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Claims Processor Jobs in Rancho Cordova, CA (NOW HIRING)

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$28

How much do claims processor jobs pay per hour?

As of Sep 7, 2026, the average hourly pay for claims processor in Rancho Cordova, CA is $20.44, according to ZipRecruiter salary data. Most workers in this role earn between $17.45 and $22.07 per hour, depending on experience, location, and employer.

What is a claims processor?

A claims processor reviews insurance claims. Their responsibilities include verifying insurance policy coverage and making sure client information is accurate. After they determine there is a covered loss, a processor documents the information and makes sure all the required paperwork is complete. Other duties include modifying new or existing policies.

What does a claims processor do?

A Claims Processor is responsible for reviewing, evaluating, and processing insurance claims submitted by policyholders. They verify the accuracy of the information provided, ensure all required documentation is present, and determine if the claim meets the policy's terms and conditions. Claims Processors work with both customers and insurance adjusters to resolve any discrepancies and help facilitate timely payments. Their role is essential in ensuring that claims are handled efficiently and fairly.

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

To thrive as a Claims Processor, you need strong analytical abilities, attention to detail, and knowledge of insurance policies, typically supported by a high school diploma or associate degree. Familiarity with claims management software, data entry systems, and sometimes industry certifications like AIC (Associate in Claims) is valuable. Excellent organization, communication, and customer service skills help you efficiently resolve claims and interact with clients. These competencies ensure accuracy, minimize errors, and maintain trust in the claims process.

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

Claims Processors often encounter challenges such as managing high volumes of claims, handling complex or incomplete documentation, and meeting strict accuracy and timeliness standards. To navigate these, strong organizational skills, effective communication with colleagues and claimants, and attention to detail are crucial. Utilizing workflow management tools and maintaining open channels with supervisors and other departments can help address issues quickly and ensure claims are processed efficiently. Regular training and staying updated on policy changes also support success in this role.

What is the difference between Claims Processor vs Claims Examiner?

AspectClaims ProcessorClaims Examiner
Required CredentialsHigh school diploma or equivalent; some roles may require certificationHigh school diploma; certification often preferred
Work EnvironmentOffice setting, processing claims efficientlyOffice setting, reviewing and approving claims
Employer & Industry UsageInsurance companies, healthcare providersInsurance companies, government agencies
Common Search & ComparisonClaims Processor vs Claims Examiner

Claims Processors primarily handle the data entry and initial processing of insurance claims, focusing on accuracy and efficiency. Claims Examiners review claims for validity, compliance, and coverage before approval. While both roles work within the insurance industry and require similar credentials, Claims Examiners typically perform more detailed reviews and decision-making tasks. Understanding these differences helps job seekers identify the right role based on their skills and career goals.

Do you need a degree to be a claims processor?

A degree is not typically required to become a claims processor, as most employers prioritize relevant skills such as attention to detail, communication, and familiarity with claims processing software. Many positions accept candidates with a high school diploma or equivalent, and on-the-job training is often provided. Certifications in claims or insurance can enhance job prospects but are not mandatory.

Is claims processing a stressful job?

Claims processing is often considered a routine administrative role that requires attention to detail and organizational skills. While it can involve handling high volumes of claims and meeting deadlines, stress levels vary depending on workload, workplace environment, and individual resilience. Proper training and time management can help mitigate stress in this job.
More about Claims Processor jobs

What are popular job titles related to Claims Processor jobs in Rancho Cordova, CA?

For Claims Processor jobs in Rancho Cordova, CA, the most frequently searched job titles are:

What cities near Rancho Cordova, CA are hiring for Claims Processor jobs?

Cities near Rancho Cordova, CA with the most Claims Processor job openings:

Claims Processor jobs near you
Infographic showing various Claims Processor job openings in Rancho Cordova, CA as of August 2026, with employment types broken down into 1% Internship, 83% Full Time, 14% Part Time, and 2% Contract. Highlights an 78% Physical, 5% Hybrid, and 17% Remote job distribution, with an average salary of $42,525 per year, or $20.4 per hour.

Claims Examiner II

Partnership HealthPlan of California

Auburn, CA • On-site

Full-time

Re-posted 10 days ago

Key responsibilities

  • Reviews, researches, and resolves pended claims for Medi-Cal claim types within established standards.

  • Routes claims to appropriate departments and follows up to complete processing.

  • Generates claims correspondence and records daily production statistics.

Job description

Overview

To review, research, and resolve claims for all Medi-Cal claim types within established production and quality standards, including manual processing. Completes and processes claims and claims worksheets. Creates appropriate documentation that reflects the actions taken and status of the claim. Generates provider communication, such as letters, as necessary. Routes and tracks claims requiring review by other staff and departments, and processes when possible. Claims Examiner II is distinguished from Claims Examiner I by a higher level of autonomy and experience, as well as an ability to process a wider range of claim types.

Responsibilities
  • Reviews, researches, and resolves pended claims for Medi-Cal types: medical, ancillary, long term care, CHDP, encounter data, other coverage, and batch claims within established production and quality standards. Completes claims from the Batch Error Report and Batch Pass Report.
  • Routes claims to appropriate Partnership departments and internal staff for additional review. Follows up and completes claims once response to request has been received.
  • Follows established Partnership policies and procedures, Partnership Claims Operating Instruction Memorandums, State of California Medi-Cal Provider Manual guidelines, Title 22 regulations, and CMS guidelines when resolving pended claims.
  • Generates claims correspondence as needed.
  • Records daily production statistics and related activities on appropriate reports. Turns in all logs and reports to the Medi-Cal Claims Supervisor.
  • Reviews all work audits in a timely manner and submits any adjustments and corrections within the allotted time frame.
  • Supports Claims Department's needs for resolving all pended claim types.
  • Participates in special projects and assignments as required.
  • Identifies and reports trends of pending claims that are increasing or processes that appear dated.
  • Recognizes and gives feedback to management on procedure changes that would result in more efficient operations.
  • Other duties as assigned.
Qualifications

Education and Experience

High school diploma or equivalent; minimum one (1) year in Medi-Cal billing and/or claims examining experience in an automated environment.

 

Special Skills, Licenses and Certifications

Effective written and oral communication skills. Good organization skills. Knowledge of claims processing and/or Medi-Cal billing, CPT, and ICD-10 knowledge preferred.

 

 

Performance Based Competencies

Ability to effectively exercise good judgement within scope of authority and handle sensitive issues with tact and diplomacy. Ability to stay focused on repetitive work and meet production and quality standards. Ability to accurately complete tasks within established timelines. Consistently meets production standards without compromising quality on all tasks.

Work Environment And Physical Demands

Ability to use a microcomputer keyboard. More than 95% of work time is spent in front of a computer monitor. When required, ability to move, carry, or lift objects of varying size, weighing up to 5 lbs.

All HealthPlan employees are expected to:

  • Provide the highest possible level of service to clients;
  • Promote teamwork and cooperative effort among employees;
  • Maintain safe practices; and
  • Abide by the HealthPlan's policies and procedures, as they may from time to time be updated.

HIRING RANGE:

$ 31.45  - $ 37.74

IMPORTANT DISCLAIMER NOTICE

The job duties, elements, responsibilities, skills, functions, experience, educational factors and the requirements and conditions listed in this job description are representative only and not exhaustive or definitive of the tasks that an employee may be required to perform. The employer reserves the right to revise this job description at any time and to require employees to perform other tasks as circumstances or conditions of its business, competitive considerations, or work environment change.

Employment Type: FULL_TIME

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