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Claims Processing Jobs in California (NOW HIRING)

WinMax

Claims Processing Specialist

Mather, CA · On-site

$25 - $28/hr

Claims Processing Specialist Location: Rancho Cordova, CA (Resources are required to work 100% onsite in Rancho Cordova from 6:00AM - 2:30PM) Contract: 6+ Months The Claims Processing Specialist ...

Winmax Systems

Claims Processing Specialist

Mather, CA · On-site

$25 - $28/hr

Claims Processing Specialist Location:Rancho Cordova, CA (Resources are required to work 100% onsite in Rancho Cordova from 6:00AM - 2:30PM) Contract: 6+ Months The Claims Processing Specialist ...

Managed Staffing

Claims Examiner

Whittier, CA · On-site

$30 - $32/hr

Accurately process, adjudicate, and pay UB-92 and HCFA-1500 claims. * Handle claims received from hospitals and affiliated medical groups for HMO patients. * Apply correct payment methodologies for ...

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 ...

LIBERTY DENTAL

Process dental claims, pre-authorizations, referrals, and benefit determinations accurately and efficiently. * Review and adjudicate claims in accordance with plan guidelines, state regulations, and ...

Managed Staffing

Healthcare Claims Examiner

Whittier, CA · On-site

$31 - $32/hr

Process and adjudicate UB-92 and HCFA-1500 claims for medical groups, hospitals, and ancillary providers. * Ensure claims are paid accurately and in compliance with timeliness and payment guidelines.

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Claims Processing information

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How much do claims processing jobs pay per hour?

As of Aug 27, 2026, the average hourly pay for claims processing in California is $18.91, according to ZipRecruiter salary data. Most workers in this role earn between $16.15 and $20.38 per hour, depending on experience, location, and employer.

What is claims processing?

Claims processing is the procedure by which insurance companies or organizations review and manage claims submitted by policyholders or clients. This involves verifying the details of the claim, ensuring all necessary documentation is provided, assessing the validity of the claim, and determining the appropriate payout or resolution. Claims processors play a crucial role in ensuring claims are handled efficiently, accurately, and in compliance with company policies and regulations.

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

To thrive as a Claims Processor, you need a solid understanding of insurance policies and claims procedures, typically supported by a high school diploma or equivalent and relevant on-the-job training. Familiarity with claims management software, data entry systems, and basic office applications is essential. Strong attention to detail, analytical thinking, and effective communication skills help you resolve claims accurately and efficiently. These skills ensure the timely and proper handling of claims, enhancing customer satisfaction and minimizing errors or fraudulent activity.

What are some common challenges faced by professionals in claims processing, and how can they be managed effectively?

Professionals in claims processing often deal with high volumes of work, tight deadlines, and complex cases that require attention to detail. Managing these challenges involves staying organized, utilizing claims management software efficiently, and continuously updating knowledge of insurance policies and regulations. Effective communication with team members and other departments is also crucial to resolve discrepancies quickly and ensure accurate claim adjudication. Many organizations offer ongoing training and mentorship to help staff adapt to changes and improve efficiency.

What is the difference between Claims Processing vs Claims Adjuster?

AspectClaims ProcessingClaims Adjuster
CredentialsHigh school diploma or equivalent; certifications varyHigh school diploma; often state licensing or certifications
Work EnvironmentOffice-based, administrative settingFieldwork and office-based, investigative environment
Industry UsageInsurance companies, healthcare providersInsurance companies, claims departments
Job FocusReviewing and processing claims for paymentInvestigating claims, determining liability and settlement

Claims Processing involves reviewing and managing insurance claims to ensure proper payment, focusing on administrative tasks. Claims Adjusters investigate claims, assess damages, and determine liability. While both roles work within the insurance industry, Claims Processing is more administrative, whereas Claims Adjusters are investigative and evaluative.

How to get a job as a claims processing?

To get a job as a claims processor, candidates typically need a high school diploma or equivalent, strong attention to detail, and good organizational skills. Relevant experience in insurance, customer service, or data entry can be beneficial, and familiarity with claims processing software is often preferred. Certifications such as the Certified Claims Professional (CCP) can improve job prospects.

Is claims processing a stressful job?

Claims processing can be a stressful job due to tight deadlines, high volume of claims, and the need for accuracy. It often requires attention to detail, communication skills, and the ability to handle complex or difficult cases, which can contribute to job stress.

What do claims processing specialists do?

Claims processing specialists review and evaluate insurance claims to determine coverage and payment amounts. They verify information, ensure accuracy, and process claims efficiently using claims management software, often adhering to company policies and industry regulations.

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 jobs?

Cities in California with the most Claims Processing job openings:

Claims Processing jobs near you
Infographic showing various Claims Processing job openings in California as of August 2026, with employment types broken down into 1% As Needed, 84% Full Time, 11% Part Time, 1% Temporary, 2% Contract, and 1% Nights. Highlights an 92% Physical, 3% Hybrid, and 5% Remote job distribution, with an average salary of $39,341 per year, or $18.9 per hour.

Claims Processing Specialist

Mather, CA • On-site

WinMax
See more jobs at WinMaxexternal

$25 - $28/hr

Other

Medical, Retirement

Posted 6 days ago

Job description

Claims Processing Specialist

Location: Rancho Cordova, CA (Resources are required to work 100% onsite in Rancho Cordova from 6:00AM - 2:30PM) Contract: 6+ Months

Job Description: The Claims Processing Specialist identifies and provides solutions for processing unique claims, refunds, overpayments, and underpayments. Other duties include processing special claims which may involve manual review of actual treatment compared to authorized treatment, and adjudicating VA CCN claims.

Essential Duties:

  • Performs analysis of authorizations compared to submitted claims.
  • Processes special claim payments, specifically for VA CCN client.
  • Processes returned client checks, personal checks, undeliverable checks, stale dated checks, and requests for voids/stop-payments/re-issues. Determines refund amounts, changes status of outstanding overpayments.
  • Reviews monthly reports for outstanding overpayments and coordinates with finance on special issues.
  • Reviews and handles special professional reviews and service issues, quality complaints and coordinates with Special Correspondence Unit.
  • This list is not all-inclusive and you are expected to perform other duties as requested or assigned

Skills/Experience: Minimum Qualifications

  • 2+ years of experience w/High School Diploma/GED
  • Previous/recent experience in claims processing
  • Ideal to have Dental Claims processing experience
  • High attention to detail
  • Some customer service experience and claims adjudication experience including the understanding of re-adjudication is preferred.

Additional Experience:

  • Proficient in MS Excel
  • Strong analytical and critical thinking skills.
  • Ability to maintain strict attention to detail.
  • Excellent customer service skills with ability to evaluate and respond to the contact needs.
  • Ability to independently prioritize work and establish, understand, and follow work rules and procedures, and take action to improve existing processes.
  • Ability to confront difficult situations and make appropriate and timely decisions.
  • Excellent organizational skills, including the ability to follow-up on commitments on a timely basis and adhere to deadlines.
  • Ability to collaborate effectively with others.
  • Basic knowledge of accounting principles.
  • Knowledge of Enterprise policies, procedures, and guidelines

Pay Transparency: "The expected pay range for this position is $25.00–$28.00 per hour. Final compensation will be determined based on experience, skills, and qualifications. Non-exempt employees are eligible for overtime. Full-time employees are eligible to select from different benefits packages. Packages may include medical, 401(k) without employer match. Paid Sick leave is provided based on state or local laws.

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