Remote Risk Adjustment Coder Jobs in Irvine, CA (NOW HIRING)

Salary : $92,618.26 - $131,463.66 Annually
Location : Riverside
Job Type: Regular
Remote Employment: Flexible/Hybrid
Job Number: 26-13522-01
Department: Human Resources
Division: Liability Insurance
Opening Date: 06/04/2026
Closing Date: 6/10/2026 11:59 PM Pacific
For questions regarding this position, please contact the Recruiter listed in the Supplemental Information section.
ABOUT THE POSITION
The Human Resources (HR) Department has an opportunity for a Claims Adjuster II to join the Liability Insurance team with the Risk Management Division located in Riverside.
The Claims Adjuster II will manage a caseload of liability claims filed against the County of Riverside. This position performs skilled professional work involving the investigation, evaluation, and resolution of public liability claims. Responsibilities include reviewing, analyzing, and managing a variety of claims-such as malpractice, property, and personal injury-while helping protect the County's financial and operational interests. The role requires strong analytical skills, sound judgment, and the ability to work independently on complex cases.
A competitive candidate will be an experienced claims professional who can quickly adapt to a fast-evolving claims environment and provide immediate operational support. The ideal individual will have experience assessing liability, conducting thorough investigations, interpreting medical and expert reports, and managing claims from intake through resolution. Due to recent changes in PRISM's program structure, the successful candidate must be able to manage increased claim volume, maintain compliance, and ensure timely and accurate case handling. Strong analytical judgment, excellent communication skills, and the ability to collaborate effectively with multiple departments are essential for success in this role.
Meet the Team!
The seeks and develops talented professionals that fit a highly engaged and collaborative culture.
EXAMPLES OF ESSENTIAL DUTIES

• Receive, review, and analyze public liability claims-including malpractice, property damage, and personal injury-to determine acceptance or denial.
• Evaluate medical reports, expert analyses, and supporting documentation to assess liability exposure and the extent of damages.
• Determine the merit of claims and recommend appropriate settlement, denial, or additional investigative action.
• Estimate anticipated settlement values; make adjustments and resolve claims within assigned monetary authority.
• Gather and review data, reports, and claim documentation; request clarification or additional information; monitor claim status and perform required follow-up.
• Conduct investigations to determine circumstances surrounding claims filed against the County, including interviewing witnesses and inspecting accident, injury, or property damage sites; prepare investigative findings reports.
• Interview individuals responsible for damage to County property or injuries to County employees to facilitate collections; contact public and private agencies to obtain collections information; recommend actions such as liens or court action to enforce recovery.

MINIMUM QUALIFICATIONS
Experience: Extensive journey-level experience of at least 5 years reviewing and processing property damage liability claims including investigating, identification and investigation of fraud cases, adjusting and settling a wide variety of claims.
Knowledge of: Rules, regulations, and laws regarding personal and property liability including, but not limited to, general provisions of California Vehicle Code, State and Federal Government Codes, laws and statutes and legal decisions pertaining to personal and property liability; Methods and techniques of subrogation recovery; Technical medical terminology related to the cause and treatment of physical injuries; Practices and procedures of insurance reserving, risk and experience analysis and statistical record keeping.
Ability to: Gather and evaluate all information pertinent to liability claims and make appropriate recommendations; Establish and analyze all relevant data, effect necessary control plans, and bring all claims to equitable conclusion; Develop action plan necessary to implement recommendations with a minimum of guidance.
Other Requirements
License: A valid California Driver's License is required at the time of appointment or the ability to arrange transportation for field travel.
The incumbent may be required to use a personal vehicle and provide verification of auto insurance coverage as required by the County of Riverside.
Job Competencies:
Work Performance Measures
• Effectively analyze and interpret federal and state laws affecting claims.
• Successfully discern and analyze alternatives in technical situations to assist in problem resolution.
• Participate appropriately in meetings as directed by the Workers' Compensation Officer or Liability Claims Program Supervisor.
• Accurately assess and calculate claim settlement costs.
• Successfully analyze information to determine appropriate strategy.
• Succinctly and clearly develop written reports and recommendations as assigned.
• Skillfully utilize computer and other available technology to maintain claims records, supporting documentation and technical/legal information.
• Meet obligations and commitments.
• Effectively investigate a wide variety of claims, data sources, regulations and laws governing claims.
• Take appropriate actions after carefully determining and analyzing all relevant factors.
• Maintain objectivity and credibility.
• Effectively maintain expertise in claims areas impacting the County including legal climate and trends.
• Appropriately utilize creative problem solving, investigative and analysis techniques.
• Persuasively communicate your findings and recommendations to a variety of audiences including attorneys and insurance representatives.
• Successfully prioritize conflicting timelines ensuring that each case or project receives appropriate time and consideration.
SUPPLEMENTAL INFORMATION
All applicants must include a copy of their completed certificates required to qualify. Applicants who fail to provide information demonstrating they possess the position requirements may not be considered further in the application process.
For questions regarding this recruitment:
Please contact Angela Tavaglione at or (951) 966-3590. Please allow 1-2 business days for response.
APPLICATION INFORMATION
Veteran's Preference
The County has a Veterans Preference Policy applicable to new hires. To qualify, attach the required documents to your job application. Documents include a copy of your (or your spouse's) Member-4 Form DD-214 indicating dates of service. For spousal preference, and as applicable, the following documents: a copy of your marriage certificate, spouse's death certificate, a letter of spouse's disability and/or letter of service-related death (if available) from the U.S. Veteran's Administration. For privacy reasons, it is recommended that you remove your social security information from the document(s). A Human Resources Representative will review the materials and determine if you qualify for veterans' preference. For complete details and documentation requirements, please review the Veterans Preference Policy, C-3 here:
Reasonable Accommodations
The County of Riverside is committed to providing reasonable accommodation to applicants as required by the Americans with Disabilities Act (ADA) and Fair Employment and Housing Act (FEHA). Qualified individuals with disabilities who need a reasonable accommodation during the application or selection process should contact the recruiter for the position noted above. For additional information and/or to obtain the appropriate form for requesting a reasonable accommodation, please visit the Disability Access Office web page located at:
Proof of Education
If using education to qualify or when requested by the recruiter, upload a copy of any license(s), official/unofficial transcript(s), degrees, and/or related employment documents to your NeoGov account at the time of application and before the closing date. Official or unofficial transcripts will be accepted.
If your education was completed outside of the United States, you will need to provide a copy of your Foreign Education Equivalency evaluation from a member of the National Association of Credential Evaluation Services () or Association of International Credential Evaluators, Inc. ().
Work Authorization Requirement
Applicants must be legally authorized to work in the United States at the time of application. The County of Riverside does not participate in visa sponsorship programs, including H1-B visas, and will not provide sponsorship for any employment-based visas.
Equal Opportunity Employer
The County of Riverside is an Equal Opportunity Employer. It is the policy of the County of Riverside to provide equal employment opportunities for all qualified persons. All applicants will be considered without regard to race, color, religion, sex, national origin, age, disability, sexual orientation, gender, gender identity, gender expression, marital status, ancestry, medical condition (cancer and genetic characteristics), genetic information, or denial of medical and family care leave, or any other non-job-related factors.
Pre-Employment
All employment offers are contingent upon successful completion of pre-employment requirements including a criminal background investigation, which involves fingerprinting. (A felony or misdemeanor conviction may disqualify the applicant from County employment). A pre-employment physical examination and background check may be required.
Probationary Period
As an Approved Local Merit System, all County of Riverside employees, except those serving "At Will," are subject to the probationary period provisions as specified in the applicable Memorandum of Understanding, County Resolution, or Salary Ordinance. Temporary and Per Diem employees serve at the pleasure of the agency/department head.
General Information
Current County of Riverside and/or current employees of the hiring department may receive priority consideration. Qualified candidates may be considered for future County vacancies.
Job postings may close without notice based on application volume. Submit your complete application by the recruitment close date; no late applications are accepted. Ensure all relevant experience/education is reflected on your application/resume, as a failure to demonstrate position requirements may disqualify applicants. A description of job duties directly copied from the job classification or job posting will not be considered.
Please read and follow any special application instructions on this posting. Click the 'Apply' link located on this page to submit your application. For additional instructions on the application process, examinations, Veteran's preference, pre-employment accommodation or other employment questions, please refer to our web site,
If you are experiencing technical problems, you may contact the governmentjobs.com applicant support desk Monday through Friday, 6 am to 5 pm Pacific Time at support@governmentjobs.com or toll-free 1-855-524-5627.
MEDICAL/DENTAL INSURANCE: A Flexible Benefit Credit is provided on a monthly basis as governed by the Management Resolution or applicable bargaining unit. Vision coverage is provided through Vision Service Plan (VSP) at no cost to employee or eligible dependents.
Note: Employees on assignment through the Temporary Assignment Program (TAP) receive different benefits. See the list
MISCELLANEOUS RETIREMENT: County of Riverside has three retirement Tiers through the California Public Employees' Retirement System (CalPERS).

• Tier I (Classic Member - Formula 3% @ 60): Applicable to current and former County of Riverside local miscellaneous employees hired prior to 08/24/2012 and did not withdraw CalPERS contributions. The employee contribution is eight (8%) percent.
• Tier II (Classic Member - Formula 2% @ 60): Applicable to local miscellaneous employees 1) hired after 08/23/2012 through 12/31/2012; 2) Previously employed with another CalPERS contracting public agency or a reciprocal retirement system, with a break in service of less than six months between the separation date with the previous employer and the appointment date with the County of Riverside. The employee contribution is seven (7%) percent.
• Tier III (PEPRA New Member - Formula 2% @ 62): Applicable to CalPERS local miscellaneous new members hired on or after the implementation of the Public Employees' Pension Reform Act of 2013 (PEPRA) which took effect January 1, 2013. Effective July 1, 2023 employee contributions are 7.25% and will increase to 7.75% effective July 1, 2024.

A new member is defined as any of the following:

1. A new hire who enters CalPERS membership for the first time on or after January 1, 2013, and who has no prior membership in any California Public Retirement System.
2. A new hire who enters CalPERS membership for the first time on or after January 1, 2013, and who was a member with another California Public Retirement System prior to that date, but who is not subject to reciprocity upon joining CalPERS.
3. A member who first established CalPERS membership prior to January 1, 2013, and who is rehired by a different CalPERS agency after a break in service of greater than six (6) months.

CalPERS refers to all members that do not fit within the definition of a new member as "classic members".
Contribution rates are subject to change based on the County of Riverside annual actuarial valuation.
Note:
This summary is for general information purposes only. Additional questions regarding retirement formulas can be sent to or by calling the Benefits Information Line at (951) 955-4981,
Option 2.
If you have prior service credit with another CalPERS agency or within age...