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Medical Claims Jobs in Riverside, CA (NOW HIRING)

Corvel

Medical Only Claims Specialist

Rancho Cucamonga, CA · Remote

$16.74 - $26.92/hr

The Workers' Compensation Medical Only Claims Specialist manages non-complex and non-problematic, medical only claims under close supervision, supporting the goals of the Claims Department and of ...

Corvel

Medical Only Claims Specialist

Rancho Cucamonga, CA · On-site

$16.74 - $26.92/hr

The Workers' Compensation Medical Only Claims Specialist manages non-complex and non-problematic, medical only claims under close supervision, supporting the goals of the Claims Department and of ...

LSMA Management Inc

Claims Examiner

San Bernardino, CA

$28.85 - $33.65/hr

Description JOB SUMMARY The Claims Examiner is responsible for reviewing, analyzing, and adjudicating medical claims for a management services organization (MSO) supporting medical clinics and ...

LSMA Management Inc

Claims Examiner

San Bernardino, CA · On-site

$28.85 - $33.65/hr

JOB SUMMARY The Claims Examiner is responsible for reviewing, analyzing, and adjudicating medical claims for a management services organization (MSO) supporting medical clinics and Independent ...

LSMA Management Inc

Claims Examiner

San Bernardino, CA · On-site

$28.85 - $33.65/hr

This role applies plan and contract rules, reimbursement methodologies, and medical billing/coding guidelines to ensure claims are processed accurately, timely, and in compliance with federal and ...

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All JobsMedical Claims JobsMedical Claims Jobs in Riverside, CA

Medical Claims information

See Riverside, CA salary details

$5

$17

$19

How much do medical claims jobs pay per hour?

As of Aug 17, 2026, the average hourly pay for medical claims in Riverside, CA is $17.55, according to ZipRecruiter salary data. Most workers in this role earn between $16.06 and $19.04 per hour, depending on experience, location, and employer.

What are medical claims?

Medical claims are formal requests submitted by healthcare providers or patients to insurance companies, asking for payment for medical services rendered. These claims contain detailed information about the patient, the services provided, dates of service, and relevant medical codes. Insurance companies review the claims to determine coverage and reimburse providers or patients accordingly. Accurate and timely submission of medical claims is crucial to ensure proper payment and avoid delays or denials.

How to become a medical claims examiner?

To become a medical claims examiner, candidates typically need a high school diploma or equivalent, with some roles requiring postsecondary education or certification in health insurance or medical billing. Relevant skills include attention to detail, knowledge of medical terminology, and familiarity with claims processing software; certifications such as the Certified Medical Claims Examiner (CMCE) can enhance job prospects.

What are the key skills and qualifications needed to thrive as a medical claims specialist?

To thrive as a Medical Claims Specialist, you need knowledge of medical terminology, insurance policies, and claims processing, typically supported by a high school diploma or relevant certification. Familiarity with claims management software, electronic health records (EHRs), and billing systems such as ICD-10 and CPT coding is essential. Attention to detail, strong organizational skills, and effective communication help ensure accuracy and resolve claim discrepancies. These skills are crucial for ensuring timely and accurate claims processing, minimizing errors, and maintaining compliance with healthcare regulations.

What are some common challenges faced in a medical claims role, and how can they be effectively managed?

Medical claims professionals often encounter challenges such as handling denied or complex claims, navigating frequent regulatory changes, and communicating with both patients and insurance providers. Staying updated with the latest healthcare regulations and payer requirements is essential to minimize claim rejections. Effective time management, attention to detail, and strong communication skills help resolve issues quickly and ensure accurate processing. Collaborating closely with billing teams and healthcare providers also aids in addressing discrepancies and expediting claim approvals.

What is the difference between Medical Claims vs Medical Billing Specialist?

AspectMedical ClaimsMedical Billing Specialist
CredentialsTypically requires knowledge of insurance policies and coding; certifications like CPC or CCS are commonRequires similar certifications; focuses on billing processes and insurance claims
Work EnvironmentHealthcare facilities, insurance companies, billing companiesMedical offices, hospitals, billing companies
Job FocusSubmitting and managing insurance claims for reimbursementPreparing and sending bills to patients and insurers, managing accounts

Medical Claims specialists primarily handle the submission and management of insurance claims to ensure healthcare providers receive payment. Medical Billing Specialists focus on creating and sending bills to patients and insurance companies, managing payments, and maintaining billing records. While both roles require knowledge of insurance processes and coding, Medical Claims roles are more centered on claims submission and follow-up, whereas Medical Billing Specialists handle the overall billing process and patient invoicing.

Is medical claims processing a stressful job?

Medical claims processing can be stressful due to tight deadlines, high accuracy requirements, and the need to handle complex or disputed claims. The job often involves detailed data entry, familiarity with insurance policies, and sometimes dealing with frustrated clients, which can contribute to stress levels. However, workload and stress vary depending on the employer and individual workload management skills.

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

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

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

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

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

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

Medical Claims jobs near you
Infographic showing various Medical Claims job openings in Riverside, CA as of August 2026, with employment types broken down into 1% As Needed, 76% Full Time, 16% Part Time, and 7% Contract. Highlights an 95% Physical, 1% Hybrid, and 4% Remote job distribution, with an average salary of $36,514 per year, or $17.6 per hour.

Medical Only Claims Specialist

CorVel Enterprise Claims, Inc.

Rancho Cucamonga, CA • Remote

$16.74 - $26.92/hr

Full-time

Posted 11 days ago

Job description

The Workers’ Compensation Medical Only Claims Specialist manages non-complex and non-problematic, medical only claims under close supervision, supporting the goals of the Claims Department and of CorVel.

This is a remote position.

ESSENTIAL FUNCTIONS & RESPONSIBILITIES:

  • Receives Workers’ Compensation claims, confirms policy coverage and acknowledgement of the claim
  • Determines the validity and compensability of the claim
  • Establishes reserves and authorizes payments within established reserving authority limits
  • Communicates claim status with the customer, claimant and client
  • Adheres to client and carrier guidelines and participates in claims review as needed
  • 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 verbal communication skills
  • Fast learner; develops knowledge and understanding of claims practice, relevant statutes, and medical terminology
  • Ability to identify, analyze and solve problems
  • Computer proficiency and technical aptitude to utilize Microsoft Office, including Excel spreadsheets
  • Strong interpersonal, time management, and organizational skills
  • Ability to work both independently and within a team environment
  • Bilingual (Preferred, not required)

EDUCATION & EXPERIENCE:

  • Bachelor's degree or a combination of education and related experience
  • Minimum of 1 year industry experience and claim handling
  • Workers’ Compensation experience required
  • Licensed as required jurisdictionally
  • SIP Certification Preferred

PAY RANGE:

CorVel uses a market based approach to pay and our salary ranges may vary depending on your location. Pay rates are established taking into account the following factors: federal, state, and local minimum wage requirements, the geographic location differential, job-related skills, experience, qualifications, internal employee equity, and market conditions. Our ranges may be modified at any time.

For leveled roles (I, II, III, Senior, Lead, etc.) new hires may be slotted into a different level, either up or down, based on assessment during interview process taking into consideration experience, qualifications, and overall fit for the role. The level may impact the salary range and these adjustments would be clarified during the offer process.

Pay Range: $16.74 - $26.92 per hour

A list of our benefit offerings can be found on our CorVel website: CorVel Careers | Opportunities in Risk Management

In general, our opportunities will be posted for up to 1 year from date of posting, or until we have selected candidate(s) to fulfill the opening, whichever comes first.

ABOUT CORVEL:

CorVel, a certified Great Place to Work® Company, is a national provider of industry-leading risk management solutions for the workers’ compensation, auto, health and disability management industries. CorVel was founded in 1987 and has been publicly traded on the NASDAQ stock exchange since 1991. Our continual investment in human capital and technology enable us to deliver the most innovative and integrated solutions to our clients. We are a stable and growing company with a strong, supportive culture and plenty of career advancement opportunities. Over 4,000 people working across the United States embrace our core values of Accountability, Commitment, Excellence, Integrity and Teamwork (ACE-IT!).

A comprehensive benefits package is available for full-time regular employees and includes Medical (HDHP) w/Pharmacy, Dental, Vision, Long Term Disability, Health Savings Account, Flexible Spending Account Options, Life Insurance, Accident Insurance, Critical Illness Insurance, Pre-paid Legal Insurance, Parking and Transit FSA accounts, 401K, ROTH 401K, and paid time off.

CorVel is an Equal Opportunity Employer, drug free workplace, and complies with ADA regulations as applicable.

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