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Claims Processing Manager Jobs in California (NOW HIRING)

LSMA Management Inc

Claims Manager

San Bernardino, CA

$87K - $97K/yr

This position plays a critical role in ensuring claims processing accuracy, maintaining provider satisfaction, protecting organizational financial integrity, and supporting delegated managed care ...

LSMA Management Inc

Claims Manager

San Bernardino, CA · On-site

$87K - $97K/yr

This position plays a critical role in ensuring claims processing accuracy, maintaining provider satisfaction, protecting organizational financial integrity, and supporting delegated managed care ...

LSMA Management Inc

Claims Manager

San Bernardino, CA · On-site

$87K - $97K/yr

This position plays a critical role in ensuring claims processing accuracy, maintaining provider satisfaction, protecting organizational financial integrity, and supporting delegated managed care ...

Astrana Health

Sr. Manager - Claims

Monterey Park, CA · On-site +1

$125K - $140K/yr

In this role, you'll oversee daily claims processing, drive quality and turnaround time performance ... Manage claims inventory and prioritize workloads to consistently meet SLAs * Support onboarding and ...

Astrana Health, Inc.

Sr. Manager - Claims

Monterey Park, CA · On-site +1

$125K - $140K/yr

In this role, you'll oversee daily claims processing, drive quality and turnaround time performance ... Manage claims inventory and prioritize workloads to consistently meet SLAs * Support onboarding and ...

Astrana Health, Inc.

Sr. Manager - Claims

Monterey Park, CA · On-site +1

$125K - $140K/yr

In this role, you'll oversee daily claims processing, drive quality and turnaround time performance ... Manage claims inventory and prioritize workloads to consistently meet SLAs * Support onboarding and ...

Managed Staffing

Claims Examiner

Whittier, CA · On-site

$30 - $32/hr

Knowledge of compliance and regulatory issues affecting claims processing. * Understanding of provider reimbursement methodologies and contract terms. * Experience with managed care computer systems ...

Astrana Health

Sr. Manager - Claims

Monterey Park, CA · On-site

In this role, you'll oversee daily claims processing, drive quality and turnaround time performance, and support the onboarding of new IPAs and implementations. You'll partner closely with internal ...

Managed Staffing

Healthcare Claims Examiner

Whittier, CA · On-site

$31 - $32/hr

The Claims Examiner will be responsible for reviewing, adjudicating, and processing professional and facility claims for HMO patients. This role reports directly to the Claims Manager and requires ...

PIH Health

Claims Quality Assurance Auditor

Whittier, CA · On-site

$23 - $36.70/hr

Managed Care Knowledge and confidence exposure and expected * Knowledge of claims processing, CPT/RBRVS/ICD codes * Level of comprehension as it relations to regulatory compliance and guidelines ...

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Claims Processing Manager information

See California salary details

$34.5K

$86.7K

$137.2K

How much do claims processing manager jobs pay per year?

As of Aug 31, 2026, the average yearly pay for claims processing 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 does a claims processing manager do?

A Claims Processing Manager oversees the team responsible for reviewing, evaluating, and processing insurance claims. Their duties include ensuring claims are handled efficiently and accurately, developing procedures to improve workflow, and maintaining compliance with industry regulations. They also resolve complex or escalated claims issues, provide staff training, and report on performance metrics. The role requires strong leadership, analytical skills, and attention to detail to ensure a fair and timely claims process.

What are the key skills and qualifications needed to thrive as a claims processing manager?

To thrive as a Claims Processing Manager, you need expertise in insurance claims procedures, analytical skills, and a solid understanding of regulatory compliance, often supported by a bachelor's degree and relevant industry experience. Familiarity with claims management software, workflow automation tools, and data analysis systems is typically required. Strong leadership, attention to detail, and effective communication are crucial soft skills that set top performers apart in this role. These abilities ensure accurate and efficient claims processing, regulatory adherence, and effective team management, all of which are vital for organizational success.

What are the primary challenges faced by a claims processing manager, and how can they be addressed?

Claims Processing Managers often navigate challenges such as ensuring timely and accurate claim adjudication, managing a team with varying workloads, and staying up to date with regulatory changes. Balancing efficiency with compliance requires strong organizational skills and effective communication. Successful managers foster a collaborative environment, implement regular training, and leverage technology to streamline processes, all while maintaining high standards of customer service and data integrity.

What are the most commonly searched types of Claims Processing jobs in California?

The most popular types of Claims Processing jobs in California are:

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

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

Claims Processing Manager jobs near you

Claims Manager

San Bernardino, CA

LSMA Management Inc
See more jobs at LSMA Management Incexternal

$87K - $97K/yr

Full-time

Re-posted yesterday

Job description

Description

JOB SUMMARY:

The Claims Manager is responsible for overseeing the daily operations, performance, and regulatory compliance of the Claims Department within the Managed Services Organization (MSO). This role provides leadership and supervision to Claims Examiners and ensures the accurate, timely, and compliant adjudication of professional and institutional claims in accordance with health plan contracts, regulatory requirements, and organizational policies.

The Claims Manager monitors claims inventory, production, and quality metrics, ensures adherence to turnaround time standards, and supports operational efficiency and compliance with federal and California regulatory requirements, including Department of Managed Health Care (DMHC), Centers for Medicare & Medicaid Services (CMS), and Department of Health Care Services (DHCS) requirements where applicable.

This position plays a critical role in ensuring claims processing accuracy, maintaining provider satisfaction, protecting organizational financial integrity, and supporting delegated managed care operations.

Requirements

MINIMUM & PREFERRED QUALIFICATIONS:


Education/Training

Minimum: High School diploma or equivalent required.

Preferred: Bachelor's degree in Healthcare Administration, Business Administration, or related field.


Experience 

Minimum: At least five years of managed care claims processing experience. Two or more years of supervisory or leadership experience. Experience processing professional and institutional claims.

Preferred: Experience in MSO, IPA, or delegated managed care environment. Experience with Medicare, Medi-Cal, Commercial, and managed care claims. Experience with claims systems such as EZ Cap, EPIC, or similar platforms. Experience supporting regulatory and delegation audits.


Certification(s)

Preferred: Certified Professional in Healthcare Quality (CPHQ)


Skills, Knowledge & Abilities

Strong knowledge of managed care claims processing and adjudication.

Knowledge of CPT, HCPCS, ICD-10, and UB-04 claim processing standards. 

Knowledge of DMHC, CMS, DHCS, and managed care regulatory requirements.

Strong leadership and staff supervision skills.

Strong analytical, organizational, and problem-solving skills.

Ability to assess workload and staffing requirements. 

Excellent written and verbal communication skills.

Proficiency in Microsoft Office Suite, including Excel. 

Ability to manage multiple priorities in a deadline-driven environment.

Ability to maintain confidentiality and data integrity.

Ability to collaborate effectively with internal and external stakeholders.


PHYSICAL, MENTAL & ENVIRONMENTAL REQUIREMENTS:

The physical demands described here are represented by those that must be met by an employee to successfully perform the essential functions of this job. Work is primarily performed in an office or hybrid office environment and involves prolonged periods of sitting, computer use, and data review. The role requires sustained concentration, analytical thinking, and attention to detail to ensure claims accuracy and regulatory compliance. Occasional lifting of materials up to approximately 10-20 pounds may be required. The position may require extended work hours or weekend work to meet operational and regulatory deadlines.


PAY RANGE  

$87,360 - $97,760 / annually 

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