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Claims Operations Jobs in California (NOW HIRING)

Insperity

Director of Claims- Healthcare

Chatsworth, CA · On-site +1

$130K - $160K/yr

The Director of Claims is a senior leadership role responsible for the strategic direction, operational management, and regulatory oversight of the Claims Department. This position oversees all ...

Insperity

Director of Claims- Healthcare

Los Angeles, CA · On-site

$130K - $160K/yr

The Director of Claims is a senior leadership role responsible for the strategic direction, operational management, and regulatory oversight of the Claims Department. This position oversees all ...

LIBERTY DENTAL

Claims Referral Specialist II (Remote - East Coast) Bring Your Dental Claims Expertise to a Mission ... Collaborate with internal teams to resolve claim-related issues and support operational goals.

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Showing results 21-40

All JobsClaims Operations JobsClaims Operations Jobs in California

Claims Operations information

See California salary details

$12

$23

$42

How much do claims operations jobs pay per hour?

As of Aug 21, 2026, the average hourly pay for claims operations in California is $23.19, according to ZipRecruiter salary data. Most workers in this role earn between $17.31 and $25.38 per hour, depending on experience, location, and employer.

What is claims operations?

Claims Operations refers to the processes and teams responsible for handling, processing, and managing insurance claims from start to finish. This includes reviewing claims submissions, verifying information, coordinating investigations, and ensuring that claims are settled efficiently and accurately. Claims Operations professionals work to streamline workflows, comply with regulations, and deliver a positive experience for policyholders. Their role is essential in preventing fraud, reducing costs, and maintaining customer satisfaction within an insurance company.

What are the key skills and qualifications needed to thrive in claims operations?

To thrive in Claims Operations, you need strong analytical abilities, attention to detail, and a background in insurance, finance, or a related field. Familiarity with claims management systems, regulatory compliance tools, and industry certifications such as AIC (Associate in Claims) is often required. Excellent communication, problem-solving skills, and adaptability help professionals handle complex claims and interact effectively with clients and stakeholders. These competencies are crucial for ensuring accurate, timely claims processing and maintaining customer satisfaction.

What are some common challenges faced in a claims operations role and how can they be managed?

Professionals in Claims Operations often encounter challenges such as managing high volumes of claims, ensuring accuracy under tight deadlines, and navigating complex regulatory requirements. To manage these effectively, strong organizational skills, attention to detail, and familiarity with claims processing software are essential. Many teams use workflow automation and regular training sessions to stay updated on procedures and compliance standards, which helps streamline operations and reduce errors. Building strong communication skills also aids in collaborating with adjusters, underwriters, and customers to resolve issues efficiently.

What is the difference between Claims Operations vs Claims Adjuster?

AspectClaims OperationsClaims Adjuster
Primary RoleOversees claims processing, manages teams, and ensures compliance across claims functions.Evaluates individual claims, investigates damages, and determines settlement amounts.
Required CredentialsTypically requires claims handling certifications, insurance licenses, and management experience.Requires adjuster licenses, claims handling certifications, and knowledge of insurance policies.
Work EnvironmentOffice-based, team management, and coordination with various departments.Fieldwork and office work, direct interaction with claimants and vendors.
Industry UsageCommonly used in insurance companies for claims processing departments.Used by insurance carriers for claim evaluation and settlement.

Claims Operations focuses on managing the overall claims process and team coordination, while Claims Adjusters handle individual claim evaluations and settlements. Both roles require insurance-related certifications and are integral to the insurance industry, but they differ in scope and daily responsibilities.

Is claims processing a stressful job?

Claims processing is a core part of claims operations and can be stressful due to tight deadlines, high workload, and the need for accuracy. Employees often manage multiple claims simultaneously and must pay close attention to detail, which can contribute to job stress, especially during busy periods or complex cases.

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 jobs in California?

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

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

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

Claims Operations jobs near you
Infographic showing various Claims Operations job openings in California as of August 2026, with employment types broken down into 1% As Needed, 86% Full Time, 9% Part Time, 1% Temporary, 2% Contract, and 1% Nights. Highlights an 93% Physical, 3% Hybrid, and 4% Remote job distribution, with an average salary of $48,245 per year, or $23.2 per hour.

Senior Claims Specialist

Artius Solutions

Orange, CA • On-site

$110K - $130K/yr

Full-time

Re-posted 29 days ago

Job description

Senior Claims Specialist – Medical Malpractice
Location: Orange, CA 92859 (Onsite)
Employment Type: Contract / Contract-to-Hire (Based on Performance)
 Schedule: Full-Time
Position Overview

We are seeking an experienced Senior Claims Specialist to manage high-exposure and complex medical malpractice claims. This role involves full lifecycle claim handling, litigation coordination, case evaluation, and mentoring junior claims professionals.

The ideal candidate will bring strong analytical expertise, litigation management experience, and the ability to handle multiple high-level claims simultaneously.

Key Responsibilities

  • Manage medical malpractice claims including high complexity and large financial exposure cases

  • Assign, direct, and coordinate with defense counsel in compliance with internal claims guidelines

  • Investigate and evaluate claims by:

    • Reviewing medical records

    • Interviewing involved parties

    • Communicating with plaintiff attorneys

    • Securing expert evaluations/opinions

  • Prepare detailed case evaluation reports for review committees

  • Participate in litigation activities including:

    • Discovery planning

    • Mediation

    • Mandatory Settlement Conferences (MSC)

    • Negotiations

  • Monitor trials and arbitrations; provide daily progress updates

  • Maintain accurate claims documentation and database updates

  • Code and document key case developments in claims systems

  • Review and index documents in document management systems (OnBase or similar)

  • Identify and address coverage-related issues

  • Respond to hotline calls and prepare hotline reports

  • Assist in training and mentoring Claims Specialist I & II team members

  • Support management with special projects as needed

Education & Experience

  • Bachelor’s degree required (Legal or Medical background preferred)

  • Minimum 5+ years of medical malpractice claims management experience
    OR

  • 3+ years of CAP claims experience

  • Strong experience managing litigation and high-value claims

  • Valid California Driver’s License required

Required Skills

  • Excellent written and verbal communication skills

  • Strong analytical and investigative abilities

  • Effective time management and ability to meet deadlines

  • Ability to manage multiple high-priority claims simultaneously

  • Proficiency with claims management systems and Microsoft Office

  • Strong documentation and reporting skills

Preferred

  • Experience working in structured claims environments

  • Familiarity with Claims Technical Manuals & Defense Attorney Guidelines

  • Experience mentoring or training junior staff

  • Work on complex, high-impact medical malpractice cases

  • Opportunity to mentor and lead within claims operations

  • Stable and professional work environment

  • Potential for long-term engagement

.