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Claims Processor Associate Jobs in Texas (NOW HIRING)

Chubb

ESIS Claims Associate

Dallas, TX · On-site

$17.50 - $23.75/hr

We are looking to add a Claims Associate to our team who will ultimately be responsible for ... Maintain control of the claims resolution process to minimize current exposure and future risks.

Sedgwick

Claims Associate - Liability (Hybrid)

Irving, TX · Hybrid

$17 - $23/hr

... Associate - Liability (Hybrid) Are you looking for an opportunity to join a global industry leader ... Processes general liability claims determining compensability and benefits due; monitors reserve ...

Sedgwick

Claims Associate - Liability (Hybrid)

Irving, TX · On-site

$17 - $23/hr

... Associate - Liability (Hybrid) Are you looking for an opportunity to join a global industry leader ... Processes general liability claims determining compensability and benefits due; monitors reserve ...

The Reny Company

Medical Claim Processor

Plano, TX · On-site

$18.50 - $21/hr

The processor will work methodically as front-end support for our bill review department to ensure ... * Assoc. Degree * 2 to 4 years of administrative experience * Experience in CPT/medical coding is ...

Geico

Claims Specialist

Richardson, TX · On-site

$28.29/hr

Claims Processing: Efficiently and accurately handle insurance claims, ensuring adherence to ... This applies to all applicants and associates. GEICO also provides a work environment in which each ...

Emergicon LLC

Fire Claims Billing Specialist

Terrell, TX · On-site

$20/hr

... associate degree in insurance, business administration, accounting, or a related field preferred. Minimum of one year of experience in fire incident claims processing or a related field required.

Amwins

Level 1 Claims Adjuster

Plano, TX · Hybrid

... the claims process * Assess coverage, identifying and addressing potential coverage issues ... Associates degree or above preferred * Must hold or be willing to obtain a Texas or Florida ...

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Claims Processor Associate information

What does a claims processor associate do?

A Claims Processor Associate is responsible for reviewing, processing, and verifying insurance claims to ensure they are accurate and comply with policy guidelines. They investigate claim details, communicate with policyholders or medical providers for additional information, and enter claim data into company systems. Their role is crucial in ensuring timely and accurate payments or denials, helping both insurance companies and clients. Attention to detail, strong organizational skills, and excellent communication abilities are important for success in this position.

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

To thrive as a Claims Processor Associate, you need strong attention to detail, analytical skills, and a high school diploma or equivalent, with some employers preferring experience in insurance or healthcare. Familiarity with claims management software, data entry systems, and basic office applications is typically required. Excellent organizational skills, clear communication, and the ability to work efficiently under deadlines are essential soft skills for this role. These abilities ensure accurate claims processing, minimize errors, and support timely service for clients and providers.

What are some common challenges faced by claims processor associates, and how can they be effectively managed?

Claims Processor Associates often encounter challenges such as handling a high volume of claims, navigating complex policy details, and meeting strict deadlines. Successfully managing these challenges requires strong organizational skills, attention to detail, and the ability to prioritize tasks effectively. Collaborating closely with team members and regularly communicating with supervisors can also help resolve discrepancies and ensure accuracy. Most organizations provide training and support to help associates stay updated on procedures and regulatory requirements, fostering a supportive work environment.

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, strong organizational skills, and the ability to handle complex or difficult cases. However, workload and stress levels vary depending on the employer and work environment.

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

The most popular types of Claims Processor jobs in Texas are:

What are popular job titles related to Claims Processor Associate jobs in Texas?

For Claims Processor Associate jobs in Texas, the most frequently searched job titles are:

What job categories do people searching Claims Processor Associate jobs in Texas look for?

The top searched job categories for Claims Processor Associate jobs in Texas are:

What cities in Texas are hiring for Claims Processor Associate jobs?

Cities in Texas with the most Claims Processor Associate job openings:

Claims Processor Associate jobs near you
Infographic showing various Claims Processor 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.

Claims Examiner & Support Specialist Level I

HealthTexas Medical Group

San Antonio, TX • On-site

Full-time

Re-posted 27 days ago

HealthTexas rating

7.5

Company rating: 7.5 out of 10

Based on 15 frontline employees who took The Breakroom Quiz

Job description

The Claims Examiner & Support Specialist Level I is responsible for accurately processing health plan delegated claims, addressing provider inquiries via phone calls, and handling various administrative tasks within the department. In addition, you will be responsible for contributing to the growth and success of HealthTexas while upholding our Mission, Vision and Values.
Culture and Values Expectations
At HealthTexas, we believe that our workplace culture is the cornerstone of our success. We are committed to fostering an inclusive, collaborative, and innovative environment where every Associate feels valued, empowered and motivated to reach their full potential. Our culture is the driving force behind our mission "to deliver quality and compassionate care with outstanding service, every patient, every time". As a (Job Title) at HealthTexas we expect you to embody and promote our Values and defined behavioral expectations.
  • Integrity: Do the right thing, the right way, every time.
    • Be honest and uphold commitments and responsibilities, earn the trust and respect of the team and those we serve, and maintain privacy and confidentiality.
  • Compassion: Treat everyone with respect and dignity.
    • Foster an environment of inclusivity and well-being, practice patience and empathy, and assume positive intent.
  • Synergy: Collaborate to improve outcomes.
    • Invite and explore new opportunities, promote effective communication and teamwork, take pride in yourself, your work and HealthTexas.
  • Stewardship: Use resources responsibly and efficiently.
    • Implement effective strategies to attain goals, achieve maximum productivity and results, and seek continuous knowledge and improvement.

Essential Job Duties & Responsibilities
  1. Processing Health Plan Delegated Claims:
    • Reviewing claim submissions for accuracy and completeness.
    • Verifying information provided in claims to ensure it aligns with established guidelines.
    • Adjudicating claims according to the policies and regulatory guidelines set by the health plans.
    • Ensuring the accurate and timely processing of delegated claims.
  2. Answering Phone Calls:
    • Handling incoming phone calls from healthcare providers and other stakeholders.
    • Providing prompt and accurate responses to inquiries related to claims processing.
    • Documenting phone calls to include topics discussed and resolution.
    • Addressing concerns and questions from providers regarding claims.
    • Assisting with claim-related issues and resolving problems over the phone.
  3. Administrative Functions:
    • Performing various administrative tasks to support the efficient operation of the claims processing department.
    • Conducting data entry accurately and efficiently.
    • Logging disputes and tracking their resolution process.
    • Processing incoming mail related to claims and ensuring timely distribution.
    • Handling other clerical duties as assigned by supervisors or managers.
  4. Other Duties as Assigned:
    • Being flexible and willing to take on additional responsibilities as needed.
    • Adapting to changes in workflow or procedures within the claims processing department.
    • Collaborating with team members to achieve overall departmental goals.

To excel in this role, attention to detail, knowledge of healthcare claim processing, and effective communication skills are crucial. You must be familiar with the specific guidelines and policies of the health plans you are working with and stay updated on any changes. Additionally, maintaining a customer-centric approach when dealing with inquiries and issues is essential to ensure a positive experience for providers and stakeholders.
Experience
  • 1 year of call center experience preferred
  • 6 months claims adjudication experience preferred
  • 1 year experience in Claims department is a plus

Education
  • High School diploma or equivalent GED

Knowledge, Skills & Abilities
  • Basic knowledge of healthcare terminology, coding, and claim processing procedures.
  • Strong attention to detail and accuracy in data entry.
  • Good communication skills, both written and verbal.
  • Ability to adapt to changing guidelines and procedures.
  • Familiarity with relevant software and computer skills for data entry and claims processing systems, a plus.
  • Basic knowledge of Microsoft Office including Outlook, Word, Excel, and Teams.
  • Data Entry/Typing skills, a minimum of 50 words per minute.
  • Ability to establish and maintain positive and effective work relationships with coworkers, clients, members, providers, and customers.
  • Ability to multi task, as needed.

Work Hours, Travel Requirements
  • Monday - Friday, 8:00 a.m. - 5:00 p.m., and as needed to complete projects.
  • Travel to medical offices may be necessary for the purpose of providing benefit education.

Working Conditions & Physical Requirements
  • This job operates in an office setting. This role routinely uses standard office equipment such as computers, phones, photocopiers, scanners, filing cabinets and fax machines.

  • The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. While performing the duties of this job, the employee is regularly required to talk and hear. This is largely a sedentary role; however, some filing is required. This would require the ability to lift files, open filing cabinets and bend or stand on a stool as necessary. Specific vision abilities required by this job include close vision, distance vision, color vision, peripheral vision, depth perception and ability to adjust focus.

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