examiners ensure that claims comply with policy terms and legal requirements, and may calculate the amount to be paid out. Their work helps prevent fraudulent claims and ensures fair processing for all parties involved.

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

To thrive as a Claims Examiner, you need strong analytical skills, attention to detail, and a background in insurance, finance, or a related field, often supported by relevant certifications or a degree. Familiarity with claims management software, regulatory compliance systems, and industry-specific databases is typically required. Excellent communication, problem-solving abilities, and good judgment help you stand out in this position. These skills and qualities are crucial for ensuring accurate claim evaluations, minimizing risk, and maintaining customer trust.

What are some common challenges faced by claims examiners, and how can they be managed effectively?

Claims Examiners often encounter challenges such as reviewing complex or incomplete documentation, managing a high volume of claims, and balancing the need for accuracy with efficiency. Effective organization, strong attention to detail, and clear communication with claimants and other team members are essential for overcoming these obstacles. Additionally, staying current with industry regulations and using claims management software can help streamline the process and reduce errors.

What is the difference between Claims Examiner vs Claims Processor?

AspectClaims ExaminerClaims Processor
Required credentialsHigh school diploma or equivalent; often some insurance or claims experienceHigh school diploma or equivalent; may have basic insurance knowledge
Work environmentOffice setting, reviewing claims, making determinationsOffice setting, processing claims data, data entry
Employer and industry usageInsurance companies, government agenciesInsurance companies, third-party administrators
Common search intentUnderstanding roles, career differences, job requirementsEntry-level position, processing claims, job duties

Claims Examiners review insurance claims to determine coverage and approve or deny payments, requiring analytical skills and some insurance knowledge. Claims Processors handle the data entry and processing of claims, focusing on accuracy and efficiency. While both roles work in insurance settings and may require similar credentials, Claims Examiners have more decision-making responsibilities, whereas Claims Processors focus on data handling.

How much do claims examiners make in the US?

Claims examiners in the US typically earn a median annual salary of around $45,000 to $65,000, depending on experience, location, and employer. Entry-level positions may start lower, while experienced examiners or those with specialized skills can earn higher wages, often supplemented with benefits and opportunities for advancement.

Is being a claims examiner hard?

Claims examiners review insurance claims to determine coverage and payment, which can involve detailed analysis and attention to accuracy. The job often requires strong organizational skills, knowledge of policies, and sometimes certification, but the difficulty varies based on experience and the complexity of claims handled.

What are the most commonly searched types of Claims Examiner jobs in Riverside, CA?

The most popular types of Claims Examiner jobs in Riverside, CA are:

What cities near Riverside, CA are hiring for Claims Examiner jobs?

Cities near Riverside, CA with the most Claims Examiner job openings:

Infographic showing various Claims Examiner job openings in Riverside, CA as of August 2026, with employment types broken down into 84% Full Time, 14% Part Time, and 2% Contract. Highlights an 84% Physical, 4% Hybrid, and 12% Remote job distribution, with an average salary of $63,802 per year, or $30.7 per hour.

Senior Workers Compensation Claims Examiner

Acrisure

Murrieta, CA • On-site

$95K - $110K/yr

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

This job post has expired today. Applications are no longer accepted.


Acrisure rating

7.5

Company rating: 7.5 out of 10

Based on 124 frontline employees who took The Breakroom Quiz

226th of 315 rated insurance


Job description

Job DescriptionAbout Acrisure

A global fintech leader, Acrisure empowers millions of ambitious businesses and individuals with the right solutions to grow boldly forward. Bringing cutting-edge technology and top-tier human support together, we connect clients with customized solutions across a range of insurance, reinsurance, payroll, benefits, cybersecurity, mortgage services, and more.

In the last twelve years, Acrisure has grown in revenue from $38 million to almost $5 billion and employs over 19,000 colleagues in more than 20 countries. Acrisure was built on entrepreneurial spirit. Prioritizing leadership, accountability, and collaboration, we equip our teams to work at the highest levels possible.

Job Summary

Acrisure is seeking a Senior Workers' Compensation Claims Examiner to independently manage complex California workers' compensation claims from assignment through resolution. This role is responsible for investigating claims, determining compensability, managing litigation, evaluating exposure, and developing claim resolution strategies while ensuring compliance with California workers' compensation laws and regulations.

Candidates must have direct, hands-on experience handling California workers' compensation claims. An active California Adjuster Certification, experience handling self-insured claims through the California Office of Self-Insurance Plans (OSIP/SIP), or a Certified Workers' Compensation Professional (CWCP) designation is required.

This is a fully remote position. Candidates must be able to support California-based claims and work business hours aligned with Mountain or Pacific Time zones.

Responsibilities
  • Independently manage a caseload of California workers' compensation claims from assignment through resolution

  • Investigate claims, evaluate compensability, and determine appropriate claim handling strategies

  • Review coverage, liability, medical documentation, and claim exposure in accordance with California regulations

  • Establish and manage reserves based on claim exposure and ongoing developments

  • Manage complex indemnity claims, including litigated files and settlement negotiations

  • Coordinate with defense counsel, medical providers, employers, and other stakeholders throughout the claims process

  • Monitor claim progress, maintain accurate diaries, and ensure timely follow-up on all assigned files

  • Coordinate return-to-work efforts and support positive claim outcomes

  • Identify fraud, subrogation, and cost containment opportunities when appropriate

  • Maintain complete, accurate, and timely documentation within the claims management system

  • Provide guidance and claim recommendations on complex files as needed

  • Perform additional duties and projects as assigned

Requirements
  • 5+ years of experience handling California workers' compensation claims required

  • Experience managing indemnity claims required

  • Experience handling litigated workers' compensation claims required

  • Current California Adjuster Certification, OSIP/SIP self-insured qualification, or Certified Workers' Compensation Professional (CWCP) designation required

  • Strong knowledge of California workers' compensation laws, regulations, and claims handling practices

  • Experience developing claim resolution strategies and negotiating settlements

  • Ability to independently manage complex claims with minimal supervision

  • Strong analytical, decision-making, and problem-solving skills

  • Excellent verbal and written communication skills

  • Strong organizational skills with the ability to manage multiple priorities in a remote environment

  • Proficiency with Microsoft Office and claims management systems

EDUCATION AND LICENSES
  • High school diploma or equivalent required

  • Additional education beneficial

  • Current California Adjuster Certification, OSIP/SIP self-insured qualification, or Certified Workers' Compensation Professional (CWCP) designation required

Pay Details:

The base compensation range for this position is $95,000 - $110,000. This range reflects Acrisure's good faith estimate at the time of this posting. Placement within the range will be based on a variety of factors, including but not limited to skills, experience, qualifications, location, and internal equity.

Candidates should be comfortable with an on-site presence to support collaboration, team leadership, and cross-functional partnership.

Why Join Us:

At Acrisure, we're building more than a business, we're building a community where people can grow, thrive, and make an impact. Our benefits are designed to support every dimension of your life, from your health and finances to your family and future.

Making a lasting impact on the communities it serves, Acrisure has pledged more than $22 million through its partnerships with Corewell Health Helen DeVos Children's Hospital in Grand Rapids, Michigan, UPMC Children's Hospital in Pittsburgh, Pennsylvania and Blythedale Children's Hospital in Valhalla, New York.

Employee Benefits

We also offer our employees a comprehensive suite of benefits and perks, including:

  • Physical Wellness: Comprehensive medical insurance, dental insurance, and vision insurance; life and disability insurance; fertility benefits; wellness resources; and paid sick time.

  • Mental Wellness: Generous paid time off and holidays; Employee Assistance Program (EAP); and a complimentary Calm app subscription.

  • Financial Wellness: Immediate vesting in a 401(k) plan; Health Savings Account (HSA) and Flexible Spending Account (FSA) options; commuter benefits; and employee discount programs.

  • Family Care: Paid maternity leave and paid paternity leave (including for adoptive parents); legal plan options; and pet insurance coverage.

  • ... and so much more!

This list is not exhaustive of all available benefits. Eligibility and waiting periods may apply to certain offerings. Benefits may vary based on subsidiary entity and geographic location.

Acrisure is an Equal Opportunity Employer. We consider qualified applicants without regard to race, color, religion, sex, national origin, disability, or protected veteran status. Applicants may request reasonable accommodation by contacting leaves@acrisure.com.

Final candidates will be required to complete post-offer verification processes related to the role and in accordance with applicable laws.

California Residents: Learn more about our privacy practices for applicants by visiting the Acrisure California Applicant Privacy Policy.

Recruitment Fraud: Please visit here to learn more about our Recruitment Fraud Notice.

Welcome, your new opportunity awaits you.


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