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Remote Claim Processor Jobs in Orange, CA (NOW HIRING)

Insperity

Medical Claims Examiner

Los Angeles, CA · On-site +1

$24 - $30/hr

Paid time off, flexible schedule, and remote work choices provided Plus, we work to maintain the ... processes, and claim review and analysis involving NCCI rules. * Extensive working knowledge of ...

USAA

Sr. Auto Appraiser - Field

Los Angeles, CA · On-site +1

USAA roles may offer remote or hybrid flexibility for active-duty military spouses consistent with ... Maintains accurate and current claim file documentation throughout the claims process for complex ...

Clarvida

Revenue Cycle Operations Analyst

Anaheim, CA · On-site +1

$85K - $95K/yr

California (Remote/Hybrid) Must live in CA in proximity of Locations being served. Employment Type ... Responsibilities · Analyze front-end revenue cycle workflows, eligibility verification processes ...

Jacoby & Meyers

Litigation Paralegal

Los Angeles, CA · Remote

$30 - $38/hr

Fully Remote Pay: $30.00/hour - $38.00/hour : Core duties and responsibilities include the ... Monitor claim statuses and maintain detailed records of submissions, correspondence, and case ...

Deloitte

Epic Denials Management Operator

Los Angeles, CA · Remote

$19.50 - $25.75/hr

This is a primarily remote role supporting enterprise Epic support, with minimal travel and ... Experience analyzing billing workflows, claim issues, or operational data The wage range for this ...

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All JobsClaim Processor JobsRemote Claim Processor JobsRemote Claim Processor Jobs in Orange, CA

Remote Claim Processor information

See Orange, CA salary details

$12

$20

$28

How much do remote claim processor jobs pay per hour?

As of Sep 9, 2026, the average hourly pay for remote claim processor in Orange, CA is $20.47, according to ZipRecruiter salary data. Most workers in this role earn between $17.45 and $22.07 per hour, depending on experience, location, and employer.

What is a remote claim processor?

A Remote Claim Processor is a professional who reviews, evaluates, and processes insurance claims from a remote location, often from home. They verify the accuracy of submitted information, ensure policy guidelines are met, and decide whether claims should be approved, denied, or require further investigation. This role typically involves working with health, auto, or property insurance claims and requires strong attention to detail, analytical skills, and familiarity with relevant software systems. Working remotely allows claim processors to handle their duties outside of a traditional office environment while maintaining communication with their team and clients through digital platforms.

What skills and qualifications are needed to thrive as a remote claim processor?

To thrive as a Remote Claim Processor, you need strong analytical skills, attention to detail, and a background in insurance or healthcare administration, typically supported by a high school diploma or relevant certification. Familiarity with claims management software, electronic health record (EHR) systems, and Microsoft Office is crucial for daily tasks. Excellent communication, problem-solving abilities, and self-motivation help remote claim processors efficiently resolve issues and work independently. These skills ensure accurate claims processing, timely resolution, and high customer satisfaction in a remote environment.

What are common challenges faced by remote claim processors, and how can they be managed?

Remote claim processors often encounter challenges such as maintaining effective communication with team members and staying up-to-date with changing insurance policies and procedures. To manage these challenges, it's important to leverage collaboration tools like instant messaging and video conferencing, and to participate actively in virtual training sessions. Additionally, setting up a dedicated workspace and following a structured daily routine can help ensure productivity and accuracy when processing claims remotely.

What is the difference between Remote Claim Processor vs Remote Claims Examiner?

AspectRemote Claim ProcessorRemote Claims Examiner
Required CredentialsHigh school diploma or equivalent; some roles may require insurance or healthcare certificationsHigh school diploma or equivalent; often requires insurance or healthcare-related certifications
Work EnvironmentHome-based, independent work settingHome-based, independent work setting
Industry UsageInsurance, healthcare, government agenciesInsurance, healthcare, government agencies
Job FocusProcessing insurance claims, data entry, verifying informationReviewing and adjudicating insurance claims, ensuring compliance

Both roles are remote positions within the insurance and healthcare industries, requiring similar credentials and work environments. The main difference lies in their focus: Remote Claim Processors handle initial claim processing and data entry, while Remote Claims Examiners review and make decisions on claims to ensure accuracy and compliance.

What are popular job titles related to Remote Claim Processor jobs in Orange, CA?

For Remote Claim Processor jobs in Orange, CA, the most frequently searched job titles are:

What job categories do people searching Remote Claim Processor jobs in Orange, CA look for?

The top searched job categories for Remote Claim Processor jobs in Orange, CA are:

What cities near Orange, CA are hiring for Remote Claim Processor jobs?

Cities near Orange, CA with the most Remote Claim Processor job openings:

Remote Claim Processor jobs near you
Infographic showing various Remote Claim Processor job openings in Orange, CA as of August 2026, with employment types broken down into 78% Full Time, 20% Part Time, and 2% Contract. Highlights an 81% Physical, 6% Hybrid, and 13% Remote job distribution, with an average salary of $42,585 per year, or $20.5 per hour.

California Workers' Compensation Insurance Adjuster

Irvine, CA • Remote

CCMSI
Insurance Services • 1 - 5K employees
Learn more about CCMSIexternal

$80K - $98K/yr

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Re-posted 12 days ago

CCMSI rating

7.9

Company rating: 7.9 out of 10

Based on 16 frontline employees who took The Breakroom Quiz

Job description

Workers’ Compensation Claim Consultant – Senior (California)


Location: Irvine, CA (100% remote)

Salary Range: $80,000 – $98,000 (dependent on experience)
License Requirement: California SIP preferred or ability to obtain within first year of employment
Build Your Career With Purpose at CCMSI

At CCMSI, we partner with global clients to solve their most complex risk management challenges, delivering measurable results through advanced technology, collaborative problem-solving, and an unwavering commitment to their success.

We don’t just process claims—we support people. As the largest privately owned Third Party Administrator (TPA), CCMSI delivers customized claim solutions that help our clients protect their employees, assets, and reputations. We are a certified Great Place to Work®, and our employee-owners are empowered to grow, collaborate, and make meaningful contributions every day.

Job Summary

We are seeking an experienced and highly skilled Senior Workers’ Compensation Claim Consultant to manage a complex California claims portfolio, including claims involving traveling and multilocation employees with stipend and per diem wage structures. This role requires advanced professional judgment, strong regulatory knowledge, and the ability to independently manage wage calculations, claim strategy, and dispute resolution.

With 5+ years of handson California workers’ compensation claims experience, you will lead thorough investigations, guide complex claim strategies, and ensure fair, timely, and compliant resolutions. This role is designed for a seasoned adjuster who thrives in gray areas, particularly around California wage determination and Average Weekly Wage (AWW) calculations, and who can confidently defend those determinations when challenged.

As a Claim Consultant, you will play a key role in delivering exceptional service to CCMSI clients while upholding our high standards of quality, accuracy, and responsiveness. This role also offers a strong development pathway into more senior claim positions.

 
This is a full lifecycle WC adjuster position within a TPA environment, and only candidates with proven Workers’ Compensation claims experience will be considered.

When we hire Workers’ Compensation Adjusters at CCMSI, we look for detaildriven problemsolvers who balance empathy with sound judgment, navigate complex regulations with confidence, and deliver fair, timely outcomes that support injured workers and strengthen client trust.

  • Investigate, evaluate, and adjust Workers’ Compensation claims in accordance with established claim handling standards and California law.
  • Independently manage complex indemnity claims, including those involving traveling employees and variable wage structures.
  • Calculate and document Average Weekly Wage (AWW) in accordance with California Labor Code, including analysis of stipends, per diem, and living allowances.
  • Establish reserves and/or provide reserve recommendations within established authority levels.
  • Review, approve, or provide oversight of medical, legal, damage estimates, and miscellaneous invoices to determine if reasonable and related to designated claims; negotiate disputed bills as needed.
  • Authorize and issue claim payments in accordance with claim procedures, industry standards, and established payment authority.
  • Negotiate settlements within Corporate Claim Standards, clientspecific handling instructions, and applicable state laws.
  • Assist in the selection, referral, and supervision of outside vendors (e.g., legal counsel, surveillance, case management).
  • Assess and monitor subrogation claims for resolution.
  • Review and maintain an accurate personal diary in the claim system.
  • Prepare claim status reports, payment summaries, and reserve reports as requested.
  • Compute and adjust disability rates in compliance with California regulations.
  • Maintain effective, timely communication with clients, claimants, employers, attorneys, and vendors throughout the claim lifecycle.
  • Attend and participate in hearings, mediations, WCAB proceedings, and informal legal conferences, as appropriate.
  • Conduct claim reviews and/or training sessions for designated clients, as requested.
  • Provide notices of qualifying claims to excess and reinsurance carriers.
  • Handle more complex and involved claims than lowerlevel claim positions with minimal supervision.
  • Ensure compliance with Corporate Claim Handling Standards and special client handling instructions.

Required Qualifications

 
  • Five (5) or more years of California Workers’ Compensation claims experience, managing full lifecycle claims.
  • Demonstrated experience handling complex indemnity claims with minimal supervision.
  • Handson experience calculating California AWW, including claims involving stipends, per diem, or other nontraditional wage components.
  • Strong understanding of California Labor Code and WC regulations related to wage determination and benefit calculations.
  • Ability to independently evaluate and defend wage determinations when disputed.
  • Proficiency with Microsoft Office products, including Word, Excel, and Outlook.
  • Adjuster license as required by jurisdiction; California SIP preferred or ability to obtain within the first year of employment.
Preferred Qualifications
  • Experience handling claims involving traveling or multilocation employees.
  • Prior experience in a TPA environment.
  • Bachelor’s degree preferred but not required.
  • Bilingual (Spanish) proficiency — highly valued for communicating with claimants, employers, and vendors.

Why You’ll Love Working Here

  • 4 weeks (Paid time off that accrues throughout the year in accordance with company policy) + 10 paid holidays in your first year
  • Comprehensive benefits: Medical, Dental, Vision, Life, and Disability Insurance
  • Retirement plans: 401(k) and Employee Stock Ownership Plan (ESOP)
  • Career growth: Internal training and advancement opportunities
  • Culture: A supportive, team-based work environment

 

How We Measure Success 

 At CCMSI, great adjusters stand out through ownership, accuracy, and impact. We measure success by:  

  • Quality claim handling – thorough investigations, strong documentation, well-supported decisions
  • Compliance & audit performance – adherence to jurisdictional and client standards
  • Timeliness & accuracy – purposeful file movement and dependable execution
  • Client partnership – proactive communication and strong follow-through
  • Professional judgment – owning outcomes and solving problems with integrity
  • Cultural alignment – believing every claim represents a real person and acting accordingly

This is where we shine, and we hire adjusters who want to shine with us.

Compensation & Compliance

The posted salary reflects CCMSI’s good-faith estimate in accordance with applicable pay transparency laws. Actual compensation will be based on qualifications, experience, geographic location, and internal equity. This role may also qualify for bonuses or additional forms of pay.

CCMSI offers comprehensive benefits including medical, dental, vision, life, and disability insurance. Paid time off accrues throughout the year in accordance with company policy, with paid holidays and eligibility for retirement programs in accordance with plan documents.

Visa Sponsorship: CCMSI does not provide visa sponsorship for this position.
ADA Accommodations: CCMSI is committed to providing reasonable accommodations throughout the application and hiring process.
Equal Opportunity Employer: CCMSI complies with all applicable employment laws, including pay transparency and fair chance hiring regulations.

Background checks, if required for the role, are conducted only after a conditional offer and in accordance with applicable fair chance hiring laws.

Our Core Values

At CCMSI, we believe in doing what’s right—for our clients, our coworkers, and ourselves. We look for team members who:

  • Lead with transparency We build trust by being open and listening intently in every interaction.
  • Perform with integrity We choose the right path, even when it is hard.
  • Chase excellence We set the bar high and measure our success. What gets measured gets done.
  • Own the outcome Every employee is an owner, treating every claim, every decision, and every result as our own.
  • Win together Our greatest victories come when our clients succeed. 

We don’t just work together—we grow together. If that sounds like your kind of workplace, we’d love to meet you.

#CCMSICareers #EmployeeOwned #GreatPlaceToWorkCertified #ESOP #TPA #InsuranceCareers

#WorkersCompensation #WCClaims #ClaimsConsultant #SeniorAdjuster #CaliforniaWC #CAWorkersComp #IndemnityClaims #WageCalculation #AWW #StipendPay #PerDiem
#RemoteJobs #RemoteCareers #CaliforniaJobs #AdjusterJobs #BilingualJobs #SpanishSpeaking
#TravelingEmployees #ComplexClaims #ClaimsCareers #IND123 #LI-Remote  

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