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Remote Claims Examiner Jobs in Riverside, CA (NOW HIRING)

Gallagher

Claims Assistant

Corona, CA · Remote

$19.25 - $24.50/hr

Overview This is a remote position based in California, and candidates must reside within the state ... As a Claims Assistant, you'll be the backbone of our claims team, assisting Examiners in every ...

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All JobsClaims Examiner JobsRemote Claims Examiner JobsRemote Claims Examiner Jobs in Riverside, CA

Remote Claims Examiner information

See Riverside, CA salary details

$16

$30

$47

How much do remote claims examiner jobs pay per hour?

As of Jul 26, 2026, the average hourly pay for remote claims examiner in Riverside, CA is $30.67, according to ZipRecruiter salary data. Most workers in this role earn between $23.32 and $36.63 per hour, depending on experience, location, and employer.

What are the key skills and qualifications needed to thrive as a Remote Claims Examiner, and why are they important?

To thrive as a Remote Claims Examiner, you need a solid understanding of insurance policies, analytical skills, and attention to detail, typically supported by a degree in business or a related field and relevant claims experience. Familiarity with claims management software, document management systems, and sometimes certifications like AIC (Associate in Claims) are often required. Strong communication, time management, and problem-solving abilities help you effectively assess claims and collaborate remotely. These skills are crucial for accurate, efficient claims processing and maintaining trust with clients and insurers in a remote environment.

What are some common challenges Remote Claims Examiners face, and how can they overcome them?

Remote Claims Examiners often encounter challenges such as maintaining clear communication with team members and accessing required documentation efficiently. Since the role is remote, staying organized and disciplined is essential to meet deadlines and manage caseloads effectively. Utilizing secure digital platforms, setting regular check-in meetings, and proactively seeking clarification on complex claims can help overcome these challenges. Additionally, embracing ongoing training on claims software and staying updated with industry regulations ensures accurate and timely claim processing.

What Does a Remote Claims Examiner Do?

Remote claims examiners review insurance claims to ensure they are accurate and completed properly. Instead of working in the office, remote claims examiners work from home or another location outside of the office. As a remote claims examiner, your job duties include researching the claim and gathering supportive documentation, such as medical records, invoices with services rendered, and policy guidelines. Once you have all the necessary information, you may make adjustments to the claim and determine payments or denial of service. You may also be responsible for contacting all parties involved. Complicated claims may require collaboration with a claims adjuster or investigator. Claims examiners work in healthcare, real estate, automotive, government agencies, and other insurance-related industries.

What is a Remote Claims Examiner?

A Remote Claims Examiner is a professional who reviews insurance claims from home or another remote location. Their primary job is to investigate, evaluate, and process claims to determine their validity and the amount that should be paid out. They work for insurance companies, healthcare providers, or third-party administrators, handling documentation, communicating with claimants, and ensuring compliance with regulations. By working remotely, they use digital tools to manage claims and collaborate with other team members online.
More about Remote Claims Examiner jobs
What are the most commonly searched types of Claims Examiner jobs in Riverside, CA? The most popular types of Claims Examiner jobs in Riverside, CA are:
What are popular job titles related to Remote Claims Examiner jobs in Riverside, CA? For Remote Claims Examiner jobs in Riverside, CA, the most frequently searched job titles are:
What job categories do people searching Remote Claims Examiner jobs in Riverside, CA look for? The top searched job categories for Remote Claims Examiner jobs in Riverside, CA are:
What cities near Riverside, CA are hiring for Remote Claims Examiner jobs? Cities near Riverside, CA with the most Remote Claims Examiner job openings:
Remote Claims Examiner jobs near you
Infographic showing various Remote Claims Examiner job openings in Riverside, CA as of July 2026, with employment types broken down into 100% Full Time. Highlights an 100% Remote job distribution, with an average salary of $63,802 per year, or $30.7 per hour.
Workers Compensation Claims Examiner CA

Workers Compensation Claims Examiner CA

Imagine Staffing Technology

Orange, CA • Remote

$72/hr

Full-time

Posted 5 days ago

Job description

Job Profile
Job Title: Claims Examiner
Location: Orange, CA -must live in CA
Hire Type: Contingent
Pay Range: $72
Work Model: Remote/Onsite
Work Shift: Monday-Friday 8 am – 4:30 pm
Recruiter Contact: Sean Craft I sean@marykraft.com I 443-345-3305
Nature & Scope:
Positional Overview
Imagine Staffing is seeking an experienced Workers' Compensation Claims Examiner to support a leading national claims management organization. This role is responsible for managing complex California workers' compensation claims from investigation through resolution while ensuring compliance with state regulations, client expectations, and industry best practices.
Please Note:
  • Only former Sedgwick employees will be considered.
  • Position is available remote within California or onsite in Orange, CA.
  • California Workers' Compensation Adjuster Certification is required.
  • Minimum 3 years of recent California Workers' Compensation claims experience required.
Role & Responsibility:
Tasks That Will Lead to Your Success
  • Manage a caseload of complex California workers' compensation claims from inception through closure.
  • Investigate claims to determine compensability, liability, and benefit eligibility.
  • Develop strategic action plans to drive timely and appropriate claim resolution.
  • Establish, monitor, and adjust claim reserves throughout the life of each claim.
  • Calculate and issue indemnity and medical benefit payments accurately and within statutory guidelines.
  • Negotiate settlements within assigned authority while maintaining cost-effective claim outcomes.
  • Manage litigated claims by coordinating with defense counsel, medical providers, and other vendors.
  • Prepare and file all required California workers' compensation documentation within regulatory deadlines.
  • Identify subrogation opportunities and pursue available recoveries when applicable.
  • Coordinate investigations, independent medical evaluations (IMEs), surveillance, and additional vendor services as needed.
  • Communicate professionally with injured workers, employers, attorneys, medical providers, and clients regarding claim activity and status.
  • Maintain accurate electronic claim files, documentation, and coding.
  • Escalate complex issues to management when appropriate.
  • Support quality assurance initiatives and perform additional duties as assigned
Skills & Experience
Qualifications That Will Help You Thrive
  • California Workers' Compensation Adjuster Certification.
  • Former Sedgwick employee (required).
  • Minimum 3 years of recent California workers' compensation claims experience.
  • Strong experience handling complex and litigated workers' compensation claims.
  • Thorough understanding of California workers' compensation laws, regulations, and claims administration.
  • Experience managing reserves, settlements, litigation, and claim recoveries.
Preferred
  • Bachelor's degree from an accredited college or university.
  • Professional claims certifications.
Skills & Experience
  • Extensive knowledge of California workers' compensation claims handling practices.
  • Strong understanding of insurance principles, litigation management, and cost containment strategies.
  • Excellent analytical, investigative, and decision-making skills.
  • Outstanding written and verbal communication skills.
  • Strong negotiation and conflict-resolution abilities.
  • Proficiency with Microsoft Office and electronic claims management systems.
  • Highly organized with the ability to manage multiple priorities in a fast-paced environment.
  • Ability to work independently while collaborating effectively with clients and internal teams.