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Claim Associate Jobs in Texas (NOW HIRING)

The Reny Company

Medical Claim Processor

Plano, TX · On-site

$18.50 - $21/hr

THIS IS NOT A REMOTE POSITION The Reny Company's medical claim processor is a professional who ... * Assoc. Degree * 2 to 4 years of administrative experience * Experience in CPT/medical coding is ...

Great American Insurance Group

$20 - $27/hr

Position Overview The Claims Operations Associate II provides operational and administrative ... This role serves as a key partner to adjusters by handling claim-related transactions ...

Chubb

ESIS Claims Associate

Dallas, TX · On-site

$17.75 - $23.75/hr

Job Title Claims Associate Are you ready to make a meaningful impact in the world of workers ... Under close supervision, receive assignments and review claim and policy information to provide ...

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All JobsClaim Associate JobsClaim Associate Jobs in Texas

Claim Associate information

See Texas salary details

$12

$19

$26

How much do claim associate jobs pay per hour?

As of Aug 16, 2026, the average hourly pay for claim associate in Texas is $19.61, according to ZipRecruiter salary data. Most workers in this role earn between $16.78 and $21.30 per hour, depending on experience, location, and employer.

What is a claim associate?

Claim Associates are professionals who handle and process insurance claims for individuals or businesses. They review claim details, gather necessary documentation, and communicate with policyholders to verify information and determine coverage. Their goal is to ensure that claims are processed efficiently and accurately according to company policies and regulations. Claim Associates may also coordinate with other departments and provide customer service throughout the claims process.

What is the difference between Claim Associate vs Claims Adjuster?

AspectClaim AssociateClaims Adjuster
Required CredentialsHigh school diploma or equivalent; some roles may prefer insurance licensesHigh school diploma; state licensing often required
Work EnvironmentOffice setting, customer service interactions, data entryField and office work, investigating claims, inspecting damages
Employer & Industry UsageInsurance companies, claims processing centersInsurance companies, third-party claims firms
Common Search & ComparisonOften compared for entry-level roles in claims processingMore experienced, investigative roles in claims handling

The main difference between a Claim Associate and a Claims Adjuster lies in their responsibilities and experience level. Claim Associates typically handle initial claims processing and customer service, while Claims Adjusters investigate and evaluate claims, often requiring more experience and licensing. Both roles are essential in the insurance industry, but they differ in scope and complexity.

What are the typical challenges a claim associate faces when handling multiple claims simultaneously?

Claim Associates often manage several claims at once, which requires strong organizational skills and attention to detail. One common challenge is prioritizing tasks to ensure timely processing while maintaining accuracy. Additionally, balancing communication with claimants, providers, and internal teams can be demanding, especially when resolving complex cases. Building effective time management strategies and leveraging claim management software can help Claim Associates meet deadlines and reduce errors.

Is claims processing a stressful job?

Claims processing is a core responsibility of Claim Associates, involving reviewing and managing insurance claims, which can be stressful due to tight deadlines, high workload, and the need for accuracy. The job often requires strong attention to detail, communication skills, and the ability to handle sensitive information under pressure.

How much do claim associates make in the US?

Claim associates in the US typically earn an average salary of around $45,000 to $55,000 per year. Salaries can vary based on experience, location, and the employer, with some earning higher with specialized skills or certifications in claims processing and insurance procedures.

What are the key skills and qualifications needed to thrive as a claim associate, and why are they important?

To thrive as a Claim Associate, you need strong analytical abilities, attention to detail, and a foundational understanding of insurance policies, typically supported by a high school diploma or equivalent. Familiarity with claims management software, document processing systems, and sometimes basic Excel skills is often required. Excellent communication, problem-solving, and customer service skills help build trust and effectively resolve client issues. These skills ensure accurate claim processing, client satisfaction, and efficient workflow in a high-volume environment.

What are the most commonly searched types of Claim jobs in Texas?

The most popular types of Claim jobs in Texas are:

What cities in Texas are hiring for Claim Associate jobs?

Cities in Texas with the most Claim Associate job openings:

Claim Associate jobs near you
Infographic showing various Claim Associate job openings in Texas as of August 2026, with employment types broken down into 1% As Needed, 73% Full Time, 24% Part Time, 1% Temporary, and 1% Contract. Highlights an 97% Physical, 1% Hybrid, and 2% Remote job distribution, with an average salary of $40,791 per year, or $19.6 per hour.

Claim Auditor I

Cook Children's Health Care System

Fort Worth, TX

Full-time

Re-posted 22 days ago

Cook Children's Health Care System rating

7.9

Company rating: 7.9 out of 10

Based on 77 frontline employees who took The Breakroom Quiz

108th of 887 rated healthcare providers

Job description

Location:

Calmont Operations Building

Department:

Reimbursement Analysis

Shift:

First Shift (United States of America)

Standard Weekly Hours:

40

Summary:

The Claim Auditor I is responsible for auditing behavioral and medical claims and ensuring quality metrics are met by conducting post claims reviews on posted claims for Texas Medicaid and CHIP programs. The Claim Auditor I is responsible for auditing a set claim sampling on a monthly basis of routine to moderate complexity which includes paper and electronic claims submission. The Claim Auditor I ensures that claims payment integrity aligns with regulatory standards, timelines, business policy, provider and HHSC contracts, appropriate coding and system configuration. Audit reports may include UB-1450 and HCFA CMS 1500 claim forms not limited to behavioral health, physician, Institutions for Mental Disease, hospital outpatient and inpatient, and long term services and support claims. The Claim auditor is also responsible for pre-auditing high dollar claims to ensure claim payment is accurate before releasing the claim for payment. The Claim Auditor I is also responsible for communicating audit results to the Reimbursement and Analysis Manager in a structured report format within required timelines. Results of the audits are to be communicated to the Claims Department. The individual in this position performs all job functions in accordance with HIPPA and security rules as it relates to protected health information and has a thorough understanding of claims life cycle.

Additional Information:

  • The Claim Auditor I is responsible for auditing behavioral and medical claims and ensuring quality metrics are met by conducting post claims reviews on posted claims for Texas Medicaid and CHIP programs. The Claim Auditor I is responsible for auditing a set claim sampling on a monthly basis of routine to moderate complexity which includes paper and electronic claims submission. The Claim Auditor I ensures that claims payment integrity aligns with regulatory standards, timelines, business policy, provider and HHSC contracts, appropriate coding and system configuration. Audit reports may include UB-1450 and HCFA CMS 1500 claim forms not limited to behavioral health, physician, Institutions for Mental Disease, hospital outpatient and inpatient, and long term services and support claims. The Claim auditor is also responsible for pre-auditing high dollar claims to ensure claim payment is accurate before releasing the claim for payment. The Claim Auditor I is also responsible for communicating audit results to the Reimbursement and Analysis Manager in a structured report format within required timelines. Results of the audits are to be communicated to the Claims Department. The individual in this position performs all job functions in accordance with HIPPA and security rules as it relates to protected health information and has a thorough understanding of claims life cycle.


Education:

  • Associates degree required or a minimum of 5 years of claims/audit experience which includes experience with federal programs (Medicaid, CHIP) or in a health plan/payor environment preferred. 7-10 years of medical claims processing, claim adjudication, coordination of benefit plan, medical terminology and coding.
  • Must have strong organizational skills, problem solving and decision-making skills. Advanced knowledge of claim adjudication and benefit plan application for Medicaid and CHIP programs.
  • Microsoft Office skills including Word, Excel and Access. Excellent customer service skills with ability to explain complicated benefit issues to staff and providers.

Certification/Licensure:

About Us:

Cook Children's Health Plan

Cook Children's Health Plan provides vital coverage to nearly 120,000 people in low-income families who qualify for government-sponsored programs in our six county service region. Cook Children's Health Plan provides health coverage for CHIP, CHIP Perinatal, STAR (Medicaid) and STAR Kids Members in the Tarrant county service area. The counties we serve includes Tarrant, Johnson, Denton, Parker, Hood and Wise.

Cook Children's is an EOE/AA, Minority/Female/Disability/Veteran employer.

What Cook Children's Health Care System employees say

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About Cook Children's Health Care System

Sourced by ZipRecruiter

Cook Children's Health Care System, based in Fort Worth, Texas, operates in the healthcare industry with a primary focus on pediatric health services. Established in 1918, the system has been committed to improving the health of children through the prevention and treatment of childhood diseases. This integrated pediatric healthcare system includes a medical center, physician network, home health company, research institute, and a health plan. At the core of its operations is the mission to 'Improve the Health of Every Child' in its community, reflecting its commitment to providing quality care, research, education, and prevention and wellness services.

Industry

Health care and social assistance

Company size

5,001 - 10,000 Employees

Headquarters location

Fort Worth, TX, US

Year founded

1918

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