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Insurance Claims Processor Jobs in California (NOW HIRING)

Orchard Hospital

Insurance Biller

Gridley, CA · On-site

The Insurance Biller is responsible for billing (UB04 and 1500 forms), follow-up and accounts ... claims with problems and making sure that they get processed. This includes analyzing ...

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All JobsInsurance Claims Processor JobsInsurance Claims Processor Jobs in California

Insurance Claims Processor information

See California salary details

$11

$22

$33

How much do insurance claims processor jobs pay per hour?

As of Sep 3, 2026, the average hourly pay for insurance claims processor in California is $22.04, according to ZipRecruiter salary data. Most workers in this role earn between $18.03 and $25.14 per hour, depending on experience, location, and employer.

What does an insurance claims processor do?

An Insurance Claims Processor reviews and handles insurance claims submitted by policyholders. Their primary responsibilities include verifying information, ensuring all necessary documentation is provided, and assessing claims for accuracy and compliance with policy guidelines. They communicate with policyholders, adjusters, and healthcare providers to gather additional information if needed, and determine how much the insurance company should pay out. The role is essential for ensuring claims are processed efficiently and fairly, maintaining customer satisfaction, and preventing fraud.

What are the key skills and qualifications needed to thrive as an insurance claims processor, and why are they important?

To thrive as an Insurance Claims Processor, you need strong attention to detail, knowledge of insurance policies and regulations, and typically a high school diploma or equivalent. Familiarity with claims management software, electronic databases, and sometimes certifications like the Associate in Claims (AIC) are common requirements. Excellent organizational skills, clear communication, and problem-solving abilities help you stand out in this role. These skills ensure accurate claim processing, effective customer service, and compliance with industry standards.

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

Insurance Claims Processors often encounter challenges such as managing high volumes of claims, navigating complex policy details, and meeting strict deadlines. Staying organized and detail-oriented is key to ensuring accuracy and timely processing. Effective communication with policyholders, adjusters, and other team members also helps resolve discrepancies quickly and improves overall workflow. Many employers provide ongoing training and support to help processors stay current on regulations and best practices, which can further ease these challenges.

What is the difference between Insurance Claims Processor vs Insurance Claims Adjuster?

AspectInsurance Claims ProcessorInsurance Claims Adjuster
CredentialsTypically requires a high school diploma or equivalent; certifications like CPCU or AIC are a plusRequires a high school diploma; often holds certifications such as AIC or CPCU
Work EnvironmentOffice setting, processing claims dataField and office work, investigating claims
Employer & IndustryInsurance companies, third-party administratorsInsurance companies, independent adjusting firms
Primary FocusProcessing and data entry of claimsInvestigating, evaluating, and settling claims

While both roles are essential in the insurance industry, Claims Processors focus on handling claim data and documentation, whereas Claims Adjusters investigate and determine claim validity and settlement amounts. Understanding these differences helps job seekers identify the right career path within insurance claims roles.

How to get a job as an insurance claims processor?

To become an insurance claims processor, candidates typically need a high school diploma or equivalent, with some roles preferring postsecondary education or relevant certifications. Experience with computer software, attention to detail, and strong organizational skills are important, and familiarity with insurance policies and claims processing systems can improve job prospects.

Is an insurance claims processor job in demand?

The demand for insurance claims processors remains steady due to the ongoing need for claims management in the insurance industry. Employment is expected to grow at a rate similar to the average for all occupations, with opportunities increasing as insurance companies seek skilled workers familiar with claims processing software and regulations.

Is claims processing a stressful job?

Claims processing as an insurance claims processor can be stressful due to tight deadlines, high workload, and the need for accuracy in evaluating claims. The role often requires attention to detail, communication skills, and the ability to handle sensitive information, which can contribute to job-related stress levels.

What are popular job titles related to Insurance Claims Processor jobs in California?

For Insurance Claims Processor jobs in California, the most frequently searched job titles are:

What job categories do people searching Insurance Claims Processor jobs in California look for?

The top searched job categories for Insurance Claims Processor jobs in California are:

What are popular job titles related to Insurance Claims Processor jobs in CA?

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

Insurance Claims Processor jobs near you
Infographic showing various Insurance Claims Processor job openings in California as of August 2026, with employment types broken down into 1% As Needed, 73% Full Time, 22% Part Time, and 4% Contract. Highlights an 91% Physical, 1% Hybrid, and 8% Remote job distribution, with an average salary of $45,853 per year, or $22 per hour.

Claims Trainer

Partnership HealthPlan of California

Fairfield, CA • On-site

Full-time

Re-posted 10 days ago

Job description

Overview

Train examiner and customer service level I staff on all related claim types for all Partnership lines of business using AMISYS Advance system and Claims Operating Instruction Memorandums.

Responsibilities
  • Train all levels of staff on all claim types on-site or regional site(s).
  • Train all levels of staff on CIF processing, generating and processing adjustments both on-site and regional site(s)
  • Provide feedback and recommendation to the Claims Audit Supervisor and Associate Director of Claims on staff training needs and system adjustments.
  • Create and maintain training materials
  • Maintain current knowledge of Partnerhsip Claims Policy and Procedures for all lines of business, Medi-Cal Provider Manual, Title 22 regulations, Knox Keene regulations, and CMS Medicare regulations.
  • Draft Claims Operating Instruction documentation for the Claims Director as assigned.

SECONDARY DUTIES AND RESPONSIBILITIES

  • Assist with system testing as needed.
  • Other duties as assigned.
Qualifications

Education and Experience

Minimum two (2) years of claims examining experience and completion of Partnership Claims training; or equivalent combination of education the experience.

 

 

Special Skills, Licenses and Certifications

Familiar with Medi0Cal and/or managed care claims processing. Knowledge of CPT, HCPC procedure coding, and ICD -9/ICD10 diagnostic coding. Typing speed 30 wpm and proficient use of 10-key calculator. Familiar with AMISYS or similar claims systems. Understanding of claims examining requirements. Valid California driver's license and proof of current automobile insurance compliant with Partnerrship policy are required to operate a vehicle and travel for company business.

 

Performance Based Competencies

Excellent oral and written communication skills. Ability to effectively exercise good judgment within scope of authority and handle sensitive issues with tact and diplomacy. Ability to work on multiple tasks within established time frames and sometimes conflicting priorities. Good organizational skills with ability to maintain accurate records and documentation of actions and decisions.

Work Environment And Physical Demands

Ability to use a computer keyboard. More than 60% of work time is spent in front of a computer monitor. When required, ability to move, carry or list 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:

$ 33.65 - $ 40.38

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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