Claim Operations Specialist (Insurance)

Location: Rancho Cordova, California, United States

Salary: $45,400–$74,900 annual base salary, plus eligibility for performance-based cash incentive awards.

Company

Property and casualty insurance organization focused on serving customers and communities through innovation and collaboration.

What you will do

• Respond to customer questions about claim status and payments, triage calls, and route inquiries to the appropriate department.
• Partner with claim professionals to document claim files, request records, review medical bills and wage statements, and prepare documents for legal and medical reviews.
• Process claim payments, vendor invoices, attorney expenses, medical processing fees, returned checks, voided checks, and credits.
• Maintain accurate claim and operational data, prepare reports, correct discrepancies, and document completed work in relevant systems.
• Perform reconciliations, assess financial controls, communicate findings, and prepare data entries according to established standards.
• Process incoming and outgoing mail, manage file storage transitions, and order and distribute supplies or equipment; occasional lifting of up to 20 pounds may be required.

Requirements

• High school diploma or GED.
• One year of service-related work experience or a bachelor's degree.
• Experience with Microsoft Office, email, web-enabled applications, and database software.
• Strong verbal and written communication, analytical thinking, judgment, decision-making, accountability, and relationship-management skills.
• Ability to remain focused during ambiguity, change, or strenuous demands.

Culture & Benefits

• Health insurance coverage is available to employees and eligible family members from the first day of employment.
• Dollar-for-dollar 401(k) matching is provided up to the first 5% of eligible pay, subject to an annual maximum, along with a company-funded pension plan.
• Benefits include at least 20 days of paid time off annually and nine paid company holidays.
• Wellness resources include discounts, caregiving support, mental health services, professional counseling, and health coaching.
• Volunteer and matching-gift programs support community involvement.