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Claims Operations Associate Jobs in California (NOW HIRING)

Lowe's

Branch Operations Supervisor

San Leandro, CA

$60K - $101K/yr

... claims, and workplace accommodations • Communicates clear expectations for associates, monitors ... operations or related area) • Minimum of 6 months experience providing direction or supervision ...

NorthBay Health

Claims Analyst II (On-Site)

Fairfield, CA · On-site

$33.29 - $40.44/hr

The position is co-responsible for the operational functions for the organization's capitated ... Associate's degree required or minimum 4 years of health care claims experience. * Four years of ...

DFS Group

Team Lead, Operations Support

Los Angeles, CA · On-site

$25.25 - $37.85/hr

You will be a helping hand to the Operations Support Manager in managing DFS' store support ... Associates and conduct refreshers as necessary Handle Customer Claims * Support frontline and ...

DFS Group

Team Lead, Operations Support

Los Angeles, CA · On-site

$25.25 - $37.85/hr

You will be a helping hand to the Operations Support Manager in managing DFS' store support ... Associates and conduct refreshers as necessary Handle Customer Claims * Support frontline and ...

Floor & Decor Holdings, Inc.

$20.50 - $40.70/hr

... and associate education. Ensures the store is a safe workplace and provided a safe shopping ... Handle claims and other KCM/MOD duties as needed * Ensure maximum scheduling coverage especially ...

Floor & Décor

Operations Manager

Los Angeles, CA

$20.50 - $40.70/hr

... and associate education. Ensures the store is a safe workplace and provided a safe shopping ... Handle claims and other KCM/MOD duties as needed * Ensure maximum scheduling coverage especially ...

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All JobsClaims Operations Associate JobsClaims Operations Associate Jobs in California

Claims Operations Associate information

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How much do claims operations associate jobs pay per hour?

As of Aug 12, 2026, the average hourly pay for claims operations associate in California is $20.71, according to ZipRecruiter salary data. Most workers in this role earn between $16.83 and $22.79 per hour, depending on experience, location, and employer.

Is claims processing a stressful job?

Claims processing as a Claims Operations Associate can be stressful due to the need for accuracy, attention to detail, and meeting deadlines. The role often involves handling complex cases and working within strict regulatory guidelines, which can contribute to workplace pressure. However, stress levels vary depending on the workload, company environment, and individual coping skills.

What is the difference between Claims Operations Associate vs Claims Analyst?

AspectClaims Operations AssociateClaims Analyst
CredentialsHigh school diploma or equivalent; some roles may require relevant certificationsHigh school diploma; some roles may prefer certifications like CPCU or similar
Work EnvironmentOffice setting, handling claims processing and customer interactionsOffice or remote, analyzing claims data and making decisions
Employer & IndustryInsurance companies, third-party administratorsInsurance firms, claims departments
Search & Comparison IntentUnderstanding entry-level claims roles and responsibilitiesAnalyzing claims data and decision-making processes

The Claims Operations Associate typically handles claims processing tasks, customer service, and administrative duties within an insurance setting. In contrast, a Claims Analyst focuses more on analyzing claims data, assessing risks, and making decisions based on policy details. Both roles require knowledge of insurance policies and claims procedures, but the Claims Analyst often involves more analytical skills and data interpretation.

What is a claims operations associate?

A Claims Operations Associate is a professional who supports the processing and administration of insurance claims. They handle tasks such as reviewing claim forms, verifying information, entering data into systems, and assisting claims adjusters or examiners with documentation and communications. Their role is crucial in ensuring that claims are processed efficiently, accurately, and in compliance with company policies and regulatory requirements. Claims Operations Associates may work for insurance companies, healthcare providers, or third-party administrators.

What skills and qualifications are needed to be a claims operations associate?

To thrive as a Claims Operations Associate, you need strong analytical abilities, attention to detail, and a solid understanding of insurance processes, often supported by a bachelor's degree or relevant experience. Familiarity with claims management systems, Microsoft Office Suite, and sometimes industry certifications like AIC (Associate in Claims) are typically required. Excellent communication, organizational skills, and problem-solving abilities help you manage complex claims and collaborate effectively with internal and external stakeholders. These competencies ensure accurate, efficient claims processing and contribute to customer satisfaction and organizational compliance.

What challenges might a claims operations associate encounter in their daily work?

As a Claims Operations Associate, you may encounter challenges such as managing a high volume of claims while ensuring accuracy and compliance with regulations. Balancing timely processing with the need to investigate discrepancies or incomplete information can be demanding. Additionally, you'll often coordinate with adjusters, customers, and other departments, so strong communication and organizational skills are essential. Staying up to date with changing policies or industry standards can also be a key part of the role.
What are the most commonly searched types of Claims Operations jobs in California? The most popular types of Claims Operations jobs in California are:
What cities in California are hiring for Claims Operations Associate jobs? Cities in California with the most Claims Operations Associate job openings:
Claims Operations Associate jobs near you
Infographic showing various Claims Operations Associate job openings in California as of August 2026, with employment types broken down into 84% Full Time, 12% Part Time, 2% Temporary, and 2% Contract. Highlights an 94% Physical, 2% Hybrid, and 4% Remote job distribution, with an average salary of $43,082 per year, or $20.7 per hour.

Claims Resolution Specialist

Integrated Pain Management Medical Group, Inc.

Walnut Creek, CA • On-site

$28 - $35/hr

Full-time

Medical, Dental, Vision, Retirement, PTO

Posted 20 days ago

Job description

The Claims Resolution Specialist is responsible for the day-to-day investigation and resolution of claim rejections, denials, edits, and reimbursement issues across a multi-site, multi-specialty healthcare organization specializing in pain management, physical medicine, and functional rehabilitation services.

Working closely with the Pre-Billing, Accounts Receivable (A/R), Denials Management, Coding, and Revenue Integrity teams, this position performs detailed claim reviews, researches payer requirements, corrects claim errors, and facilitates timely claim resubmission and payment. The Claims Resolution Specialist serves as a key resource in resolving billing issues and ensuring claims are processed accurately and efficiently.


*This is a remote role. We are only hiring in the following states: AZ, CA, NM, NV, OR, TX and WA.


What you will do:

Claims Resolution & Follow-Up

  • Investigate and resolve claim rejections, denials, and payer edits identified before or after claim submission.
  • Review claim history, payer correspondence, medical records, authorizations, and supporting documentation to determine the cause of claim issues.
  • Correct billing, coding, demographic, authorization, and insurance-related claim errors as appropriate.
  • Process claim corrections, adjustments, resubmissions, and reconsideration requests in accordance with payer guidelines.
  • Perform payer research and communicate directly with insurance carriers to resolve claim processing issues.
  • Monitor assigned work queues and ensure timely resolution of outstanding claims.
  • Escalate complex reimbursement, coding, or compliance issues to senior team members.

Denial Management Support

  • Partner with A/R and Denials Management teams to resolve denied and underpaid claims.
  • Assist in preparing appeal documentation and supporting materials for denied claims.
  • Identify recurring denial patterns and communicate findings to the Senior Claims Resolution Coordinator.
  • Maintain accurate documentation of denial resolution activities and payer communications.
  • Support efforts to reduce preventable denials and improve reimbursement outcomes.

Pre-Billing & Revenue Cycle Collaboration

  • Work closely with the pre-billing team to identify and correct claim issues prior to submission.
  • Review claims for completeness and compliance with payer billing requirements.
  • Verify insurance information, authorizations, referrals, diagnosis coding, procedure coding, and modifier usage.
  • Collaborate with coding and clinical teams to obtain information needed for claim resolution.
  • Assist with reducing claim holds and billing delays.

Audit & Compliance Support

  • Participate in routine claim quality reviews and internal audit activities.
  • Ensure claim corrections comply with payer regulations, organizational policies, and billing guidelines.
  • Support Revenue Integrity initiatives through accurate claim review and documentation.
  • Maintain knowledge of Medicare, Medicaid, Workers' Compensation, and Commercial payer requirements.
  • Adhere to HIPAA, CMS, and organizational compliance standards.

Documentation & Reporting

  • Maintain detailed documentation of claim investigations, resolutions, payer communications, and follow-up activities.
  • Track assigned workloads and resolution outcomes.
  • Assist with compiling information for denial trend reporting and operational reviews.
  • Provide feedback regarding workflow issues contributing to claim errors or payment delays.
  • Assumes other responsibilities as appropriate to the position and organizational needs



Qualifications:

  • High School Diploma or equivalent required.
  • Associate degree in Healthcare Administration, Medical Billing and Coding, or related field preferred.
  • Minimum 2-4 years of experience in medical billing, claims resolution, denial management, accounts receivable, or healthcare revenue cycle operations.
  • Working knowledge of Medicare, Medicaid, Workers' Compensation, and Commercial insurance billing requirements.
  • Knowledge of CPT, ICD-10-CM, HCPCS, modifiers, and medical terminology.
  • Experience researching and resolving denied or rejected claims.
  • Strong analytical and critical thinking skills.
  • Ability to manage multiple priorities and meet productivity expectations.


Compensation Range: 

$28.00 to $35.00 Hourly

All compensation ranges are posted based on internal equity, job requirements, experience, and geographical locations.


Why You'll Love Working Here:

  • Amazing work/life balance
  • Generous Medical, Dental, Vision, and Prescription benefits (PPO & HMO)
  • 401(K) Plan with Employer Matching
  • License & Tuition Reimbursements
  • Paid Time Off
  • Holiday Pay & Floating Holiday
  • Employee Perks and Discount Programs
  • Supportive environment to help you grow and succeed

Boomerang Healthcare (BHC) is a multidisciplinary and comprehensive team of experienced, committed healthcare providers that treat pain. Our team of doctors approaches each patient with one goal in mind: to help patients return to normal daily activities. We work with our patients to identify the cause of their pain and create a personalized treatment plan, recognizing that no two patients are alike, and neither is their pain. Our providers create a comprehensive care plan, then monitor, manage and coordinate patient access to health services at BHC. 

Boomerang Healthcare strives to be a diverse workforce that reflects, at all job levels, the patients we serve. We are an equal opportunity employer. Boomerang Healthcare is committed to compliance with the American Disabilities Act. If you require reasonable accommodation during the application process or have a question regarding an essential job function, please contact us.



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