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Remote Medicare Claims Processing Jobs in Riverside, CA

Corvel

CA Senior Claims Specialist

Rancho Cucamonga, CA · Remote

$29.35 - $47.28/hr

This is a remote position but candidate must reside in California. Candidate must be bilingual and ... process taking into consideration experience, qualifications, and overall fit for the role. The ...

CCMSI

WC Claim Associate I LevelUP

Irvine, CA · Remote

$19 - $25.75/hr

We don't just process claims-we support people. As the largest privately-owned Third Party ... Remote #CCMSILevelUP Employment Type: OTHER

MCKESSON

Field Reimbursement Manager

Anaheim, CA · On-site +1

... remote interaction and on-site training. This position is client-facing and customer-facing and ... Educate on Benefit Investigation, Prior Authorization Process, Support Center Services, Medicare ...

GTT, LLC

Customer Service Representative

Irvine, CA · Remote

$17.25 - $23.25/hr

Medicare/Medicaid knowledge. * Claims/Billing and coding experience. * Experience with Cisco phone ... Remote within the U.S.; candidates must be available to work PST business hours. About the Client ...

New

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

Jobot

Litigation Attorney (Remote)

Irvine, CA · On-site +1

$170K - $180K/yr

Experience working with insurance carriers and insurance-related claims is a plus. * Strong legal ... Information collected and processed as part of your Jobot candidate profile, and any job ...

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Showing results 21-40

All JobsMedicare Claims Processing JobsRemote Medicare Claims Processing JobsRemote Medicare Claims Processing Jobs in Riverside, CA

Remote Medicare Claims Processing information

See Riverside, CA salary details

$12

$23

$35

How much do remote medicare claims processing jobs pay per hour?

As of Aug 12, 2026, the average hourly pay for remote medicare claims processing in Riverside, CA is $23.30, according to ZipRecruiter salary data. Most workers in this role earn between $19.04 and $26.59 per hour, depending on experience, location, and employer.

What are the key skills and qualifications needed to thrive as a remote Medicare claims processor?

To thrive as a Remote Medicare Claims Processor, you need strong attention to detail, knowledge of medical billing and coding, and a solid understanding of Medicare regulations, often supported by a relevant certification like CPC or CCA. Familiarity with claims processing software, electronic health record (EHR) systems, and Medicare-specific platforms such as the Fiscal Intermediary Standard System (FISS) is typically required. Strong organizational skills, effective written communication, and problem-solving abilities help you excel in remote work environments. These skills ensure timely and accurate claims processing, minimize errors, and support compliance with complex healthcare regulations.

What are some common challenges faced by remote Medicare claims processors and how can they be managed?

One common challenge for remote Medicare claims processors is staying up-to-date with frequent changes in Medicare regulations and billing codes. Additionally, working remotely can make it harder to quickly clarify complex cases with colleagues or supervisors. To manage these challenges, it's important to participate in regular training sessions, utilize internal communication platforms for collaboration, and maintain organized documentation. Employers often provide digital resources and support channels to help remote processors stay connected and informed.

What is remote Medicare claims processing?

Remote Medicare claims processing involves reviewing, verifying, and submitting medical claims to Medicare from a location outside of a traditional office, often from home. Professionals in this role ensure that healthcare providers are reimbursed for services rendered to Medicare patients by checking claims for accuracy, compliance, and eligibility. They use specialized software to process electronic and paper claims, resolve discrepancies, and follow up on denied or delayed payments. This job requires knowledge of Medicare regulations, coding, and strong attention to detail. Remote work allows for flexible scheduling but also demands self-discipline and secure handling of sensitive patient data.

What is the difference between Remote Medicare Claims Processing vs Remote Medical Billing Specialist?

AspectRemote Medicare Claims ProcessingRemote Medical Billing Specialist
CertificationsCPAR, CPC, or similarCPB, CPC, or similar
Work EnvironmentHealthcare insurance, government programsHealthcare providers, clinics, hospitals
Job FocusSubmitting and managing Medicare claimsBilling for various medical services and insurance

Remote Medicare Claims Processing involves handling claims specifically for Medicare, focusing on government regulations and Medicare-specific procedures. Remote Medical Billing Specialists manage billing for a variety of insurance types and healthcare providers. While both roles require similar certifications and work remotely in healthcare settings, Medicare Claims Processing is specialized in government insurance claims, whereas Medical Billing covers broader insurance billing tasks.

What are popular job titles related to Remote Medicare Claims Processing jobs in Riverside, CA? For Remote Medicare Claims Processing jobs in Riverside, CA, the most frequently searched job titles are:
What job categories do people searching Remote Medicare Claims Processing jobs in Riverside, CA look for? The top searched job categories for Remote Medicare Claims Processing jobs in Riverside, CA are:
What cities near Riverside, CA are hiring for Remote Medicare Claims Processing jobs? Cities near Riverside, CA with the most Remote Medicare Claims Processing job openings:
Remote Medicare Claims Processing jobs near you
Infographic showing various Remote Medicare Claims Processing job openings in Riverside, CA as of August 2026, with employment types broken down into 1% As Needed, 78% Full Time, 14% Part Time, 1% Temporary, 5% Contract, and 1% Nights. Highlights an 92% Physical, 2% Hybrid, and 6% Remote job distribution, with an average salary of $48,472 per year, or $23.3 per hour.

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

Sedgwick

Ontario, CA • On-site, Remote

$85/hr

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Re-posted 26 days ago

Sedgwick rating

7.6

Company rating: 7.6 out of 10

Based on 321 frontline employees who took The Breakroom Quiz

208th of 304 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 (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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