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

Corvel

CA Utilization Review Nurse I

Rancho Cucamonga, CA · Remote

$30.64 - $45.80/hr

This is a remote position. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: * Identifies the necessity of the review process and communicates issues of concern to the appropriate claims staff/customer

Western Growers

Director of EDI

Irvine, CA · Remote

$102K - $145K/yr

This is a remote position. SUMMARY The Director of Electronic Data Interchange (EDI) is responsible ... Advanced knowledge of healthcare processes, including eligibility verification, claims processing ...

Qodoro Global LLC

Accounting Manager

Irvine, CA · Remote

Primarily Remote - Onsite one week per quarter Employment Type: Full-Time / Direct Hire Industry ... Oversee month-end and year-end close processes * Manage accounts payable/receivable, cash receipts ...

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Remote Claims Processor information

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$12

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How much do remote claims processor jobs pay per hour?

As of Jul 2, 2026, the average hourly pay for remote claims processor in Riverside, CA is $19.99, according to ZipRecruiter salary data. Most workers in this role earn between $17.07 and $21.59 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 Riverside, CA? For Remote Claims Processor jobs in Riverside, CA, the most frequently searched job titles are:
What job categories do people searching Remote Claims Processor jobs in Riverside, CA look for? The top searched job categories for Remote Claims Processor jobs in Riverside, CA are:
What cities near Riverside, CA are hiring for Remote Claims Processor jobs? Cities near Riverside, CA with the most Remote Claims Processor job openings:
Remote Claims Processor jobs near you
CA Utilization Review Nurse I

CA Utilization Review Nurse I

Corvel

Rancho Cucamonga, CA • Remote

$30.64 - $45.80/hr

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Posted 2 days ago

CorVel rating

7.9

Company rating: 7.9 out of 10

Based on 51 frontline employees who took The Breakroom Quiz

82nd of 146 rated financial services

Job description

The Utilization Review Nurse gathers demographic and clinical information on prospective, concurrent and retrospective in-patient admissions and out-patient treatment, certifies the medical necessity and assigns an appropriate length of stay while supporting the goals of the Case Management department and of CorVel.

This is a remote position.

ESSENTIAL FUNCTIONS & RESPONSIBILITIES:

  • Identifies the necessity of the review process and communicates issues of concern to the appropriate claims staff/customer
  • Collects data and analyzes information to make decisions regarding certification or denial of treatment
  • Documents all work in the appropriate manner
  • Promotes utilization review services with stakeholders
  • Complies with all safety rules and regulations during work hours in conjunction with the Injury and Illness Prevention Program (IIPP)
  • Additional duties as assigned

KNOWLEDGE & SKILLS: 

  • Must have thorough knowledge of both CPT and ICD coding
  • Ability to interface with claims staff, attorneys, physicians and their representatives, as well as advisors/clients and coworkers
  • Effective organization skills in a high-volume, fast-paced environment
  • Strong time management skills with the ability to meet designated deadlines
  • Excellent written and verbal communication skills
  • Ability to work both independently and within a team environment
  • Strong interpersonal skills
  • Ability to utilize Microsoft Office including Excel spreadsheets
  • Knowledge of the workers’ compensation claims process preferred
  • Knowledge of outpatient utilization review preferred

EDUCATION & EXPERIENCE: 

  • Graduate of accredited school of nursing with an associate’s degree, Bachelor of Science degree or Bachelor of Science in Nursing
  • Current Nursing licensure in the state of operation required; RN is required unless local state regulations permit LVN/LPN
  • 4 or more years of recent clinical experience
  • Prospective, concurrent, and retrospective utilization review experience preferred
  • Experience in the clinical areas of OR, ICU, CCU, ER and/or orthopedics preferred

PAY RANGE:

CorVel uses a market based approach to pay and our salary ranges may vary depending on your location.  Pay rates are established taking into account the following factors:  federal, state, and local minimum wage requirements, the geographic location differential, job-related skills, experience, qualifications, internal employee equity, and market conditions.  Our ranges may be modified at any time.

For leveled roles (I, II, III, Senior, Lead, etc.) new hires may be slotted into a different level, either up or down, based on assessment during interview process taking into consideration experience, qualifications, and overall fit for the role.  The level may impact the salary range and these adjustments would be clarified during the offer process.

Pay Range: $30.64 - $45.80 per hour

A list of our benefit offerings can be found on our CorVel website: CorVel Careers | Opportunities in Risk Management

In general, our opportunities will be posted for up to 1 year from date of posting, or until we have selected candidate(s) to fulfill the opening, whichever comes first.

ABOUT CORVEL:

CorVel, a certified Great Place to Work® Company, is a national provider of industry-leading risk management solutions for the workers’ compensation, auto, health and disability management industries.   CorVel was founded in 1987 and has been publicly traded on the NASDAQ stock exchange since 1991. Our continual investment in human capital and technology enable us to deliver the most innovative and integrated solutions to our clients.  We are a stable and growing company with a strong, supportive culture and plenty of career advancement opportunities.  Over 4,000 people working across the United States embrace our core values of Accountability, Commitment, Excellence, Integrity and Teamwork (ACE-IT!). 

A comprehensive benefits package is available for full-time regular employees and includes Medical (HDHP) w/Pharmacy, Dental, Vision, Long Term Disability, Health Savings Account, Flexible Spending Account Options, Life Insurance, Accident Insurance, Critical Illness Insurance, Pre-paid Legal Insurance, Parking and Transit FSA accounts, 401K, ROTH 401K, and paid time off.

CorVel is an Equal Opportunity Employer, drug free workplace, and complies with ADA regulations as applicable.

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