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Remote Claims Associate Jobs in California (NOW HIRING)

Liberty Mutual

Associate Staff Attorney

Ontario, CA · On-site +1

Description This role is primarily remote in the state of California except for required ... Provide clear and reasoned legal opinions and strategic advice to Claims Representatives and ...

Liberty Mutual

Associate Staff Attorney

Los Angeles, CA · On-site +1

$100K - $171K/yr

This role is primarily remote in the state of California except for required appearances. At ... Provide clear and reasoned legal opinions and strategic advice to Claims Representatives and ...

Liberty Mutual

Associate Staff Attorney

San Jose, CA · On-site +1

Description This role is primarily remote in the state of California except for required ... Provide clear and reasoned legal opinions and strategic advice to Claims Representatives and ...

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Remote Claims Associate information

What is a remote claims associate?

A Remote Claims Associate is a professional who reviews, processes, and manages insurance claims from a remote location, typically working from home. They evaluate claim details, verify information, and communicate with policyholders, service providers, and other stakeholders to ensure claims are handled accurately and efficiently. This role often requires strong attention to detail, good communication skills, and proficiency with digital tools and claims management software. Remote Claims Associates may work for insurance companies, third-party administrators, or other organizations handling claims. The position allows for flexibility in work location while maintaining high standards of customer service and accuracy.

What skills and qualifications are needed to be a remote claims associate?

To excel as a Remote Claims Associate, you typically need knowledge of insurance processes, attention to detail, and a high school diploma or relevant experience. Familiarity with claims management software, CRM systems, and sometimes specific certifications like AIC (Associate in Claims) are highly beneficial. Strong organizational skills, effective communication, and the ability to work independently are crucial soft skills for remote success. These competencies ensure accurate claims processing, customer satisfaction, and efficient remote workflow management.

How does a remote claims associate collaborate with other team members while working from home?

As a Remote Claims Associate, you'll regularly communicate with team members, supervisors, and other departments through digital channels like email, instant messaging, and video conferencing. Collaboration often involves sharing updates on claim statuses, seeking guidance on complex cases, and participating in virtual team meetings. Many organizations use workflow management platforms and secure document-sharing tools to ensure seamless coordination and maintain data security. Building strong virtual communication skills is important to stay connected and contribute effectively to team goals.

What are the most commonly searched types of Remote Claims jobs in California?

The most popular types of Remote Claims jobs in California are:

What are popular job titles related to Remote Claims Associate jobs in California?

For Remote Claims Associate jobs in California, the most frequently searched job titles are:

What job categories do people searching Remote Claims Associate jobs in California look for?

The top searched job categories for Remote Claims Associate jobs in California are:

What cities in California are hiring for Remote Claims Associate jobs?

Cities in California with the most Remote Claims Associate job openings:

Remote Claims Associate jobs near you
Infographic showing various Remote Claims Associate job openings in California as of August 2026, with employment types broken down into 100% Part Time. Highlights an 100% Remote job distribution.

Senior Provider Auditor - Claims

Scripps Health

San Diego, CA • Remote

Full-time

Posted 5 days ago

Scripps Health rating

8.6

Company rating: 8.6 out of 10

Based on 141 frontline employees who took The Breakroom Quiz

8th of 888 rated healthcare providers

Job description

This is a full-time, benefit eligible position that is remote and located in San Diego. Will be required to come into the office at minimum once a month or as needed.

Why join Scripps Health?

At Scripps Health, your ambition is empowered and your abilities are appreciated:

  • Nearly a quarter of our employees have been with Scripps Health for over 10 years.
  • Scripps is a Great Place to Work Certified company for 2025.
  • Scripps Health has been consistently ranked as a top employer for women, millennials, diversity, and as an overall workplace by various national publications.
  • Becker's Healthcare ranked Scripps Health on its 2026 list of 150 top places to work in health care.
  • We have transitional and professional development programs to create a learning environment that enables you to thrive in your specific field as well as in your overall career.
  • Our specialties have been nationally recognized for quality in areas such as cardiovascular care, oncology, orthopedics, geriatrics, obstetrics and gynecology, and gastroenterology.

Under general supervision, the Senior Provider Auditor utilizes key data to perform analysis and audits of managed care functions such as credentialing, claims, coding, provider information, timely access, or quality data. Maintains and performs ongoing monitoring of data, validation and identifies root cause analysis, risks and resolve data integrity issues. Prepares materials for committees and conducts face to face or remote provider education including the creation of the corrective action plan, training documents, and narrative to support and respond to regulatory deficiencies. Assembles evidence and documentation to investigate allegations of fraud, waste, and abuse.

Key responsibilities include:

  • Maintaining and updating Virtual Examiner (VE) coding edits to ensure alignment with industry standards, CPT, HCPCS, CMS, NCCI, and payer-specific coding requirements.
  • Working directly with the Information Systems (IS) Tapestry team and the VE vendor to develop, implement, and validate coding editor enhancements and updates.
  • Performing testing and validation of new coding rules and system changes prior to production implementation.
  • Managing coding editor escalations and resolving complex coding and reimbursement issues.
  • Serving as the subject matter expert for coding-related inquiries from Claims, Provider Operations, Configuration, Audit, Compliance, and Delegation Oversight teams.
  • Coordinating and validating semi-annual Medicare Fee Schedule (MFS) updates and related testing activities.
  • Supporting claims payment accuracy initiatives, audit readiness, and compliance requirements.

Required Education/Experience/Specialized Skills: 

  • Minimum of three (3) years' experience in healthcare/medical office environment.
  • Proficient with all Microsoft Office application.
  • Experience leading and facilitating work teams, with superior facilitation, interpersonal, verbal, and written communication skills.
  • Strong organizational and analytical skills; innovative with ability to identify, anticipate and solve problems.
  • Able to adapt, prioritize and meet deadlines.
  • Ability to present to key stake holders including physicians; ability to educate and train all levels of professional staff.

Required Certification/Registration: 

  • Required CCS-P, CCS, CDIP, CCDS, CHC, CIC, COC, CPC, CPMA, CPB, CRC, CDEO, Associate degree, or 5 years of related healthcare experience managing quality or data.

Preferred Education/Experience/Specialized Skills/Certification: 

  • Bachelor's degree and/or college coursework in a related field.
  • Knowledge of Epic Tapestry, Health Planet, and Timely Access Compliance and network filing.
  • Knowledge of claims processing regulations.
  • Experience with coding and HIPPA.
  • Strong knowledge of Excel.

What Scripps Health employees say

Pay

Benefits

Hours and flexibility

Workplace

Get the full story on Breakroom

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About Scripps Health

Sourced by ZipRecruiter

As a nationally recognized health system, Scripps Health is committed to providing the highest quality care to our patients. Through collaboration and innovation, our healthcare professionals lead the frontier in caring for our community. With a culture centered around teamwork, each laboratory site serves as a resource of support for each other, setting our laboratories as the benchmark for standardization.

Industry

Health care and social assistance

Company size

10,000+ Employees

Headquarters location

San Diego, CA, US

Year founded

1924

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