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Medical Claims Jobs in Riverside, CA (NOW HIRING)

Walgreens

Specialty Billing Technician

Mission Viejo, CA · On-site

$22 - $29/hr

Ensure all required documentation for billing is completed and accurate prior to claim submission (i.e., medical claims billing). * Process reimbursement checks/payment in accordance with policy.

New

Currance Inc

Biller III

Irvine, CA · On-site

$23 - $24/hr

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

Job Duties and Responsibilities · Submit hospital medical claims in accordance with federal, state and payer mandated guidelines. · Research, analyze, and review hospital claim errors and ...

American Family Care

Medical Billing Specialist

Ladera Ranch, CA · On-site

$18 - $23/hr

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

Evaluate medical claims and coverage policy documentation to determine validity for an appeal. * Responsible for ensuring and monitoring the effectuation of all decisions as a result of the follow-up ...

Capital Insurance Group

Claims Counsel

Orange, CA · On-site

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

Medical, dental, vision plans * One hundred percent covered plans * Basic Life & AD&D * Employee ... Responsible for consultation with claims staff in a variety of claims issues, including but not ...

California Capital Insurance (CIG)

Claims Counsel

Anaheim, CA · Remote

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

Medical, dental, vision plans * One hundred percent covered plans * Basic Life & AD&D * Employee ... Responsible for consultation with claims staff in a variety of claims issues, including but not ...

Artius Solutions

Senior Claims Specialist

Orange, CA · On-site

$110K - $130K/yr

Senior Claims Specialist - Medical Malpractice Location: Orange, CA 92859 (Onsite) Employment Type: Contract / Contract-to-Hire (Based on Performance) Schedule: Full-Time Position Overview We are ...

Currance Inc

Biller II

Irvine, CA · On-site

$20 - $25.50/hr

Prepare and submit billing data and medical claims (hospital and physician) to insurance companies in accordance with federal, state, and payer mandated guidelines. * Comply with productivity ...

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Showing results 21-40

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.

Workers Compensation - Claims Adjuster | HYBRID | Riverside, CA

Sedgwick

Riverside, CA • Hybrid

$65K - $85K/yr

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Re-posted 7 days ago

Sedgwick rating

7.6

Company rating: 7.6 out of 10

Based on 323 frontline employees who took The Breakroom Quiz

211th of 309 rated insurance

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 Adjuster | HYBRID | Riverside, CA

OFFICE LOCATION:

Riverside, CA (3 days In Office/2 days WFH)

PRIMARY PURPOSE: To analyze mid- and higher-level workers compensation claims to determine benefits due; to ensure ongoing adjudication of claims within company standards and industry best practices; and to identify subrogation of claims and negotiate settlements.

ESSENTIAL FUNCTIONS and RESPONSIBILITIES

  • Manages workers compensation claims determining compensability and benefits due on long term indemnity claims, monitors reserve accuracy, and files necessary documentation with state agency.

  • Develops and manages workers compensation claims' action plans to resolution, coordinates return-to-work efforts, and approves claim payments.

  • Approves and processes assigned claims, determines benefits due, and manages action plan pursuant to the claim or client contract.

  • Manages subrogation of claims and negotiates settlements.

  • Communicates claim action with claimant and client.

  • Ensures claim files are properly documented and claims coding is correct.

  • May process complex lifetime medical and/or defined period medical claims which include state and physician filings and decisions on appropriate treatments recommended by utilization review.

  • Maintains professional client relationships.

ADDITIONAL FUNCTIONS and RESPONSIBILITIES

  • Performs other duties as assigned.

  • Supports the organization's quality program(s).

  • Travels as required.

QUALIFICATIONS

Education & Licensing

Bachelor's degree from an accredited college or university preferred.

Experience

Three (3) years of claims management experience or equivalent combination of education and experience required.

Licensing / Jurisdiction Knowledge: California workers' compensation claims experience required | SIP Preferred

WORK ENVIRONMENT

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, travel as required

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 $65,000 - $85,000/yr. 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.

#claimsadjuster #claims #hybrid

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.

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