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Remote Claims Processor Jobs in Oxnard, CA (NOW HIRING)

emids

Business_Analyst

Moorpark, CA · Remote

California, United States (Remote) Work time zone: PST Must have skills: * EZ-CAP 5-6 years * Medi ... Review, process, and adjudicate high-complexity healthcare claims in compliance with company ...

APR

Commercial Lines Account Executive

Calabasas, CA · On-site +1

$90K - $115K/yr

Remote BUT must have ability to report to office once per month. System: AMS360 preferred About the ... Lead the renewal process, including marketing, proposal development, and coverage analysis.

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All JobsRemote Claims Processor JobsRemote Claims Processor Jobs in Oxnard, CA

Remote Claims Processor information

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How much do remote claims processor jobs pay per hour?

As of Jun 16, 2026, the average hourly pay for remote claims processor in Oxnard, CA is $20.30, according to ZipRecruiter salary data. Most workers in this role earn between $17.31 and $21.88 per hour, depending on experience, location, and employer.

What are some common challenges faced by Remote Claims Processors, and how can they be addressed?

Remote Claims Processors often encounter challenges such as managing high volumes of claims, maintaining accuracy without in-person supervision, and communicating effectively with team members across different locations. To address these, it's essential to develop strong organizational skills, utilize digital tools for tracking and documentation, and participate actively in virtual team meetings. Proactively seeking feedback and staying updated on policy changes can also enhance efficiency and reduce errors in a remote setting.

What Does a Remote Claims Processor Do?

The job duties of a remote claims processor revolve around working to process insurance claims. You typically work from home or another remote location. Your responsibilities start with assessing the claimant's insurance policy and coverage. You review documents and records related to the claim and decide on approval or denial of the claim. A processor also prepares the paperwork necessary for the insurer to process the case for the client. You also have customer service duties, such as answering patient questions and telling them about the claim status. Processors can work with medical insurance, property insurance, or casualty insurance.

What does a Remote Claims Processor do?

A Remote Claims Processor reviews, evaluates, and processes insurance claims from a remote location, typically working from home. They verify information, assess documentation, and determine the validity of claims for insurance companies or healthcare providers. This role requires attention to detail, knowledge of insurance policies, and the ability to communicate with clients or providers to resolve discrepancies. Remote Claims Processors use specialized software to manage claims efficiently and ensure compliance with industry regulations.

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

To thrive as a Remote Claims Processor, you need strong attention to detail, analytical skills, and a solid understanding of insurance policies, often supported by a high school diploma or relevant experience. Familiarity with claims management software, Microsoft Office Suite, and sometimes industry certifications like AIC (Associate in Claims) are typically required. Excellent written communication, time management, and problem-solving abilities help you stand out in this role. These skills ensure accurate and efficient claims handling, customer satisfaction, and compliance with regulatory standards in a remote work environment.

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

AspectRemote Claims ProcessorRemote Claims Examiner
Required CredentialsHigh school diploma or equivalent; some roles may require insurance or claims processing certificationsHigh school diploma or equivalent; often requires licensing or certification in insurance claims examination
Work EnvironmentHome-based or remote office; primarily computer and phone workHome-based or remote; involves reviewing and analyzing insurance claims
Industry UsageInsurance, healthcare, government agenciesInsurance companies, healthcare providers, government agencies
Common Search/ComparisonYesYes

Remote Claims Processors and Remote Claims Examiners both work in the insurance industry, often remotely, handling claims. While both roles require similar credentials and work environments, Claims Examiners typically perform more detailed analysis and may require specific licensing. Understanding these differences helps job seekers identify the right position based on their skills and certifications.

More about Remote Claims Processor jobs
What are popular job titles related to Remote Claims Processor jobs in Oxnard, CA? For Remote Claims Processor jobs in Oxnard, CA, the most frequently searched job titles are:
What job categories do people searching Remote Claims Processor jobs in Oxnard, CA look for? The top searched job categories for Remote Claims Processor jobs in Oxnard, CA are:
What cities near Oxnard, CA are hiring for Remote Claims Processor jobs? Cities near Oxnard, CA with the most Remote Claims Processor job openings:
Remote Claims Processor jobs near you
Claims Adjuster - Workers Compensation (West Hills,CA/Remote 3 days)

Claims Adjuster - Workers Compensation (West Hills,CA/Remote 3 days)

Sedgwick

West Hills, CA • On-site, Remote

$75K - $85K/yr

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Posted 29 days ago

Sedgwick rating

7.5

Company rating: 7.5 out of 10

Based on 308 frontline employees who took The Breakroom Quiz

186th of 261 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
Claims Examiner - Workers Compensation (West Hills,CA/Remote 3 days)
Are you looking for an opportunity to join a global industry leader where you can bring your big ideas to help solve problems for some of the world's best brands?
  • Apply your knowledge and experience to adjudicate complex customer claims in the context of an energetic culture.
  • Deliver innovative customer-facing solutions to clients who represent virtually every industry and comprise some of the world's most respected organizations.
  • Be a part of a rapidly growing, industry-leading global company known for its excellence and customer service.
  • Leverage Sedgwick's broad, global network of experts to both learn from and to share your insights.
  • Take advantage of a variety of professional development opportunities that help you perform your best work and grow your career.
  • Enjoy flexibility and autonomy in your daily work, your location, and your career path.
  • Access diverse and comprehensive benefits to take care of your mental, physical, financial and professional needs.

ARE YOU AN IDEAL CANDIDATE? We are looking for driven individuals that embody our caring counts model and core values that include empathy, accountability, collaboration, growth, and inclusion.
OFFICE LOCATIONS: West Hills, CA (Agile) 3 days remote
PRIMARY PURPOSE OF THE ROLE:
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 RESPONSIBLITIES MAY INCLUDE
  • 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

QUALIFICATIONS
Education & Licensing: 4 years of claims management experience or equivalent combination of education and experience required.
  • High School Diploma or GED required. Bachelor's degree from an accredited college or university preferred.
  • Professional certification as applicable to line of business preferred.

Licensing / Jurisdiction Knowledge: SIP required or must be obtained within one (1) year of employment; California workers compensation jurisdictional knowledge required.
TAKING CARE OF YOU
Flexible work schedule.
Referral incentive program.
Career development and promotional growth opportunities.
A diverse and comprehensive benefits offering including medical, dental vision, 401K on day one.
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 $75,000 - $85,000. 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.
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.
Sedgwick is 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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