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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 You'll ...

Sr Claim Examiner-WC (CA)

Brea, CA

$33.75 - $45.75/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 You'll ...

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 ...

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

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$47

How much do claims examiner jobs pay per hour?

As of Aug 12, 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.

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.

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.

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 do I need to be a claims examiner?

To become a claims examiner, candidates typically need a high school diploma or equivalent, with some roles preferring an associate's or bachelor's degree in fields like insurance, finance, or healthcare. Strong analytical skills, attention to detail, and knowledge of insurance policies and claims processing are essential, along with proficiency in computer software and sometimes relevant certifications such as the Certified Claims Professional (CCP).

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 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 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.

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 88% Full Time, 4% Part Time, 4% Temporary, and 4% Contract. Highlights an 86% In-person, 5% Hybrid, and 9% Remote job distribution, with an average salary of $63,802 per year, or $30.7 per hour.

Senior Claims Examiner

Venbrook

Anaheim, CA • On-site

$69K - $89K/yr

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Re-posted 5 days ago


Job description

JOB TITLE: 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 of Venbrook Group, LLC, a holding company with subsidiaries engaged in retail broking, wholesale broking, programs, and claims services. Venbrook's team of experts and industry specialists partners with clients to manage their risks, create security, promote growth, and add value by delivering best-in-class commercial property & casualty, employee benefits, and personal risk insurance products and programs.
Venbrook Claims brings together decades of specialized expertise by integrating respected legacy claims brands: Carl Warren & Company, DMA Claims, and OneSource Claims Management. Venbrook works across the claims lifecycle with services that include Third Party Administration (TPA), Complex Claims Management, Catastrophe, Independent Adjusting, subrogation recovery, litigation management, investigative, and Special Investigations Unit (SIU) services.
Venbrook Claims has long-term clients across the public and private sectors, including insurance companies, captives, MGAs, transportation companies, manufacturers, public school systems, and property owners.
With over a century of combined claims experience, our organization's legacy brands have been unified as Venbrook Claims to deliver scalable, flexible solutions supported by centralized governance, compliance, and technology infrastructure. Our culture is derived from the people who create it. We are not different in what we do - we are different in how we do it. We believe our clients are our partners, and we earn their trust every day.
We offer competitive compensation and a comprehensive benefits package:
  • 401(k) + employee match
  • Medical, Dental, Vision, Life, and Disability Insurance
  • Paid Time Off (PTO)
  • Paid Holidays
  • Paid Parental Leave
  • Paid Sick Leave
  • Professional development programs
  • Work-life quality and flexibility

Visit us at https://www.venbrook.com/contact-us/careers
JOB SUMMARY
The Claims Adjuster, Public Entity is responsible for the end-to-end management of property and casualty claims on behalf of public entity clients, including municipalities, school districts, and government agencies. This role requires sound judgment, strong investigative skills, and an understanding of the unique legal and regulatory environment governing public sector claims. The Adjuster will manage litigation, communicate proactively with clients, and deliver high-quality outcomes consistent with client guidelines and best practices.
POSITION COMPETENCIES
Communication Skills: Consistently and effectively communicates with a diverse spectrum of people, including public entity clients, attorneys, claimants, and vendors. Demonstrates active listening and the ability to convey complex claims information clearly to varied audiences - both verbally and in writing.
Problem Solving & Decision Making: Applies sound judgment to determine the best path to claim resolution. Considers short- and long-term effects through the decision-making process, ensuring all relevant stakeholders are engaged and exposures are properly evaluated.
Customer Service Orientation: Aligns efforts to support a client-centric culture. Understands performance expectations, delivers high-quality service, and maintains timely and responsive communication with both internal and external clients.
Interpersonal Skills & Collaboration: Builds and maintains strong working relationships with clients, team members, vendors, and legal partners. Demonstrates resilience, approachability, and the ability to work effectively in a team environment.
Public Entity & Legal Acumen: Demonstrates knowledge of the unique regulatory environment, governmental immunities, and litigation considerations specific to public sector claims. Able to read, interpret, and apply legal documents and case law relevant to public entity exposure.
Strategic Thinking: Continuously monitors claims activity, identifies trends, and makes recommendations to improve outcomes. Maintains awareness of industry and market changes that may impact public entity claim handling.
Functional/Technical Expertise: Demonstrates the ability to investigate, evaluate, and resolve moderate to high-severity claims. Maintains technical expertise through continuing education, designations, and professional development. Proficient in claims management systems and Microsoft Office applications.
Accountability & Integrity: Takes ownership of assigned files, meets deadlines, and holds to the highest standards of professional conduct. Consistently achieves audit and quality benchmarks and operates transparently with clients and leadership.
DUTIES & RESPONSIBILITIES
  • Manage end-to-end handling of auto, general liability, property damage, and bodily injury claims for public entity clients, from first notice of loss through resolution.
  • Execute client strategies to achieve claims quality, customer service, and operational objectives in accordance with Claim Handling Guidelines and Best Practices.
  • Conduct thorough investigations, including field investigations when required, to establish coverage, liability, and damages.
  • Proactively work claims to ensure file quality meets client-specific handling requirements and internal quality standards.
  • Develop resolution strategies with clear, focused, and well-documented file notes reflecting control, momentum, and accuracy.
  • Identify, retain, and actively manage vendors and subcontractors to achieve satisfactory outcomes on both expense and indemnity costs.
  • Maintain a timely diary and caseload management consistent with the age and complexity of assigned files.
  • Achieve audit scores of 90% or above and maintain a high standard of work product quality.
  • Prepare and present client reports, claim reviews, and roundtable summaries as required.
  • Communicate clearly and regularly with clients, claimants, coverage counsel, and defense attorneys.
  • Identify potential fraud, subrogation, and recovery opportunities and take appropriate action.
  • Perform other duties as assigned.

REQUIRED SKILLS & ABILITIES
  • 3+ years of handling litigated auto and/or general liability property damage and bodily injury claims
  • Working knowledge of public entity claims handling, governmental immunities, and applicable statutes of limitations
  • Strong analytical, investigative, and problem-solving skills
  • Excellent verbal and written communication skills
  • Proficiency in claims management systems and Microsoft Office applications (Outlook, Word, Excel, PowerPoint)
  • Ability to read and interpret legal documents, coverage opinions, and reports
  • Ability to manage a high-volume caseload in a fast-paced environment
  • Some travel may be required for field investigations, depositions, and client meetings

EDUCATION & EXPERIENCE
  • 3+ years of P&C claims experience required; public entity claims experience strongly preferred
  • Field investigation experience preferred
  • College degree in Business, Risk Management, or equivalent discipline preferred
  • Insurance designation (e.g., AIC, AIM, ARM, CPCU) and/or insurance-related coursework preferred

Salary Range 80k-90k