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Ethos Risk Jobs in California (NOW HIRING)

Ethos Risk Services

Bill Review Specialist

CA · On-site

$22 - $28/hr

Ethos Risk Services is a leading provider of workers' compensation medical management, investigations, and claims solutions, dedicated to helping clients make better decisions through industry ...

Ethos Risk Services

Entry-Level Investigator

Riverside, CA

$48K - $59K/yr

Ethos Risk Services is a leading insurance claims investigation and medical management company, specializing in surveillance and fraud detection. At the forefront of, we provide accurate data and ...

Ethos Risk Services

Bill Review Specialist

Lake Forest, CA · On-site +1

$20.25 - $28/hr

Ethos Risk Services is a leading provider of workers' compensation medical management, investigations, and claims solutions, dedicated to helping clients make better decisions through industry ...

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How much do ethos risk jobs pay per hour?

As of Aug 22, 2026, the average hourly pay for ethos risk in California is $29.94, according to ZipRecruiter salary data. Most workers in this role earn between $19.23 and $38.17 per hour, depending on experience, location, and employer.

What is Ethos Risk?

Ethos Risk is a company that specializes in risk management, investigations, and surveillance services. They primarily serve insurance companies, employers, law firms, and other organizations by helping to detect and prevent fraud, conduct background checks, and perform due diligence investigations. Their team often includes field investigators who gather evidence, conduct interviews, and provide comprehensive reports to clients. Ethos Risk aims to deliver objective, reliable information to help their clients make informed decisions and reduce potential losses.

What are the key skills and qualifications needed to thrive as an insurance investigator at Ethos Risk?

To excel as an Insurance Investigator at Ethos Risk, you need strong analytical abilities, attention to detail, and experience in investigative techniques, often backed by a relevant degree or prior law enforcement background. Proficiency with surveillance equipment, case management software, and digital research tools is commonly required. Exceptional communication, discretion, and critical thinking skills help investigators conduct interviews and write clear, objective reports. These skills ensure thorough and ethical investigations that protect clients from fraud and uphold industry standards.

What are some common challenges faced by investigators at Ethos Risk and how are they supported in overcoming them?

Investigators at Ethos Risk often encounter challenges such as gathering reliable evidence in unpredictable environments, managing tight deadlines, and maintaining confidentiality in sensitive cases. To help overcome these obstacles, Ethos Risk provides comprehensive training, access to advanced surveillance technology, and ongoing support from experienced team leads. Collaboration with colleagues and regular case debriefings also help investigators share insights and best practices, fostering a supportive and solution-oriented work environment.

What is the difference between Ethos Risk vs Security Guard?

AspectEthos RiskSecurity Guard
CredentialsVaries; often requires security training or licensesSecurity license or certification often required
Work EnvironmentRisk assessment, investigations, consultingPatrols, access control, surveillance
Employer & IndustryPrivate security firms, corporate clientsSecurity companies, private or public facilities

Ethos Risk focuses on risk management, investigations, and consulting services, often requiring specialized training. Security Guards primarily provide physical security, patrols, and access control. While both roles serve security purposes, Ethos Risk offers a broader scope in risk assessment and investigative services, whereas Security Guards focus on on-site physical security.

What are popular job titles related to Ethos Risk jobs in California?

For Ethos Risk jobs in California, the most frequently searched job titles are:

What job categories do people searching Ethos Risk jobs in California look for?

The top searched job categories for Ethos Risk jobs in California are:

What cities in California are hiring for Ethos Risk jobs?

Cities in California with the most Ethos Risk job openings:

Ethos Risk jobs near you
Infographic showing various Ethos Risk job openings in California as of August 2026, with employment types broken down into 1% As Needed, 91% Full Time, 6% Part Time, and 2% Contract. Highlights an 87% Physical, 5% Hybrid, and 8% Remote job distribution, with an average salary of $62,273 per year, or $29.9 per hour.

Bill Review Specialist

Ethos Risk Services

CA • On-site

$22 - $28/hr

Full-time

Re-posted 21 days ago

Job description

ABOUT US:
Ethos Risk Services is a leading provider of workers' compensation medical management, investigations, and claims solutions, dedicated to helping clients make better decisions through industry expertise, innovation, and exceptional service. As we continue to grow, we're expanding our cost containment capabilities through Definiti, a national leader in medical bill review, pharmacy benefit management, PPO network solutions, and reimbursement services. Together, we're building a comprehensive suite of solutions that helps clients reduce costs, improve efficiency, and achieve better claim outcomes.
JOB SUMMARY:
Our dynamic Bill Review team is seeking a full-time Bill Review Specialist (REMOTE) to review, audit, and process workers' compensation medical bills while ensuring compliance with state fee schedules, regulatory requirements, and client-specific guidelines. The ideal candidate is analytical, organized, and committed to delivering accurate, high-quality work in a fast-paced environment.
KEY RESPONSIBILITIES:
  • Analyze Medical Bills - Review and adjudicate hospital, ambulatory surgery center (ASC), durable medical equipment (DME), pharmacy, transportation, home health, and other specialty medical bills for reimbursement accuracy and compliance.
  • Research Provider Appeals - Investigate provider appeals, reconsiderations, and billing disputes by interpreting applicable fee schedules, reimbursement methodologies, regulations, and client guidelines.
  • Prepare Reimbursement Determinations - Draft clear, professional written correspondence explaining payment decisions and reimbursement methodologies to providers.
  • Communicate with Providers - Respond to provider inquiries via phone and written correspondence regarding reimbursement decisions, payment methodologies, and billing questions.
  • Support Cross-Functional Teams - Partner with the Account Management team and other internal stakeholders to resolve billing issues, answer client questions, and support operational objectives.

QUALIFICATIONS:
Education: High school diploma or equivalent (required). Associate's degree or higher is preferred.
Experience:
  • Minimum of 3 to 5 years of workers' compensation bill review experience, reviewing and adjudicating medical bills using state fee schedules, PPO contracts, reimbursement methodologies, client guidelines, and applicable workers' compensation regulations. (required).
  • Knowledge of CPT, ICD-10, HCPCS (required).
  • Experience using Conduent Strataware software (preferred).
  • Experience in billing accuracy, reimbursement eligibility, code relationships, bundled services, modifier usage, and reimbursement calculations while applying regulatory and client-specific guidelines (required).
  • Experience applying multi-state workers' compensation fee schedules, reimbursement methodologies, payment policies, and jurisdiction-specific regulations (preferred).
  • Experience researching complex reimbursement issues, fee schedules, and regulatory guidance to support accurate and defensible payment determinations (preferred).
  • Experience managing provider appeals, reconsiderations, and billing disputes, including communicating reimbursement methodologies and payment decisions (preferred).
  • Experience reviewing complex medical bills, including hospital, ASC, DME, transportation, home health, dental, and other specialty bill types involving advanced reimbursement analysis (preferred).

WORKING CONDITIONS:
This position offers flexible work arrangements, including remote, hybrid or full on-site options. If your preference is hybrid or remote, our office is located at 26445 Rancho Parkway Street, Lake Forest, CA 92630.
Flexible start times are available between 6:00 a.m. and 9:00 a.m., with eligibility for a 9/80 alternate work schedule (every other Monday or Friday off) following successful completion of training, satisfactory performance, business needs, and management approval.
Ethos Risk Services and Definiti Comp Solutions is an equal opportunity employer that does not discriminate on the basis of religious creed, sex, national origin, race, veteran status, disability, age, marital status, color or sexual orientation or any other characteristic.

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