Claims Specialist Jobs in California
Claims Specialist jobs in California are among the most active in the country, concentrated in property and casualty insurance, workers' compensation, and employee benefits across a market that runs from entry-level adjusters to senior litigation specialists. The largest hiring metros are Los Angeles, San Francisco, and San Diego, where major carriers and self-insured employers like State Farm, Sedgwick, and Zurich Insurance maintain substantial California operations. Workers' compensation claims, liability, and health and disability are the sub-areas with the steadiest demand. Find a role that fits below and apply directly.
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Showing 5 of 56+ Claims Specialist jobs
Crum & Forster (C&F), with a proud history dating to 1822, provides specialty and standard commercial lines insurance products through our admitted and surplus lines insurance companies. C&F enjoys a financial strength rating of "A+" (Superior) by AM Best and is proud of our superior customer service platform. Our claims and risk engineering services are recognized as among the best in the industry.
Our most valuable asset is our people: more than 2000 employees in locations throughout the United States. The company is increasingly winning recognition as a great place to work, earning several workplace and wellness awards, including the 2025 Great Place to Work® Award for our employee-first focus and our steadfast commitment to diversity, equity and Inclusion.
C&F is part of Fairfax Financial Holdings, a global, billion dollar organization. For more information about Crum & Forster, please visit our website: www.cfins.com.
Job Description:Examines claims data and conducts investigations into routine and moderately complex claims to determine coverage, compensability, subrogation and benefits under moderate supervisory direction. Adjusts and manages claims within the limit of assigned authority.
- Must be well versed in California Compensation statute claims.
- Receives lost time and complex medical only assignments. Verifies and determines applicability of coverage. Initiates 24-hour contact with employer, employee and 48-hour contact with attending physician.
- Handles catastrophic claims with supervisory oversight.
- Conducts telephone investigations as required by company claims handling manual and procedures.
- Evaluates and adjusts claims within the limits of authority.
- Consults with Claim Manager on those claims where assistance and consultation is needed.
- Makes assignments to nurse case management when indicated, monitoring their billing and performance.
- Sets reserves for anticipated exposure up to authority limits.
- Completes mandatory Reserve Worksheets. Establishes reserves requiring complex analysis with lifetime pharmacy and cost inflation.
- Coordinates return to work (RTW) and sets target dates.
- Maintain diaries on maximum three (3) month intervals.
- Documents files in the claims system.
- Reviews medical bills for causal relationship, medical bill charges for appropriateness and approves payments.
- Adheres to special account handling (SHI) instructions.
- Attends account meetings by telephone and in-person.
- Manages litigation on the files.
- College degree, B.A. or equivalent experience.
- 3+ years of experience handling workers compensation claims.
- Strong organizational skills.
- Good time management skills.
- Foreign language communications a plus.
- Excellent verbal and written communication skills are essential.
- Strong aptitude and knowledge of Microsoft Office programs and the ability to quickly learn new programs.
- Will abide by departmental policies and procedures, including authority levels, to comply with C&F’s risk management controls.
- Competitive compensation package
- Generous 401K employer match
- Employee Stock Purchase plan with employer matching
- Generous Paid Time Off
- Excellent benefits that go beyond health, dental & vision. Our programs are focused on your whole family’s wellness, including your physical, mental and financial wellbeing
- A core C&F tenet is owning your career development, so we provide a wealth of ways for you to keep learning, including tuition reimbursement, industry-related certifications and professional training to keep you progressing on your chosen path
- A dynamic, ambitious, fun and exciting work environment
- We believe you do well by doing good and want to encourage a spirit of social and community responsibility, matching donation program, volunteer opportunities, and an employee-driven corporate giving program that lets you participate and support your community
At C&F you will BELONG
If you require special accommodations, please let us know. We value inclusivity and diversity. We are committed to equal employment opportunity and welcome everyone regardless of race, color, ancestry, religion, sex, national origin, sexual orientation, age, citizenship, marital status, disability, gender identity, or Veteran status. If you require special accommodations, please let us know
For California Residents Only: Information collected and processed as part of your career profile and any job applications you choose to submit are subject to our privacy notices and policies, visit https://www.cfins.com/onlineprivacypolicy/ca/noticeatcollection/ for more information.
Crum & Forster is committed to ensuring a workplace free from discriminatory pay disparities and complying with applicable pay equity laws. Salary ranges are available for all positions at this location, taking into account roles with a comparable level of responsibility and impact in the relevant labor market and these salary ranges are regularly reviewed and adjusted in accordance with prevailing market conditions. The annualized base pay for the advertised position, located in the specified area, ranges from a minimum of $55,800.00 to a maximum of $104,900.00. The actual compensation is determined by various factors, including but not limited to the market pay for the jobs at each level, the responsibilities and skills required for each job, and the employee’s contribution (performance) in that role. To be considered within market range, a salary is at or above the minimum of the range. You may also have the opportunity to participate in discretionary equity (stock) based compensation and/or performance-based variable pay programs.
#LI-AV1
Crum & Forster (C&F), with a proud history dating to 1822, provides specialty and standard commercial lines insurance products through our admitted and surplus lines insurance companies. C&F enjoys a financial strength rating of "A+" (Superior) by AM Best and is proud of our superior customer service platform. Our claims and risk engineering services are recognized as among the best in the industry.
Our most valuable asset is our people: more than 2000 employees in locations throughout the United States. The company is increasingly winning recognition as a great place to work, earning several workplace and wellness awards, including the 2025 Great Place to Work® Award for our employee-first focus and our steadfast commitment to diversity, equity and Inclusion.
C&F is part of Fairfax Financial Holdings, a global, billion dollar organization. For more information about Crum & Forster, please visit our website: www.cfins.com.
Job Description:Examines claims data and conducts investigations into routine and moderately complex claims to determine coverage, compensability, subrogation and benefits under moderate supervisory direction. Adjusts and manages claims within the limit of assigned authority.
- Must be well versed in California Compensation statute claims.
- Receives lost time and complex medical only assignments. Verifies and determines applicability of coverage. Initiates 24-hour contact with employer, employee and 48-hour contact with attending physician.
- Handles catastrophic claims with supervisory oversight.
- Conducts telephone investigations as required by company claims handling manual and procedures.
- Evaluates and adjusts claims within the limits of authority.
- Consults with Claim Manager on those claims where assistance and consultation is needed.
- Makes assignments to nurse case management when indicated, monitoring their billing and performance.
- Sets reserves for anticipated exposure up to authority limits.
- Completes mandatory Reserve Worksheets. Establishes reserves requiring complex analysis with lifetime pharmacy and cost inflation.
- Coordinates return to work (RTW) and sets target dates.
- Maintain diaries on maximum three (3) month intervals.
- Documents files in the claims system.
- Reviews medical bills for causal relationship, medical bill charges for appropriateness and approves payments.
- Adheres to special account handling (SHI) instructions.
- Attends account meetings by telephone and in-person.
- Manages litigation on the files.
- College degree, B.A. or equivalent experience.
- 3+ years of experience handling workers compensation claims.
- Strong organizational skills.
- Good time management skills.
- Foreign language communications a plus.
- Excellent verbal and written communication skills are essential.
- Strong aptitude and knowledge of Microsoft Office programs and the ability to quickly learn new programs.
- Will abide by departmental policies and procedures, including authority levels, to comply with C&F’s risk management controls.
- Competitive compensation package
- Generous 401K employer match
- Employee Stock Purchase plan with employer matching
- Generous Paid Time Off
- Excellent benefits that go beyond health, dental & vision. Our programs are focused on your whole family’s wellness, including your physical, mental and financial wellbeing
- A core C&F tenet is owning your career development, so we provide a wealth of ways for you to keep learning, including tuition reimbursement, industry-related certifications and professional training to keep you progressing on your chosen path
- A dynamic, ambitious, fun and exciting work environment
- We believe you do well by doing good and want to encourage a spirit of social and community responsibility, matching donation program, volunteer opportunities, and an employee-driven corporate giving program that lets you participate and support your community
At C&F you will BELONG
If you require special accommodations, please let us know. We value inclusivity and diversity. We are committed to equal employment opportunity and welcome everyone regardless of race, color, ancestry, religion, sex, national origin, sexual orientation, age, citizenship, marital status, disability, gender identity, or Veteran status. If you require special accommodations, please let us know
For California Residents Only: Information collected and processed as part of your career profile and any job applications you choose to submit are subject to our privacy notices and policies, visit https://www.cfins.com/onlineprivacypolicy/ca/noticeatcollection/ for more information.
Crum & Forster is committed to ensuring a workplace free from discriminatory pay disparities and complying with applicable pay equity laws. Salary ranges are available for all positions at this location, taking into account roles with a comparable level of responsibility and impact in the relevant labor market and these salary ranges are regularly reviewed and adjusted in accordance with prevailing market conditions. The annualized base pay for the advertised position, located in the specified area, ranges from a minimum of $55,800.00 to a maximum of $104,900.00. The actual compensation is determined by various factors, including but not limited to the market pay for the jobs at each level, the responsibilities and skills required for each job, and the employee’s contribution (performance) in that role. To be considered within market range, a salary is at or above the minimum of the range. You may also have the opportunity to participate in discretionary equity (stock) based compensation and/or performance-based variable pay programs.
#LI-AV1
See All 56 Claims Specialist Jobs in California
Find roles in California that match your experience and apply in just a few clicks.
Find Claims Specialist JobsClaims Specialist Jobs by City in California
Where California roles are concentrated, by current openings.
Claims Specialist Job Market in California
A snapshot from current California openings, updated as new roles post.
Who's Hiring
- Progressive10
- CorVel Corporation5
- Philadelphia Insurance Companies3
- USAA2
- Sedgwick2
Top Industries Hiring
- Technology & Software
- Government & Public Sector
What California Employers Look For
The qualifications that appear most often in claims specialist jobs across California.
- Active California Department of Insurance adjuster license or qualifying exemption
- Experience reviewing and processing insurance claims in a California regulatory environment
- Familiarity with California workers' compensation statutes and Labor Code requirements
- Proficiency in claims management software such as Guidewire, Xactimate, or comparable platforms
- Strong written communication skills for coverage letters, denials, and regulatory correspondence
- Associate or bachelor's degree in business, risk management, or a related field preferred
Claims Specialist Jobs in California: Frequently Asked Questions
How do you become a claims specialist in California?
Most claims specialists in California need a claims adjuster license issued through the California Department of Insurance, which requires passing the California Adjuster Examination and submitting a license application. Property and casualty, workers' compensation, and life and health lines each have their own exam. A degree in business, finance, or risk management strengthens your application, though many employers hire candidates with a high school diploma who have passed the required state exam.
Which companies hire claims specialists in California?
Companies currently hiring claims specialists in California include Progressive, CorVel Corporation, and Philadelphia Insurance Companies, per current listings on Migrate Mate as of September 2026. California's large self-insured employers, third-party administrators, and statewide carriers make it one of the most active claims hiring markets in the U.S.
Which California cities have the most claims specialist jobs?
Rancho Cucamonga, Irvine, and Orange have the most claims specialist openings in California. Los Angeles dominates due to its concentration of major insurance carriers, self-insured corporations, and third-party administrators, while San Francisco and San Diego attract openings through their large employer bases in tech, healthcare, and financial services.
Are there remote claims specialist jobs in California?
Yes, and more than most fields, because claims work is largely desk-based and document-driven. About 92% of claims specialist openings tied to California are remote or hybrid as of September 2026, reflecting how broadly carriers and third-party administrators have adopted distributed teams. Roles focused on complex litigation or field inspection tend to remain on-site, while desk adjusting and medical bill review positions are the most consistently remote.
How can I get hired as a claims specialist in California with little or no experience?
The most realistic entry path is passing the California Department of Insurance adjuster exam and applying directly to workers' compensation or auto claims trainee programs run by large California carriers and third-party administrators. Customer service roles in insurance call centers, medical billing positions, and paralegal work at personal injury firms are recognized lateral moves that California hiring managers accept as relevant background. Sedgwick and Keenan and Associates, both with large California operations, post associate claims representative openings that require no prior claims experience.
Where can I find and apply to claims specialist jobs in California?
You can find and apply to claims specialist jobs in California on Migrate Mate, which lists current California openings across carriers, third-party administrators, and self-insured employers. Find the roles that fit your experience and specialty and apply directly.
See All 56 Claims Specialist Jobs in California
Find roles in California that match your experience and apply in just a few clicks.
Find Claims Specialist Jobs