ZipRecruiter

Log In

1

Claims Professional Jobs in Riverside, CA (NOW HIRING)

Artius Solutions

Senior Claims Specialist

Orange, CA · On-site

$110K - $130K/yr

This role involves full lifecycle claim handling, litigation coordination, case evaluation, and mentoring junior claims professionals. The ideal candidate will bring strong analytical expertise ...

Corvel

Medical Only Claims Specialist

Rancho Cucamonga, CA · Remote

$16.74 - $26.92/hr

Assists other claims professionals with more complex or problematic claims as necessary * Additional duties as assigned KNOWLEDGE & SKILLS: * Excellent customer service skills * Excellent written and ...

Corvel

Medical Only Claims Specialist

Rancho Cucamonga, CA · On-site

$16.74 - $26.92/hr

Assists other claims professionals with more complex or problematic claims as necessary * Additional duties as assigned KNOWLEDGE & SKILLS: * Excellent customer service skills * Excellent written and ...

LSMA Management Inc

Claims Manager

San Bernardino, CA · On-site

$87K - $97K/yr

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 ...

LSMA Management Inc

Claims Manager

San Bernardino, CA · On-site

$87K - $97K/yr

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 ...

LSMA Management Inc

Claims Manager

San Bernardino, CA · On-site

$87K - $97K/yr

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 ...

LSMA Management Inc

Claims Examiner

San Bernardino, CA · On-site

$28.85 - $33.65/hr

... professional customer service with providers and internal stakeholders. · Working knowledge of HIPAA transactions (837/835) and claims-related regulatory requirements including prompt pay and ...

LSMA Management Inc

Claims Examiner

San Bernardino, CA · On-site

$28.85 - $33.65/hr

... professional customer service with providers and internal stakeholders. • Working knowledge of HIPAA transactions (837/835) and claims-related regulatory requirements including prompt pay and ...

LSMA Management Inc

Claims Examiner

San Bernardino, CA · On-site

$28.85 - $33.65/hr

Effective written and verbal communication; professional customer service with providers and internal stakeholders. Working knowledge of HIPAA transactions (837/835) and claims-related regulatory ...

previous pagenext page

Showing results 21-40

All JobsClaims Professional JobsClaims Professional Jobs in Riverside, CA

Claims Professional information

See Riverside, CA salary details

$16

$30

$47

How much do claims professional jobs pay per hour?

As of Sep 5, 2026, the average hourly pay for claims professional in Riverside, CA is $30.67, according to ZipRecruiter salary data. Most workers in this role earn between $23.32 and $36.63 per hour, depending on experience, location, and employer.

What is a claims professional?

Claims Professionals are specialists who handle insurance claims on behalf of insurance companies or policyholders. Their main responsibilities include investigating, evaluating, and settling claims to ensure fair compensation is provided in accordance with the terms of the insurance policy. They often interact with clients, assess damage or loss, and work with other professionals such as adjusters and legal experts to resolve disputes. Claims Professionals play a critical role in ensuring that claims are processed efficiently and accurately, maintaining trust between insurers and their clients.

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

To thrive as a Claims Professional, you need strong analytical skills, attention to detail, and a background in insurance or finance, often supported by a bachelor's degree. Familiarity with claims management systems, industry-specific software such as Guidewire, and relevant certifications like AIC (Associate in Claims) is highly valuable. Excellent communication, negotiation, and problem-solving abilities help you effectively interact with clients and resolve disputes. These skills are essential for accurately assessing claims, minimizing risk, and ensuring customer satisfaction throughout the claims process.

What are some common challenges faced by claims professionals, and how can they be addressed on the job?

Claims Professionals often encounter challenges such as managing a high volume of cases, navigating complex policy details, and communicating effectively with clients who may be experiencing stress. To address these challenges, it is important to stay organized, leverage claims management software, and develop strong interpersonal skills. Regular training on policy updates and clear communication with both clients and colleagues can also help ensure efficient and fair claims resolution.

What is the difference between Claims Professional vs Claims Adjuster?

AspectClaims ProfessionalClaims Adjuster
CredentialsCertifications like CPCU, ARM, or state licensing often preferredSimilar certifications, often required or preferred
Work EnvironmentOffice-based, administrative, and customer service rolesField or desk-based, investigating and evaluating claims
Employer & Industry UsageInsurance companies, third-party administratorsInsurance companies, independent adjusting firms

Claims Professionals and Claims Adjusters both work within the insurance industry, often sharing similar certifications and work environments. However, Claims Professionals typically focus on administrative tasks, policy management, and customer service, while Claims Adjusters are more involved in investigating and evaluating claims, often in the field. Understanding these differences helps job seekers target the right roles within the insurance sector.

What are the most commonly searched types of Claims jobs in Riverside, CA?

The most popular types of Claims jobs in Riverside, CA are:

What are popular job titles related to Claims Professional jobs in Riverside, CA?

For Claims Professional jobs in Riverside, CA, the most frequently searched job titles are:

What job categories do people searching Claims Professional jobs in Riverside, CA look for?

The top searched job categories for Claims Professional jobs in Riverside, CA are:

What cities near Riverside, CA are hiring for Claims Professional jobs?

Cities near Riverside, CA with the most Claims Professional job openings:

Claims Professional jobs near you
Infographic showing various Claims Professional job openings in Riverside, CA as of August 2026, with employment types broken down into 1% As Needed, 72% Full Time, 21% Part Time, and 6% Contract. Highlights an 92% Physical, 2% Hybrid, and 6% Remote job distribution, with an average salary of $63,802 per year, or $30.7 per hour.

Senior Claims Specialist

Artius Solutions

Orange, CA • On-site

$110K - $130K/yr

Full-time

Re-posted 14 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

.