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Claims Professional Jobs in Riverside, CA (NOW HIRING)

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 ...

Medical Only Claims Specialist

Rancho Cucamonga, CA · Remote

$16.74 - $26.92/hr

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

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 ...

Medical Only Claims Specialist

Rancho Cucamonga, CA · On-site

$16.74 - $26.92/hr

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

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 ...

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 ...

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 ...

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 ...

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

Showing results 21-40

Claims Professional information

See Riverside, CA salary details

$16

$30

$47

How much do claims professional jobs pay per hour?

As of Aug 12, 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 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 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 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 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:
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.

Claims Representative (IAP) - Workers Compensation Training Program - Ontario, CA

York Risk Services

Ontario, CA

$27.69/hr

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Re-posted 3 days ago


Job description

By joining Sedgwick, you'll be part of something truly meaningful. It's what our 33,000 colleagues do every day for people around the world who are facing the unexpected. We invite you to grow your career with us, experience our caring culture, and enjoy work-life balance. Here, there's no limit to what you can achieve.

Newsweek Recognizes Sedgwick as America's Greatest Workplaces National Top Companies

Certified as a Great Place to Work

Fortune Best Workplaces in Financial Services & Insurance

Workers Compensation Claims Representative | Ontario, CA (In-Office)

Are you looking for an impactful job that offers an opportunity to develop a professional career?

  • A stable and consistent work environment in an office setting.
  • A training program to learn how to investigate and resolve complex situations for employees and customers from some of the world's most reputable brands.
  • Career development and promotional growth opportunities through increasing responsibilities.
  • A diverse and comprehensive benefits package to take care of your mental, physical, financial and professional needs including medical, dental, vision & 401k.

PRIMARY PURPOSE OF THE ROLE: To be oriented and trained as a new industry professional. This role begins with a comprehensive 4-week concept-based learning and professional training program, followed by a dedicated onboarding experience before entering the on-the-job phase. You will be assigned a mentor and manager that will support and guide you on your career journey and be equipped with the foundational skills needed for a successful career in claims adjusting. While in the program, you'll have the opportunity to grow and advance within the industry.

Next Class Date: 8/31/26

Location: Ontario, CA - Onsite

ARE YOU AN IDEAL CANDIDATE? We are seeking enthusiastic and service-oriented individuals for an entry-level trainee position who are:

  • Strong Communicators
  • Empathetic
  • Multi-Taskers
  • Accountable
  • Structured Thinkers
  • Ambitious
  • Agile Learners
  • Team Collaborators

ESSENTIAL RESPONSIBLITIES INCLUDE

  • Attendance and completion of designated claims professional training program.
  • Adjusting various levels of workers' compensation claims under close supervision, which includes:
    • Processing and responding to incoming mail, emails and other claim related documents according to status of the claim.
    • Communicating effectively with injured workers, insureds/employers, medical providers, attorneys and carrier representatives, primarily through telephonic, video conference and email.
    • Thoroughly investigating new and existing claims by gathering relevant information including medical records, employer reports, and witness statements. Investigating employer/employee relationships, policy verification, coverage and any potential for subrogation issues or fraud indicators.
    • Determining coverage, compensability and appropriate benefits in accordance with jurisdictional guidelines and carrier program requirements.
    • Documenting claims files and properly coding claim activity. Preparing detailed reports documenting findings and recommendations.
    • Administering claim benefits i.e., indemnity and medical benefits, through maintenance of calendared claim-related action items, ensuring state compliance.
    • Participating in virtual and/or in-person meetings, claim reviews and business functions as needed for educational training, claim discussions and various meetings.

QUALIFICATIONS

Education Requirement - High School Diploma or GED.

  • Bachelor's degree preferred and 2 years of customer service experience and/or combination of education and experience.

WORK ENVIRONMENT REQUIREMENTSINCLUDE

When applicable and appropriate, consideration will be given to reasonable accommodations.

Mental:Clear and conceptual thinking ability; excellent judgment, troubleshooting, problem solving, analysis, and discretion; ability to handle work-related stress; ability to handle multiple priorities simultaneously; and ability to meet deadlines

Physical:Computer keyboarding

Auditory/Visual: Hearing, vision and talking

As required by law, Sedgwick provides a reasonable range of compensation for roles that may be hired in jurisdictions requiring pay transparency in job postings. Actual compensation is influenced by a wide range of factors including but not limited to skill set, level of experience, and cost of specific location. For the jurisdiction noted in this job posting only, the range of starting pay for this role is $27.69/hr. A comprehensive benefits package is offered including but not limited to, medical, dental, vision, 401k and matching, PTO, disability and life insurance, employee assistance, flexible spending or health savings account, and other additional voluntary benefits. #claims #entrylevel

Qualified applicants with arrest or conviction records will be considered for employment in accordance with the Los Angeles County Fair Chance Ordinance for Employers, the City of Los Angeles' Fair Chance Initiative for Hiring Ordinance, the San Diego Fair Chance Ordinance, the San Francisco Fair Chance Ordinance, the California Fair Chance Act, and all other applicable laws.

Sedgwickis an Equal Opportunity Employer and a Drug-Free Workplace.

If you're excited about this role but your experience doesn't align perfectly with every qualification in the job description, consider applying for it anyway! Sedgwick is building a diverse, equitable, and inclusive workplace and recognizes that each person possesses a unique combination of skills, knowledge, and experience. You may be just the right candidate for this or other roles.