Claims Analyst Jobs in California
Claims Analyst jobs in California represent one of the most active markets in the country, concentrated in property and casualty insurance, workers' compensation, and employee benefits across a workforce that runs from entry-level adjusters to senior litigation specialists. The heaviest hiring is in Los Angeles, San Francisco, and Sacramento, where carriers and third-party administrators such as Farmers Insurance, Kaiser Permanente, and Sedgwick maintain large California operations. Workers' compensation claims, liability analysis, and medical bill review are the most consistently sought specialties statewide. Scan the live roles below and apply to whichever ones fit.
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Showing 5 of 9+ Claims Analyst jobs
Authorizations and Claims Analytics Solutions Business Insights and Data Analyst III
Los Angeles, CA, US, 90017
Salary Range: $102,183.00 (Min.) - $132,838.00 (Mid.) - $163,492.00 (Max.)
Established in 1997, L.A. Care Health Plan is an independent public agency created by the state of California to provide health coverage to low-income Los Angeles County residents. We are the nation’s largest publicly operated health plan. Serving more than 2 million members, we make sure our members get the right care at the right place at the right time.
Mission: L.A. Care’s mission is to provide access to quality health care for Los Angeles County's vulnerable and low-income communities and residents and to support the safety net required to achieve that purpose.
Job Summary
The Authorizations and Claims Analytics Solutions and Data Analyst III serves as a Subject Matter expert (SME), technical and analytic integrator, responsible for designing, developing, and operationalizing advanced analytic solutions that drive strategic insight and organizational performance. This position combines strong data engineering fluency with analytical acumen transforming complex, multi-domain data (membership, encounters, providers, claims, quality metrics) into interpretable and actionable insights used by leaders across the health plan.
This position emphasizes the development of insight rich, production ready analytic assets, delivering repeatable, governed analyses that illuminate key drivers of care quality, efficiency, and financial outcomes.
Acts as a Subject Matter Expert (SME), serves as a resource and mentor for other staff.
Duties
Designs and maintains reusable analytic data models and Extract, Transform, and Load (ETL) pipelines that support recurring insight generation and performance monitoring.
Leads development of advanced dashboards, reports, and analytic tools that surface trends, correlations, and performances opportunities across enterprise domains.
Partners with analysts, data scientists, and operational stakeholders to embed insights directly into workflows and decision processes.
Implements and maintains version control, peer review (pull request), and continuous integration practices for analytic codebases.
Ensures adherence to data lineage, governance, and reproducibility standards across all analytic products.
Supports enterprise level measure refresh cycles and ensures alignment with standardized data abstraction layers.
Drives continuous enhancement of the analytic ecosystem by integrating new data sources, improving data structures, and optimizing performance.
Translates analytic findings into business relevant narratives and partners with stakeholders to act on insights.
Applies subject matter expertise in evaluating business operations and processes. Identifies areas where technical solutions would improve business performance. Consults across business operations, providing mentorship, and contributing specialized knowledge. Ensures that the facts and details are correct so that the program's deliverable meets the needs of the department, organization and legislation's policies, standards, and best practices. Provides training, recommends process improvements, and mentors junior level staff, department interns, etc. as needed.
Performs other duties as assigned.
Duties Continued
Education Required
Education Preferred
Experience
Required:
At least 5 years of progressive analytics experience in healthcare, managed care, or related industries.
Proven experience designing, developing, and operationalizing analytic solutions across multiple domains.
Experience translating multi-domain analytics into actionable insights for leadership and enterprise-wide initiatives.
Demonstrated successful experience in communicating insights effectively to senior leadership and executives.
Experience with Utilization Management (UM) authorization workflows and prior authorization metrics.
Preferred:
Experience with enterprise level initiatives, such as Key Performance Indicator (KPI) maintenance, cross-domain dashboards, measure ROI, or strategic investment analytics.
Strong experience managing care operations, including capitation, provider networks, risk adjustment, or quality incentive programs.
Skills
Required:
Expertise in designing, building, and maintaining complex ETL pipelines and analytic data models that support enterprise reporting, dashboards, and predictive insights. Advanced experience with BI tools (Tableau, Power BI) to design insight rich, production ready dashboards and analytic products. Proficiency with SQL and/or Python/R for large-scale data manipulation, advanced analyses, and operationalization of analytic workflows. Strong knowledge of version control (Git/GitHub) and CI/CD processes for analytic code and pipelines. Ability to integrate, optimize, and enhance multiple data sources for performance, governance, and reproducibility.
Ability to apply advanced statistical, predictive, and diagnostic methods to uncover drivers of quality, efficiency, and financial outcomes. Deep understanding of managed care operations, such as capitation models, provider networks, utilization management, and quality incentive programs. Ability to translate multi-domain data into actionable insights that directly inform strategic and operational decisions. Ability to conduct root-cause analyses, scenario modeling, and complex problem solving with minimal guidance.
Ability to operate with high autonomy, independently defining priorities and managing complex, ambiguous analytic projects. Ability to communicate complex analytic findings effectively to senior leadership, executives, and external stakeholders. Ability to translate insights into actionable recommendations and strategic narratives that influence enterprise decision making. Ability to mentor and guide other analysts, promoting analytic best practices across teams. Ability to drive continuous improvement of analytic tools, data structures, and reporting ecosystems, proactively identifying opportunities to enhance organizational performance.
Ability to influence operational or strategic decisions. Knowledge of claims operations, including receiving, adjudication, and provider dispute resolution. Knowledge of clinical and financial aspects of UM/claims and collaboration with operations or provider teams. Ability to analyze operational KPIs (e.g., turnaround times, denial rates, appeals outcomes) and translate data into actionable insights.
Preferred:
Proficient with Process Improvement Methodology including defining and documenting workflow. Knowledge of program and project level planning, mobilization and management.
Licenses/Certifications Required
Licenses/Certifications Preferred
Required Training
Physical Requirements
Additional Information
Salary Range Disclaimer: The expected pay range is based on many factors such as geography, experience, education, and the market. The range is subject to change.
L.A. Care offers a wide range of benefits including
- Paid Time Off (PTO)
- Tuition Reimbursement
- Retirement Plans
- Medical, Dental and Vision
- Wellness Program
- Volunteer Time Off (VTO)
Nearest Major Market: Los Angeles
Job Segment: Claims, Insurance
Authorizations and Claims Analytics Solutions Business Insights and Data Analyst III
Los Angeles, CA, US, 90017
Salary Range: $102,183.00 (Min.) - $132,838.00 (Mid.) - $163,492.00 (Max.)
Established in 1997, L.A. Care Health Plan is an independent public agency created by the state of California to provide health coverage to low-income Los Angeles County residents. We are the nation’s largest publicly operated health plan. Serving more than 2 million members, we make sure our members get the right care at the right place at the right time.
Mission: L.A. Care’s mission is to provide access to quality health care for Los Angeles County's vulnerable and low-income communities and residents and to support the safety net required to achieve that purpose.
Job Summary
The Authorizations and Claims Analytics Solutions and Data Analyst III serves as a Subject Matter expert (SME), technical and analytic integrator, responsible for designing, developing, and operationalizing advanced analytic solutions that drive strategic insight and organizational performance. This position combines strong data engineering fluency with analytical acumen transforming complex, multi-domain data (membership, encounters, providers, claims, quality metrics) into interpretable and actionable insights used by leaders across the health plan.
This position emphasizes the development of insight rich, production ready analytic assets, delivering repeatable, governed analyses that illuminate key drivers of care quality, efficiency, and financial outcomes.
Acts as a Subject Matter Expert (SME), serves as a resource and mentor for other staff.
Duties
Designs and maintains reusable analytic data models and Extract, Transform, and Load (ETL) pipelines that support recurring insight generation and performance monitoring.
Leads development of advanced dashboards, reports, and analytic tools that surface trends, correlations, and performances opportunities across enterprise domains.
Partners with analysts, data scientists, and operational stakeholders to embed insights directly into workflows and decision processes.
Implements and maintains version control, peer review (pull request), and continuous integration practices for analytic codebases.
Ensures adherence to data lineage, governance, and reproducibility standards across all analytic products.
Supports enterprise level measure refresh cycles and ensures alignment with standardized data abstraction layers.
Drives continuous enhancement of the analytic ecosystem by integrating new data sources, improving data structures, and optimizing performance.
Translates analytic findings into business relevant narratives and partners with stakeholders to act on insights.
Applies subject matter expertise in evaluating business operations and processes. Identifies areas where technical solutions would improve business performance. Consults across business operations, providing mentorship, and contributing specialized knowledge. Ensures that the facts and details are correct so that the program's deliverable meets the needs of the department, organization and legislation's policies, standards, and best practices. Provides training, recommends process improvements, and mentors junior level staff, department interns, etc. as needed.
Performs other duties as assigned.
Duties Continued
Education Required
Education Preferred
Experience
Required:
At least 5 years of progressive analytics experience in healthcare, managed care, or related industries.
Proven experience designing, developing, and operationalizing analytic solutions across multiple domains.
Experience translating multi-domain analytics into actionable insights for leadership and enterprise-wide initiatives.
Demonstrated successful experience in communicating insights effectively to senior leadership and executives.
Experience with Utilization Management (UM) authorization workflows and prior authorization metrics.
Preferred:
Experience with enterprise level initiatives, such as Key Performance Indicator (KPI) maintenance, cross-domain dashboards, measure ROI, or strategic investment analytics.
Strong experience managing care operations, including capitation, provider networks, risk adjustment, or quality incentive programs.
Skills
Required:
Expertise in designing, building, and maintaining complex ETL pipelines and analytic data models that support enterprise reporting, dashboards, and predictive insights. Advanced experience with BI tools (Tableau, Power BI) to design insight rich, production ready dashboards and analytic products. Proficiency with SQL and/or Python/R for large-scale data manipulation, advanced analyses, and operationalization of analytic workflows. Strong knowledge of version control (Git/GitHub) and CI/CD processes for analytic code and pipelines. Ability to integrate, optimize, and enhance multiple data sources for performance, governance, and reproducibility.
Ability to apply advanced statistical, predictive, and diagnostic methods to uncover drivers of quality, efficiency, and financial outcomes. Deep understanding of managed care operations, such as capitation models, provider networks, utilization management, and quality incentive programs. Ability to translate multi-domain data into actionable insights that directly inform strategic and operational decisions. Ability to conduct root-cause analyses, scenario modeling, and complex problem solving with minimal guidance.
Ability to operate with high autonomy, independently defining priorities and managing complex, ambiguous analytic projects. Ability to communicate complex analytic findings effectively to senior leadership, executives, and external stakeholders. Ability to translate insights into actionable recommendations and strategic narratives that influence enterprise decision making. Ability to mentor and guide other analysts, promoting analytic best practices across teams. Ability to drive continuous improvement of analytic tools, data structures, and reporting ecosystems, proactively identifying opportunities to enhance organizational performance.
Ability to influence operational or strategic decisions. Knowledge of claims operations, including receiving, adjudication, and provider dispute resolution. Knowledge of clinical and financial aspects of UM/claims and collaboration with operations or provider teams. Ability to analyze operational KPIs (e.g., turnaround times, denial rates, appeals outcomes) and translate data into actionable insights.
Preferred:
Proficient with Process Improvement Methodology including defining and documenting workflow. Knowledge of program and project level planning, mobilization and management.
Licenses/Certifications Required
Licenses/Certifications Preferred
Required Training
Physical Requirements
Additional Information
Salary Range Disclaimer: The expected pay range is based on many factors such as geography, experience, education, and the market. The range is subject to change.
L.A. Care offers a wide range of benefits including
- Paid Time Off (PTO)
- Tuition Reimbursement
- Retirement Plans
- Medical, Dental and Vision
- Wellness Program
- Volunteer Time Off (VTO)
Nearest Major Market: Los Angeles
Job Segment: Claims, Insurance
See All 9 Claims Analyst Jobs in California
Find roles in California that match your experience and apply in just a few clicks.
Find Claims Analyst JobsClaims Analyst Jobs by City in California
Where California roles are concentrated, by current openings.
Claims Analyst Job Market in California
A snapshot from current California openings, updated as new roles post.
Who's Hiring
What California Employers Look For
The qualifications that appear most often in claims analyst jobs across California.
- Active California Department of Insurance adjuster license or reciprocal recognition for the relevant line
- Experience handling workers' compensation or property and casualty claims under California law
- Familiarity with California Labor Code, insurance regulations, and claim documentation standards
- Proficiency with claims management systems such as Guidewire, Duck Creek, or Salesforce
- Strong written communication skills for coverage letters, investigation summaries, and denial notices
- Bachelor's degree in business, finance, or a related field or equivalent claims experience
Claims Analyst Jobs in California: Frequently Asked Questions
How do you become a claims analyst in California?
Most employers require a California Department of Insurance adjuster license, which you obtain by passing a written examination administered through the CDI for the applicable line of authority such as property, casualty, or workers' compensation. You apply directly through the CDI after meeting the prelicensing requirements. A bachelor's degree in business, finance, or a related field strengthens your application, though some carriers will sponsor licensing for candidates who join as trainees.
Which companies hire claims analysts in California?
Employers hiring claims analysts in California right now include MIEC, TRISTAR, and First American, based on current listings on Migrate Mate as of September 2026. California's large self-insured employer community and its mandatory workers' compensation system mean that insurers, third-party administrators, and major corporations across the state maintain steady in-house claims teams year-round.
Which California cities have the most claims analyst jobs?
The cities with the most claims analyst openings in California are San Diego, Fresno, and Lathrop. Los Angeles dominates because of the concentration of regional carrier headquarters, third-party administrators, and self-insured employers tied to its entertainment, construction, and logistics industries, while Sacramento's volume reflects state government agencies and the workers' compensation system that flows through the state capital.
Are there remote claims analyst jobs in California?
Yes, and more than most fields. About 86% of claims analyst openings tied to California are remote or hybrid as of September 2026, reflecting how much of the role involves documentation review, coverage analysis, and phone-based investigation rather than on-site inspection. Medical bill review and commercial lines desk adjusting positions tend to be the most consistently remote.
How can I get hired as a claims analyst in California with little or no experience?
The most realistic entry path is a claims trainee or claims assistant role at a large California carrier or third-party administrator, where you work supervised files while the employer sponsors your CDI adjuster license. Carriers such as Farmers Insurance and third-party administrators like Sedgwick and Gallagher Bassett run formal trainee pipelines in California. Coming from adjacent roles such as customer service representative, billing specialist, or paralegal assistant at an insurance or legal office gives you the transferable skills most hiring managers recognize.
Where can I find and apply to claims analyst jobs in California?
You can find and apply to claims analyst jobs in California on Migrate Mate, which lists current California openings. Search the roles available, find the ones that match your experience and preferred location, and apply directly to the employers posting them.
See All 9 Claims Analyst Jobs in California
Find roles in California that match your experience and apply in just a few clicks.
Find Claims Analyst Jobs