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Remote Medical Claim Auditor Jobs in Riverside, CA

Ethos Risk Services

Bill Review Specialist

Lake Forest, CA · On-site +1

$20.25 - $28/hr

... claim outcomes. JOB SUMMARY: Our dynamic Bill Review team is seeking a full-time Bill Review Specialist (REMOTE) to review, audit, and process workers' compensation medical bills while ensuring ...

Clarvida

Revenue Cycle Operations Analyst

Lake Forest, CA · On-site +1

$85K - $95K/yr

California (Remote/Hybrid) Employment Type: Full-time Salary: $85,000 - $95,000 per year (dependent ... to improve claim readiness and reduce denial risks · Develop and maintain key performance ...

New

Clarvida

Revenue Cycle Operations Analyst

Santa Ana, CA · On-site +1

$85K - $95K/yr

California (Remote/Hybrid) Employment Type: Full-time Salary: $85,000 - $95,000 per year (dependent ... to improve claim readiness and reduce denial risks · Develop and maintain key performance ...

New

LIBERTY DENTAL

Overpayment Specialist

Tustin, CA · On-site +1

$24.50 - $28/hr

Overpayment Specialist (Remote) Make an impact behind the scenes of quality healthcare by helping ... In this role, you will investigate and resolve claim overpayments, manage recovery efforts, analyze ...

New

Clarvida

Revenue Cycle Operations Analyst

Orange, CA · On-site +1

$85K - $95K/yr

California (Remote/Hybrid) Employment Type: Full-time Salary: $85,000 - $95,000 per year (dependent ... to improve claim readiness and reduce denial risks · Develop and maintain key performance ...

New

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All JobsMedical Claim Auditor JobsRemote Medical Claim Auditor JobsRemote Medical Claim Auditor Jobs in Riverside, CA

Remote Medical Claim Auditor information

See Riverside, CA salary details

$15

$26

$52

How much do remote medical claim auditor jobs pay per hour?

As of Aug 7, 2026, the average hourly pay for remote medical claim auditor in Riverside, CA is $26.71, according to ZipRecruiter salary data. Most workers in this role earn between $18.56 and $25.58 per hour, depending on experience, location, and employer.

What are the key skills and qualifications needed to thrive as a remote medical claim auditor?

To thrive as a Remote Medical Claim Auditor, you need a solid understanding of medical billing and coding, healthcare regulations, and insurance claims processes, often supported by a degree in health information management or a related field. Familiarity with auditing software, electronic health records (EHR) systems, and certifications such as CPC (Certified Professional Coder) or CPMA (Certified Professional Medical Auditor) are typically required. Strong attention to detail, analytical thinking, and effective communication skills help auditors identify discrepancies and collaborate with healthcare providers. These skills and qualifications are vital for ensuring accuracy, compliance, and cost savings in healthcare reimbursement.

How do remote medical claim auditors typically collaborate with healthcare providers and insurance teams while working off-site?

Remote Medical Claim Auditors routinely engage with healthcare providers and insurance teams through secure digital platforms, email, and virtual meetings. They review claims data, clarify documentation, and resolve discrepancies by communicating directly with billing departments and insurance representatives. Effective collaboration relies on clear, timely communication and a strong understanding of compliance regulations. While working independently, auditors are still part of a broader team, often participating in regular check-ins and process improvement discussions.

What does a remote medical claim auditor do?

A Remote Medical Claim Auditor reviews and evaluates healthcare claims to ensure accuracy, compliance with regulations, and proper documentation. They work from a remote location, analyzing medical records and billing information to identify errors, fraud, or overpayments. Their goal is to ensure that healthcare providers and insurance companies process claims correctly and adhere to industry standards. This role often involves communicating findings, recommending corrective actions, and sometimes working with multiple software systems. Attention to detail and knowledge of medical coding and billing practices are essential for success in this position.

What is the difference between Remote Medical Claim Auditor vs Remote Medical Billing Specialist?

AspectRemote Medical Claim AuditorRemote Medical Billing Specialist
CredentialsCertifications like CPC, CPC-H, or equivalentCertifications like CPC, CPC-H, or equivalent
Work EnvironmentHealthcare insurance companies, third-party administrators, or healthcare providersMedical offices, billing companies, or healthcare providers
Job FocusReviewing and auditing insurance claims for accuracy and compliancePreparing and submitting insurance claims, following up on payments

Both roles require similar certifications and often operate within healthcare or insurance environments. The key difference is that Remote Medical Claim Auditors focus on reviewing claims for accuracy and compliance, while Remote Medical Billing Specialists handle the submission and management of claims. Understanding these distinctions helps job seekers identify the right role based on their skills and career goals.

What are popular job titles related to Remote Medical Claim Auditor jobs in Riverside, CA? For Remote Medical Claim Auditor jobs in Riverside, CA, the most frequently searched job titles are:
What job categories do people searching Remote Medical Claim Auditor jobs in Riverside, CA look for? The top searched job categories for Remote Medical Claim Auditor jobs in Riverside, CA are:
What cities near Riverside, CA are hiring for Remote Medical Claim Auditor jobs? Cities near Riverside, CA with the most Remote Medical Claim Auditor job openings:
Remote Medical Claim Auditor jobs near you
Infographic showing various Remote Medical Claim Auditor job openings in Riverside, CA as of August 2026, with employment types broken down into 1% As Needed, 76% Full Time, 18% Part Time, and 5% Contract. Highlights an 91% Physical, 1% Hybrid, and 8% Remote job distribution, with an average salary of $55,564 per year, or $26.7 per hour.

Claims Examiner - Workers Compensation (On-Site Ontario, California or REMOTE in California)

York Risk Services

Ontario, CA • On-site, Remote

$85/hr

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Re-posted 21 days ago

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 (On-Site Ontario, California or REMOTE in California)

Are you lookingfor an opportunity to join a global industry leader where you can bring yourbig ideasto help solve problems for some of the world's best brands?

Apply your knowledge and experience toadjudicatecomplex workers compensation claims in the context of an energetic culture.

Deliver innovative customer-facing solutions to clients whorepresentvirtually everyindustry andcomprisesome 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,financialand professional needs.

ARE YOU AN IDEAL CANDIDATE?Seeking a seasoned California Workers Compensation Examiner who values strong client partnerships, enjoys a reasonable caseload, and works within a wellmanaged intake environment.

OFFICE LOCATION: ONTARIO, CA

PRIMARY PURPOSE OF THE ROLE:To analyzeWorkers Compensationclaims on behalf of our valued clients todeterminebenefits due, while ensuring ongoing adjudication of claims within service expectations, industry best practices, and specific client service requirements.

ESSENTIAL RESPONSIBLITIES MAY INCLUDE

Analyzing and processing claims through well-developed action plans toan appropriateandtimelyresolution by investigating and gathering information todeterminethe exposure on the claim.

Negotiating settlement of claims within designated authority.

Communicating claim activity and processing with the claimant and the client.

Reporting claims to the excess carrier and responding to requests of directions in a professional andtimelymanner.

QUALIFICATIONS

Education & Licensing: 3 years of claims management experience or equivalent combination of education and experiencerequired.

High School Diploma or GEDrequired. Bachelor's degree from an accredited college or university preferred.

Professional certification as applicable to line of business preferred.

Licensing / Jurisdiction Knowledge:3 or more years California workers compensation jurisdictional knowledge required, SIP required or must be obtained within one (1) year of employment

TAKING CARE OF YOU

Flexibleworkschedule.

Referralincentiveprogram.

Career development and promotional growth opportunities.

Diverse and comprehensive benefits offering including medical, dental vision, 401K on dayone.

WORK ENVIRONMENT REQUIREMENTSINCLUDE
When applicable and appropriate, consideration will be given to reasonable accommodations.

Mental:Clear and conceptual thinking ability; excellent judgment, troubleshooting, problem solving, analysis, and discretion; ability to handle work-related stress; ability to handle multiple priorities simultaneously; and ability to meet deadlines

Physical:Computer keyboarding

Auditory/Visual: Hearing, vision and talking

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 $85-95K. 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.

The statements contained in this document are intended to describe the general nature and level of work being performed by a colleague assigned to this description.They are not intended to constitute a comprehensive list of functions, duties, or local variances.Management retains the discretion to add or to change the duties of the position at any time.

#LI-REMOTE #LI-HYBRID

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.

Sedgwickis 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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