ZipRecruiter

Log In

1

Claims Operations Manager Jobs in California (NOW HIRING)

Raydar

Strategy & Operations

San Francisco, CA · On-site

$100K - $150K/yr

Our client is a 25-person AI-native insurance claims company building technology and operations for ... management consulting, investment banking, private equity, or strategy and operations at a ...

next page

Showing results 1-20

All JobsClaims Operations JobsClaims Operations Manager JobsClaims Operations Manager Jobs in California

Claims Operations Manager information

See California salary details

$34.5K

$86.7K

$137.2K

How much do claims operations manager jobs pay per year?

As of Sep 13, 2026, the average yearly pay for claims operations manager in California is $86,711.00, according to ZipRecruiter salary data. Most workers in this role earn between $67,100.00 and $103,600.00 per year, depending on experience, location, and employer.

What is a claims operations manager?

Claims Operations Managers are professionals responsible for overseeing and managing the daily operations of an insurance claims department. They ensure that claims are processed efficiently, accurately, and in compliance with company policies and regulations. Their duties often include supervising staff, implementing process improvements, handling escalated issues, and analyzing performance metrics. Claims Operations Managers play a key role in optimizing workflow, maintaining customer satisfaction, and minimizing risk for the organization.

How does a claims operations manager typically interact with cross-functional teams within an insurance organization?

A Claims Operations Manager regularly collaborates with cross-functional teams such as underwriting, customer service, legal, and IT to ensure smooth processing of claims and adherence to company policies. This role often requires coordinating process improvements, addressing compliance requirements, and resolving escalated issues that span multiple departments. Effective communication and project management skills are essential, as the manager must balance operational efficiency with customer satisfaction while ensuring regulatory standards are met.

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

To thrive as a Claims Operations Manager, you need expertise in insurance claims processes, analytical skills, and a background in business or finance, often supported by a bachelor's degree and relevant industry experience. Familiarity with claims management systems, workflow automation tools, and regulatory compliance platforms is typically required. Strong leadership, problem-solving, and communication skills help manage teams and resolve complex claims efficiently. These abilities are vital for ensuring timely and accurate claims processing, regulatory adherence, and high levels of customer satisfaction.

What is the difference between Claims Operations Manager vs Claims Adjuster?

AspectClaims Operations ManagerClaims Adjuster
CredentialsTypically requires a bachelor’s degree, industry certifications (e.g., CPCU), and management experienceRequires a high school diploma or bachelor’s degree, licensing, and adjuster certifications
Work EnvironmentOversees teams, manages claims processes, and develops policies within an office or corporate settingInvestigates claims, assesses damages, and interacts directly with claimants, often in the field or office
Employer & Industry UsageCommon in insurance companies, large agencies, and corporate claims departmentsFound in insurance companies, independent adjusting firms, and public adjusting roles

The Claims Operations Manager focuses on managing teams and streamlining claims processes, while the Claims Adjuster handles the investigation and evaluation of individual claims. Both roles are essential in the claims lifecycle but differ in responsibilities, work environment, and required credentials.

How much do claims operations managers make in the US?

Claims operations managers in the US typically earn an average salary between $70,000 and $120,000 annually, depending on experience, location, and company size. They often oversee claims processing teams, utilize claims management software, and require strong leadership and industry knowledge.

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 are popular job titles related to Claims Operations Manager jobs in California?

For Claims Operations Manager jobs in California, the most frequently searched job titles are:

What job categories do people searching Claims Operations Manager jobs in California look for?

The top searched job categories for Claims Operations Manager jobs in California are:

What cities in California are hiring for Claims Operations Manager jobs?

Cities in California with the most Claims Operations Manager job openings:

Claims Operations Manager jobs near you
Infographic showing various Claims Operations Manager job openings in California as of August 2026, with employment types broken down into 82% Full Time, 15% Part Time, and 3% Contract. Highlights an 93% Physical, 3% Hybrid, and 4% Remote job distribution, with an average salary of $86,711 per year, or $41.7 per hour.

Lead - Claims Operations

Monterey Park, CA • On-site

Astrana Health, Inc.
See more jobs at Astrana Health, Inc.external

$27 - $32/hr

Full-time

Re-posted 11 days ago

Job description

Lead - Claims Operations
Department: Ops - Claims Ops
Employment Type: Full Time
Location: 1600 Corporate Center Dr., Monterey Park, CA 91754
Reporting To: Nita Alailefaleula
Compensation: $27.00 - $32.00 / hour
Description
We are currently seeking a highly motivated Lead - Claims Operations. This role will report to the Sr. Manager - Claims and enable us to continue to scale in the healthcare industry. This is a hybrid role where the expectation is to work both in office and at home on a weekly basis.
What You'll Do
  • Monitor and review work of all Claims Quality, Appeals and Recovery staff to identify additional training needs and to ensure compliance with department quality/production standard
  • Provides performance feedback, as well as identifies developmental opportunities for Claims Quality, Appeals and Recovery staff
  • Monitor and review claims audit and transaction reports. Responsible for identifying claims error trends, implementing controls and changes that will minimize incorrect claims adjudication
  • Coordinate potential recovery efforts with Company Accounting and coordinate potential physician education opportunities with Company Physician Services
  • Work closely with other Company departments to ensure that all areas supporting claims meet appropriate claims quality goals
  • Ensures that all legal, regulatory and policy requirements are met by keeping informed of changes and by implementing necessary controls and/or programs to meet requirements
  • In collaboration with the Claims QA and Training Specialist, claims lead, responsible for ensuring that Claims Representatives have a thorough understanding of Company claims adjudication policies and procedures
  • Coordinate provider contract, health plan benefit/DOFR and system rules configuration testing with Business Applications Configuration team
  • Responsible for ensuring accurate reporting and timely submission of quarterly PDR timeliness reports
  • Work with the Company departments on implementing controls to minimize claims overpayments and identify physician education opportunities with Network Management
  • Work closely with other Company departments and specifically, the Claims QA and Training Specialist to communicate findings of recovery audits and to facilitate accurate adjudication of claims

Qualifications
  • Bachelor's degree in a relevant field or equivalent combination of education and progressively responsible experience
  • At least 5 years of claims experience working for either a Medical Group, IPA, MSO, or Health Plan
  • Advanced knowledge of and working experience with healthcare coding conventions such as ICD-10, CPT, and HCPCS
  • Thorough knowledge of medical claim processing procedures/systems, auditing, and a thorough understanding of claim protocols, industry standards and CMS regulations as it relates to claims payment and compliance
  • Knowledge of claims processing systems configuration and architecture, which will facilitate troubleshooting of claims transaction related issues

You're great for the role if:
  • Have EZ Cap knowledge

Environmental Job Requirements and Working Conditions
  • Our organization follows a hybrid work structure where the expectation is to work both in office and at home on a weekly basis. The office is located at 1600 Corporate Center Dr, Monterey Park, CA 91754.
  • The target pay range for this role is between $27.00 - $32.00 per hour. Actual compensation will be determined based on geographic location (current or future), experience, and other job-related factors.

Astrana Health is proud to be an Equal Employment Opportunity and Affirmative Action employer. We do not discriminate based upon race, religion, color, national origin, gender (including pregnancy, childbirth, or related medical conditions), sexual orientation, gender identity, gender expression, age, status as a protected veteran, status as an individual with a disability, or other applicable legally protected characteristics. All employment is decided on the basis of qualifications, merit, and business need. If you require assistance in applying for open positions due to a disability, please email us at humanresourcesdept@astranahealth.com to request an accommodation.
Additional Information:
The job description does not constitute an employment agreement between the employer and employee and is subject to change by the employer as the needs of the employer and requirements of the job change.

Apply