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Medical Claims Jobs in Riverside, CA (NOW HIRING)

Chubb

ESIS Claims Representative, WC

Irvine, CA · On-site

Serve as the primary point of contact for injured workers, employers, medical providers, and other stakeholders, providing clear and professional communication throughout the claims process.

Corvel

Claims Supervisor

Rancho Cucamonga, CA · Remote

$73K - $113K/yr

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

Assists Claims Manager with recruitment, interviewing, and onboarding new staff, ensuring ... A comprehensive benefits package is available for full-time regular employees and includes Medical ...

Chubb

ESIS Claims Representative, WC

Irvine, CA · On-site

Serve as the primary point of contact for injured workers, employers, medical providers, and other stakeholders, providing clear and professional communication throughout the claims process.

Corvel

Claims Supervisor

Rancho Cucamonga, CA · On-site

$73K - $113K/yr

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

Assists Claims Manager with recruitment, interviewing, and onboarding new staff, ensuring ... A comprehensive benefits package is available for full-time regular employees and includes Medical ...

Chubb

ESIS Claims Representative, WC

Irvine, CA

Serve as the primary point of contact for injured workers, employers, medical providers, and other stakeholders, providing clear and professional communication throughout the claims process.

Trean Corporation

Senior Claims Adjuster

Ontario, CA · On-site

$85K - $95K/yr

All new lost time claims require an initial contact with the employer, the injured worker and the medical provider. This must be done within 24 hours of receipt of the claim or notification of a ...

Trean Corporation

Senior Claims Adjuster

Ontario, CA · On-site

$85K - $95K/yr

All new lost time claims require an initial contact with the employer, the injured worker and the medical provider. This must be done within 24 hours of receipt of the claim or notification of a ...

LSMA Management Inc

Claims Manager

San Bernardino, CA · On-site

$87K - $97K/yr

The Claims Manager is responsible for overseeing the daily operations, performance, and regulatory compliance of the Claims Department within the Managed Services Organization (MSO). This role ...

Trean Corporation

Senior Claims Adjuster

Ontario, CA · On-site

$85K - $95K/yr

All new lost time claims require an initial contact with the employer, the injured worker and the medical provider. This must be done within 24 hours of receipt of the claim or notification of a ...

LSMA Management Inc

Claims Manager

San Bernardino, CA · On-site

$87K - $97K/yr

The Claims Manager is responsible for overseeing the daily operations, performance, and regulatory compliance of the Claims Department within the Managed Services Organization (MSO). This role ...

LSMA Management Inc

Claims Manager

San Bernardino, CA · On-site

$87K - $97K/yr

The Claims Manager is responsible for overseeing the daily operations, performance, and regulatory compliance of the Claims Department within the Managed Services Organization (MSO). This role ...

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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.

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.

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.

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.

ESIS Claims Representative, WC

Chubb

Irvine, CA • On-site

Other

Re-posted 11 days ago

Chubb rating

8.2

Company rating: 8.2 out of 10

Based on 67 frontline employees who took The Breakroom Quiz

142nd of 309 rated insurance

Job description


Are you looking to grow your career in workers' compensation and claims support? Join ESIS, a leader in risk management and insurance services, where you can help support effective claims handling and contribute to positive outcomes for employees and clients.
Under direct supervision initially, performs customer service and/or claims functions while training to become a claims representative. Gains exposure to all facets of a professional claims representative position through classroom and hands on learning. Will be assigned a caseload as training progresses.
Duties may include but are not limited to:
  • Claims Management: Investigate, evaluate, and manage workers' compensation claims from inception to resolution, ensuring compliance with applicable laws, regulations, and company policies.
  • Communication: Serve as the primary point of contact for injured workers, employers, medical providers, and other stakeholders, providing clear and professional communication throughout the claims process.
  • Investigation: Conduct thorough investigations of claims, including gathering statements, reviewing medical records, and analyzing accident reports to determine compensability and liability.
  • Decision-Making: Make timely and accurate decisions regarding claim acceptance, denial, or settlement based on the facts of the case and applicable laws.
  • Documentation: Maintain detailed and organized claim files, documenting all activities, communications, and decisions in the claims management system.
  • Cost Control: Monitor and manage claim costs, including medical expenses, indemnity payments, and legal fees, while ensuring appropriate reserves are established and maintained.
  • Compliance: Ensure adherence to state-specific workers' compensation laws, regulations, and reporting requirements.
  • Customer Service: Provide exceptional service to clients by addressing inquiries, resolving issues, and delivering timely updates on claim status.
Collaboration: Work closely with internal teams, including legal, medical, and risk management professionals, to achieve optimal claim outcomes.
Qualifications
  • Preferred Qualifications: A minimum of 2 years' experience in handling workers' compensation claims in California is preferred, with prior experience at ESIS or similar third-party administrators being advantageous, and/or Bachelor's degree or equivalent experience.
  • Industry Knowledge: Strong familiarity with workers' compensation laws, medical terminology, and best practices in claims handling is preferred.
  • Technical Skills: Demonstrated proficiency in claims management systems and the Microsoft Office Suite.
  • Communication Skills: Excellent written and verbal communication skills, enabling effective interactions with external investigative sources and insureds over the phone.
  • Team Collaboration: Proven ability to contribute effectively within a team environment, providing and receiving constructive feedback while identifying growth opportunities for both self and colleagues.
  • Analytical Skills: Strong analytical and problem-solving abilities to navigate complex scenarios efficiently.
  • Organizational Skills: Capable of managing multiple priorities and meeting deadlines in a fast-paced work environment.
  • Customer Focus: Strong commitment to customer service, with a proactive approach to addressing and supporting customer needs.
  • Judgment and Decision-Making: Confidence in personal judgment, with the ability to support and defend decisions made.
  • Commitment to Excellence: Dedicated to maintaining high standards of behavior and performance.
  • Adaptability: Flexible in adapting approaches and behaviors to fit specific situations effectively.
  • Positive Representation: Strong focus on building and maintaining a positive image for Chubb and ESIS.
  • Skills:
    • Strong analytical and problem-solving abilities.
    • Excellent verbal and written communication skills.
    • Proficiency in claims management systems and Microsoft Office Suite.
    • Ability to manage multiple priorities and meet deadlines in a fast-paced environment.
  • Knowledge: Familiarity with workers' compensation laws, medical terminology, and claim handling best practices.

An applicable resident or designated home state adjuster's license is required for ESIS Field Claims Adjusters. Adjusters that do not fulfill the license requirements will not meet ESIS's employment requirements for handling claims. ESIS supports independent self-study time and will allow up to 4 months to pass the adjuster licensing exam.
ESIS, a Chubb company, provides claim and risk management services to a wide variety of commercial clients. ESIS' innovative best-in-class approach to program design, integration, and achievement of results aligns with the needs and expectations of our clients' unique risk management needs. With more than 70 years of experience, and offerings in both the U.S. and globally, ESIS provides one of the industry's broadest selections of risk management solutions covering both pre- and post-loss services.
The pay range for the role is $62,700 to $81,300. The specific offer will depend on an applicant's skills and other factors. This role may also be eligible to participate in a discretionary annual incentive program. Chubb offers a comprehensive benefits package, more details on which can be found on our careers website. The disclosed pay range estimate may be adjusted for the applicable geographic differential for the location in which the position is filled.
About Us
Chubb is a world leader in insurance. With operations in 54 countries, Chubb provides commercial and personal property and casualty insurance, personal accident and supplemental health insurance, reinsurance, and life insurance to a diverse group of clients. The company is distinguished by its extensive product and service offerings, broad distribution capabilities, exceptional financial strength, underwriting excellence, superior claims handling expertise and local operations globally.
At Chubb, we are committed to equal employment opportunity and compliance with all laws and regulations pertaining to it. Our policy is to provide employment, training, compensation, promotion, and other conditions or opportunities of employment, without regard to race, color, religious creed, sex, gender, gender identity, gender expression, sexual orientation, marital status, national origin, ancestry, mental and physical disability, medical condition, genetic information, military and veteran status, age, and pregnancy or any other characteristic protected by law. Performance and qualifications are the only basis upon which we hire, assign, promote, compensate, develop and retain employees. Chubb prohibits all unlawful discrimination, harassment and retaliation against any individual who reports discrimination or harassment.

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About Chubb

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Chubb is the world's largest publicly traded property and casualty insurer. With operations in 54 countries, Chubb provides commercial and personal property and casualty insurance, personal accident and supplemental health insurance, reinsurance and life insurance to a diverse group of clients. We are a unique global organization with a culture of individuals passionately committed to our respective crafts. With underwriting at our core, each of us contributes to providing the best insurance coverage and service to our clients. Our highly collaborative, inclusive nature helps us drive better business outcomes through diversity of background, experiences, insights and values.

Industry

Insurance services

Company size

10,000+ Employees

Headquarters location

Warren, NJ, US

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