ZipRecruiter

Log In

1

Insurance Claim Review Jobs in California (NOW HIRING)

Trucordia

Claims Specialist, Workers Compensation

Fresno, CA · On-site +1

$23 - $31.75/hr

Ensure quarterly claim reviews are conducted (In-person or teams meeting as appropriate), assist in ... Life Insurance and AD&D * FSA / HSA * Accident * Critical Illness * Hospital Indemnity

well-known hospital system

Be Seen First

Epic Billing Specialist

Sacramento, CA · On-site

$30 - $32/hr

Responding to insurance claim rejections by pulling clinical documentation, fixing billing codes, and resubmitting claims to ensure timely payment. [1] * Charge Review and Auditing: Monitoring ...

Allied Universal

SIU Investigator

Fresno, CA · On-site

$30 - $38/hr

... insurance claim investigation. As a global leader, we provide dynamic opportunities for claim ... Create and maintain detailed documentation for investigations, file reviews, audits, training tasks ...

Allied Universal

SIU Investigator

Fresno, CA · On-site

$30 - $38/hr

... insurance claim investigation. As a global leader, we provide dynamic opportunities for claim ... Create and maintain detailed documentation for investigations, file reviews, audits, training tasks ...

Allied Universal

SIU Investigator

Los Angeles, CA

$30 - $38/hr

... insurance claim investigation. As a global leader, we provide dynamic opportunities for claim ... Create and maintain detailed documentation for investigations, file reviews, audits, training tasks ...

United Westlabs

Account Analyst

Santa Ana, CA · On-site

$26 - $33/hr

... claim issues, recovering outstanding accounts receivable, researching denials, pursuing appeals ... Review and resolve insurance denials and rejections. * Conduct payer research and follow-up ...

Allied Universal

SIU Investigator

Fresno, CA · On-site

$30 - $38/hr

... insurance claim investigation. As a global leader, we provide dynamic opportunities for claim ... Create and maintain detailed documentation for investigations, file reviews, audits, training tasks ...

Allied Universal

SIU Investigator

Los Angeles, CA · On-site

$30 - $38/hr

... insurance claim investigation. As a global leader, we provide dynamic opportunities for claim ... Create and maintain detailed documentation for investigations, file reviews, audits, training tasks ...

previous pagenext page

Showing results 21-40

All JobsInsurance Claim Review JobsInsurance Claim Review Jobs in California

Insurance Claim Review information

See California salary details

$12

$23

$42

How much do insurance claim review jobs pay per hour?

As of Aug 8, 2026, the average hourly pay for insurance claim review in California is $23.19, according to ZipRecruiter salary data. Most workers in this role earn between $17.31 and $25.38 per hour, depending on experience, location, and employer.

What is the difference between Insurance Claim Review vs Insurance Adjuster?

AspectInsurance Claim ReviewInsurance Adjuster
CredentialsTypically requires insurance or claims processing certificationsRequires licensing and adjuster certifications
Work EnvironmentOffice-based, reviewing claims remotely or on-siteFieldwork, inspecting damages, meeting clients
Employer & Industry UsageInsurance companies, third-party claims servicesInsurance companies, independent adjusting firms
Search & Comparison IntentUnderstanding claim review roles, job dutiesAssessing damage, settling claims

Insurance Claim Review professionals focus on evaluating and verifying insurance claims, often working in an office setting. Insurance Adjusters, on the other hand, inspect damages firsthand and negotiate settlements. Both roles require insurance-related certifications but differ in work environment and responsibilities.

What are the key skills and qualifications needed to thrive as an insurance claim review specialist?

To thrive as an Insurance Claim Review Specialist, you typically need a strong understanding of insurance policies, claims processes, and relevant regulations, often backed by a degree in business, finance, or a related field. Familiarity with claims management software, document management systems, and sometimes certifications such as AIC (Associate in Claims) are commonly required. Attention to detail, analytical thinking, and effective communication are critical soft skills for evaluating claims and interacting with policyholders. These skills ensure accurate, timely, and fair claim resolutions that uphold company standards and customer satisfaction.

What is insurance claim review?

Insurance claim review is the process by which insurance companies evaluate claims submitted by policyholders to determine their validity and the extent of coverage. Claims reviewers carefully examine documentation, such as medical records, police reports, or repair estimates, to ensure all policy requirements are met. This process helps prevent fraud, ensures claims are paid accurately, and maintains the integrity of the insurance system. Claim reviewers may also communicate with claimants, request additional information, or work with other professionals to make informed decisions.

What are some common challenges faced in an insurance claim review role, and how can they be managed effectively?

One of the most common challenges in Insurance Claim Review is managing a high volume of claims while maintaining accuracy and compliance with regulatory standards. Claims can often be complex, requiring careful analysis of policy terms, medical or incident documentation, and communications with policyholders or third parties. Effective time management, attention to detail, and strong communication skills are essential. Collaborating closely with other departments, such as underwriting and legal, can also help resolve ambiguous cases more efficiently. Ongoing training and keeping up with changes in industry regulations further support success in this role.
What are popular job titles related to Insurance Claim Review jobs in California? For Insurance Claim Review jobs in California, the most frequently searched job titles are:
What job categories do people searching Insurance Claim Review jobs in California look for? The top searched job categories for Insurance Claim Review jobs in California are:
What cities in California are hiring for Insurance Claim Review jobs? Cities in California with the most Insurance Claim Review job openings:
Insurance Claim Review jobs near you
Infographic showing various Insurance Claim Review job openings in California as of August 2026, with employment types broken down into 1% As Needed, 65% Full Time, 28% Part Time, 2% Temporary, and 4% Contract. Highlights an 91% Physical, 1% Hybrid, and 8% Remote job distribution, with an average salary of $48,245 per year, or $23.2 per hour.

Claims Specialist, Workers Compensation

Trucordia

Fresno, CA • On-site, Remote

$23 - $31.75/hr

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Posted 9 days ago

Job description

Company Description
Extraordinary opportunity. Exceptional experience.
Sometimes in life, you find yourself in the right place, at the right time, looking at an opportunity so extraordinary it cannot be ignored. At Trucordia, our company is built on wildly successful businesses in our communities across the country, and now we've come together to create the next great insurance brokerage. We offer an unrivaled combination of people, tools and solutions, and deliver exceptional experiences and opportunities for our employees, clients and stakeholders.
We celebrate both individual successes and collective accomplishments, making sure the industry recognizes the remarkable company we're building together, as well as the impact we're having on our clients and communities. Ranked as one of the fastest-growing companies in the U.S. for three consecutive years, we have more than 5,000 team members across 200 offices across the country, who actively, genuinely care about our clients, each other and the quality of our work, and in every interaction, represent a company that people want to work for and do business with.
Trucordia Values
  1. We actively, genuinely CARE about our clients, each other and the quality of our work, and in every interaction, represent a company that people want to work for and do business with.
  2. We COLLABORATE continuously because, together, we are more powerful and make amazing things happen for our clients and company.
  3. We LEAD with intelligence, hunger, curiosity, energy and a future-focused attitude of "what's next"?
  4. We are RESULT-ORIENTED, growth-focused and driven to out-perform expectations of what an insurance brokerage can achieve.
  5. We CELEBRATE both individual successes and collective accomplishments, making sure the industry recognizes the remarkable company we're building together, as well as the impact we're having on our clients and communities.

Job Description
As the Workers' Compensation Claims Advocate's at Trucordia you will serve as a strategic advisor and liaison between clients, insurance carriers, and third-party administrators (TPAs). This role ensures that claims are managed effectively, supports clients in navigating complex claim processes, and promotes best practices in workers' compensation programs.
Duties and Responsibilities:
  • Act as the primary point of contact for clients regarding workers' compensation claims. Advocate for aggressive investigation of questionable claims and use of sub-rosa surveillance when appropriate.
  • Monitor open claims to ensure timely and appropriate handling by Carriers/TPAs. Provide guidance on claim strategy and resolution options. Identify opportunities for claim closure, cost containment, and fraud prevention.
  • Assist clients in understanding claim status, medical treatment plans, and return-to-work strategies. Educate clients on the use of Medical Provider Networks (MPNs) and help identify quality care providers.
  • Work with clients and Carriers/TPAs to establish and enforce claims handling protocols.
  • Evaluate Carriers/TPA's bill review and utilization review programs.
  • Ensure quarterly claim reviews are conducted (In-person or teams meeting as appropriate), assist in preparing claim summaries, and presentations for client meetings. Ensure that a quarterly claim review is conducted close to unit stat filing date.
  • Complete WC Claim Call Reports that are professional in appearance and consistent in accordance with established standards and provide copies to Producers to support client discussions.
  • Review and analyze loss runs, claim trends, and reserve accuracy.
  • Prepare projected experience mods ratings and using the established format to explain increase or decrease.
  • Stay current on legislative changes and industry trends affecting workers' compensation. To ensure claims are managed in accordance with state regulations.
  • Assist Trucordia Account Managers in obtaining experience rating worksheets and responding to WC claim questions.
  • Provide training and resources to clients on workers' compensation procedures and process, including the interactive process when returning an employee to work with permanent work restrictions.
  • Collaborate with Producers and Account Managers to support client retention and new business development.

Qualifications
  • Bachelor's Degree or higher is desired but not required if appropriate work experience is present
  • 7-10+ years CA workers' compensation claims handling or consulting - required
  • SIP certificate required
  • Strong understanding of CA WCAB processes, reserves, litigation strategy - required
  • Ability to interpret loss runs, mod worksheets, and actuarial data
  • Excellent communication skills - both written and oral
  • Proficiency with Excel, Word, and RMIS platforms
  • The ability to be a team player and proactively support others

Additional Information
Please see our company Benefits:
  • Medical, Dental, Vision
  • Life Insurance and AD&D
  • FSA / HSA
  • Accident
  • Critical Illness
  • Hospital Indemnity
  • Supplemental Health Insurance
  • EAP
  • Pet Insurance
  • 11 Paid Holidays
  • Flexible PTO
  • 401K

Trucordia Insurance Services, LLC and its affiliates (collectively, the "Company") is aware of scams involving false offers of employment with the Company. The false offers use fake websites, email addresses, group chats and text messages. The Company does not (a) interview prospective candidates via instant message or group chat; (b) request banking or credit card information during the interview process; or (c) require candidates to purchase products or services or process payments on its behalf as a condition of any employment offer.
Trucordia is an equal opportunity employer. We believe that every employee has the right to work in an environment that is free from all forms of discrimination. It is our policy that all decisions involving any aspect of the employment relationship such as hiring, compensation and training, promotions, transfers, discipline, and termination will be based on merit, qualifications, and abilities. Such decisions will be made without regard to age, ancestry, color, race, national origin, disability, protected medical condition, genetic information, military service, veteran status, citizenship status, religion, creed, sex, gender, gender identity, sexual orientation, pregnancy, childbirth, marital status, or any other condition, characteristic or activity protected by law. Discrimination based on any of these factors is contrary to our operating philosophy. Attention Recruitment Agencies: Trucordia does not accept unsolicited resumes from any agencies that have not signed a mutual service agreement. All unsolicited resumes will be considered property of Trucordia, and we will not be obligated to pay a referral fee. This includes resumes submitted directly to hiring managers without contacting Trucordia's Talent Acquisition Department.

Apply