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Claims Processing Jobs in Houston, TX (NOW HIRING)

IQVIA

Medical Biller/Claims Processing

Houston, TX · Remote

$23/hr

Evaluate claims against program-specific business rules todetermineapproval or rejection ... Experience in claim processing Required * Ability to interpret EOBs Required * Insurance ...

RemX

Be Seen First

Medical Claims Eligibility Specialist - Billing & Collections

Houston, TX · On-site

$22/hr

Process billing for in-network and out-of-network medical claims . * Review and resubmit claims under the No Surprises Act when applicable. * Maintain accurate electronic and physical claim files.

Apache Industrial Services

Claims Manager

Houston, TX · On-site

Manages the COI process * Oversight of OCIP and CCIP insurance processes and timely claims reporting * Supports the renewal process by gathering and reporting incurred claims data for each line of ...

Apache Industrial Services

Claims Manager

Houston, TX · On-site

Manages the COI process * Oversight of OCIP and CCIP insurance processes and timely claims reporting * Supports the renewal process by gathering and reporting incurred claims data for each line of ...

Apache Industrial Services

Claims Manager

Houston, TX · On-site

Manages the COI process * Oversight of OCIP and CCIP insurance processes and timely claims reporting * Supports the renewal process by gathering and reporting incurred claims data for each line of ...

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Claims Processing information

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How much do claims processing jobs pay per hour?

As of Aug 27, 2026, the average hourly pay for claims processing in Houston, TX is $18.30, according to ZipRecruiter salary data. Most workers in this role earn between $15.62 and $19.76 per hour, depending on experience, location, and employer.

What is claims processing?

Claims processing is the procedure by which insurance companies or organizations review and manage claims submitted by policyholders or clients. This involves verifying the details of the claim, ensuring all necessary documentation is provided, assessing the validity of the claim, and determining the appropriate payout or resolution. Claims processors play a crucial role in ensuring claims are handled efficiently, accurately, and in compliance with company policies and regulations.

What are the key skills and qualifications needed to thrive as a claims processor?

To thrive as a Claims Processor, you need a solid understanding of insurance policies and claims procedures, typically supported by a high school diploma or equivalent and relevant on-the-job training. Familiarity with claims management software, data entry systems, and basic office applications is essential. Strong attention to detail, analytical thinking, and effective communication skills help you resolve claims accurately and efficiently. These skills ensure the timely and proper handling of claims, enhancing customer satisfaction and minimizing errors or fraudulent activity.

What are some common challenges faced by professionals in claims processing, and how can they be managed effectively?

Professionals in claims processing often deal with high volumes of work, tight deadlines, and complex cases that require attention to detail. Managing these challenges involves staying organized, utilizing claims management software efficiently, and continuously updating knowledge of insurance policies and regulations. Effective communication with team members and other departments is also crucial to resolve discrepancies quickly and ensure accurate claim adjudication. Many organizations offer ongoing training and mentorship to help staff adapt to changes and improve efficiency.

What is the difference between Claims Processing vs Claims Adjuster?

AspectClaims ProcessingClaims Adjuster
CredentialsHigh school diploma or equivalent; certifications varyHigh school diploma; often state licensing or certifications
Work EnvironmentOffice-based, administrative settingFieldwork and office-based, investigative environment
Industry UsageInsurance companies, healthcare providersInsurance companies, claims departments
Job FocusReviewing and processing claims for paymentInvestigating claims, determining liability and settlement

Claims Processing involves reviewing and managing insurance claims to ensure proper payment, focusing on administrative tasks. Claims Adjusters investigate claims, assess damages, and determine liability. While both roles work within the insurance industry, Claims Processing is more administrative, whereas Claims Adjusters are investigative and evaluative.

How to get a job as a claims processing?

To get a job as a claims processor, candidates typically need a high school diploma or equivalent, strong attention to detail, and good organizational skills. Relevant experience in insurance, customer service, or data entry can be beneficial, and familiarity with claims processing software is often preferred. Certifications such as the Certified Claims Professional (CCP) can improve job prospects.

Is claims processing a stressful job?

Claims processing can be a stressful job due to tight deadlines, high volume of claims, and the need for accuracy. It often requires attention to detail, communication skills, and the ability to handle complex or difficult cases, which can contribute to job stress.

What do claims processing specialists do?

Claims processing specialists review and evaluate insurance claims to determine coverage and payment amounts. They verify information, ensure accuracy, and process claims efficiently using claims management software, often adhering to company policies and industry regulations.

What are the most commonly searched types of Claims Processing jobs in Houston, TX?

The most popular types of Claims Processing jobs in Houston, TX are:

What cities near Houston, TX are hiring for Claims Processing jobs?

Cities near Houston, TX with the most Claims Processing job openings:

Claims Processing jobs near you
Infographic showing various Claims Processing job openings in Houston, TX as of August 2026, with employment types broken down into 1% As Needed, 80% Full Time, 14% Part Time, 1% Temporary, 3% Contract, and 1% Nights. Highlights an 93% Physical, 2% Hybrid, and 5% Remote job distribution, with an average salary of $38,068 per year, or $18.3 per hour.

Workflow Specialist Claims Processing

Tata Consultancy Services

Cypress, TX • On-site

$50K - $53K/yr

Other

Medical, Dental, Vision, Retirement, PTO

Re-posted 15 days ago

Tata Consultancy Services rating

6.5

Company rating: 6.5 out of 10

Based on 21 frontline employees who took The Breakroom Quiz

174th of 225 rated it services

Job description

Responsibilities:
To provide Absence case management and claim adjudications, based on medical documentation and the applicable Disability/FMLA/Paid Family Leave interpretation, including determining benefits due and making timely payments and adjustments.
Review and analyze the claim nuances, eligibility review, and type of claims (intermittent or continuous)
Review and analyze medical information (i.e. attending physician reports, medical records such as diagnostic tests, office notes, operative reports, etc.) to determine if the claimant is disabled as defined.
Approval or denial on FMLA claims as per Insurance carrier, and employers guidelines
Analyzes, approves and authorizes assigned claims and determines benefits due pursuant to US paid family law regulations.
Review claims for Not in good order cases, and work on securing missing documentations including employee, physician, or employer outreach.
Communicates clearly with the claimants and clients to set expectations on all aspects of claims process either by phone and/or written correspondence.
Reviews client critical deliverables, manages the overall workload, and second-level process escalation.
Determines benefits due, makes timely claims payments/approvals and adjustments for Workers Compensation, State Short Term Disability, and other disability offsets.
Refers cases as appropriate to team lead and clinical case management
Responsible for managing the day-to-day workload and first-level process escalation, and reviews processes for accuracy and timeliness where applicable in case of peer reviews.
Provide ideas to management on continuous improvement and service level management
Performs other duties or participates in special projects as assigned
Requirements:
1+ year of Disability/FMLA/PFL claims or insurance claims experience
Experience working with FINEOS
Working knowledge of medical terminology and documents, including APS, Diagnostic Tests, Imaging Tests reports
Knowledge of disability insurance claims, benefits administration, offsets and deductions, disability duration and medical management practices mandatory
Excellent oral and written communication, including presentation skills
Strong Analytical, decision making, problem solving, and people management skills
Computer experience with keyboarding skills and proficiency in using software applications and packages including MS Office (Excel, Word, PPT)
Willingness to embrace change in a fast paced work environment
A strong desire to continuously learn and improve
Identify escalated cases and work with Team Leader to develop a plan to address key issues.
TCS Employee Benefits Summary:
• Discretionary Annual Incentive.
• Comprehensive Medical Coverage: Medical & Health, Dental & Vision, Disability Planning & Insurance, Pet Insurance Plans.
• Family Support: Maternal & Parental Leaves.
• Insurance Options: Auto & Home Insurance, Identity Theft Protection.
• Convenience & Professional Growth: Commuter Benefits & Certification & Training Reimbursement.
• Time Off: Vacation, Time Off, Sick Leave & Holidays.
• Legal & Financial Assistance: Legal Assistance, 401K Plan, Performance Bonus, College Fund, Student Loan Refinancing.
Salary Ran ge: $50,000 - $53,000 per year

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