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Claims Processor Jobs in Frisco, TX (NOW HIRING)

Guidewell

Claims Examiner I

Irving, TX · On-site

Day-to-day processing of claims for accounts: * Responsible for processing of claims (medical, dental, vision, and mental health claims) * Claims processing and adjudication. * Claims research where ...

Guidewell

Claims Examiner I

Irving, TX · On-site

Day-to-day processing of claims for accounts: * Responsible for processing of claims (medical, dental, vision, and mental health claims) * Claims processing and adjudication. * Claims research where ...

WebTPA

Claims Examiner I

Irving, TX

Day-to-day processing of claims for accounts: * Responsible for processing of claims (medical, dental, vision, and mental health claims) * Claims processing and adjudication. * Claims research where ...

WebTPA

Claims Examiner I

Irving, TX

Day-to-day processing of claims for accounts: * Responsible for processing of claims (medical, dental, vision, and mental health claims) * Claims processing and adjudication. * Claims research where ...

Guidewell

Claims Examiner I

Irving, TX · On-site

Day-to-day processing of claims for accounts: * Responsible for processing of claims (medical, dental, vision, and mental health claims) * Claims processing and adjudication. * Claims research where ...

Guidewell

Claims Examiner I

Irving, TX · On-site

Day-to-day processing of claims for accounts: * Responsible for processing of claims (medical, dental, vision, and mental health claims) * Claims processing and adjudication. * Claims research where ...

Careington

Claims Finance Manager

Frisco, TX · On-site

Provider Claim Payment Cycle Processing * Provider Recoupments * Own the reconciliation of claims funding, payment disbursements, credits, recoupments, refunds, and related general ledger activity

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 the proper sorting and organization of bills prior to data entry into our software system.

NTT DATA Services

Claims Examiner Remote

Plano, TX · On-site +1

We are currently seeking a Claims Examiner Remote to join our team in Plano, Texas (US-TX), United ... Processing of Professional claim forms files by provider Reviewing the policies and benefits Comply ...

Corvel

Claims Assistant

Irving, TX · Remote

$13.08 - $22.89/hr

Process mail, handle files (until paperless), and input notes/diary entries in the claims system * Process payments, as needed * Process form letters, state forms and reports * Assist claims ...

NTT DATA Services

Claims Examiner Remote

Plano, TX · On-site +1

NTT DATA is seeking to hire a Remote Claims Processing Associate to work for our end client and their team. In this Role the candidate will be responsible for: • Processing of Professional claim ...

WebTPA

Claims Examiner I

Irving, TX

Claims processing and adjudication. * Claims research where applicable. * Reviews and processes insurance to verify medical necessities and coverage under policy guidelines (clinical edit logic)

NTT DATA Services

Claims Examiner Remote

Plano, TX · On-site +1

NTT DATA is seeking to hire a Remote Claims Processing Associate to work for our end client and their team. In this Role the candidate will be responsible for: • Processing of Professional claim ...

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Showing results 21-40

All JobsClaims Processor JobsClaims Processor Jobs in Frisco, TX

Claims Processor information

See Frisco, TX salary details

$11

$17

$24

How much do claims processor jobs pay per hour?

As of Sep 4, 2026, the average hourly pay for claims processor in Frisco, TX is $17.94, according to ZipRecruiter salary data. Most workers in this role earn between $15.29 and $19.33 per hour, depending on experience, location, and employer.

What is a claims processor?

A claims processor reviews insurance claims. Their responsibilities include verifying insurance policy coverage and making sure client information is accurate. After they determine there is a covered loss, a processor documents the information and makes sure all the required paperwork is complete. Other duties include modifying new or existing policies.

What does a claims processor do?

A Claims Processor is responsible for reviewing, evaluating, and processing insurance claims submitted by policyholders. They verify the accuracy of the information provided, ensure all required documentation is present, and determine if the claim meets the policy's terms and conditions. Claims Processors work with both customers and insurance adjusters to resolve any discrepancies and help facilitate timely payments. Their role is essential in ensuring that claims are handled efficiently and fairly.

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

To thrive as a Claims Processor, you need strong analytical abilities, attention to detail, and knowledge of insurance policies, typically supported by a high school diploma or associate degree. Familiarity with claims management software, data entry systems, and sometimes industry certifications like AIC (Associate in Claims) is valuable. Excellent organization, communication, and customer service skills help you efficiently resolve claims and interact with clients. These competencies ensure accuracy, minimize errors, and maintain trust in the claims process.

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

Claims Processors often encounter challenges such as managing high volumes of claims, handling complex or incomplete documentation, and meeting strict accuracy and timeliness standards. To navigate these, strong organizational skills, effective communication with colleagues and claimants, and attention to detail are crucial. Utilizing workflow management tools and maintaining open channels with supervisors and other departments can help address issues quickly and ensure claims are processed efficiently. Regular training and staying updated on policy changes also support success in this role.

What is the difference between Claims Processor vs Claims Examiner?

AspectClaims ProcessorClaims Examiner
Required CredentialsHigh school diploma or equivalent; some roles may require certificationHigh school diploma; certification often preferred
Work EnvironmentOffice setting, processing claims efficientlyOffice setting, reviewing and approving claims
Employer & Industry UsageInsurance companies, healthcare providersInsurance companies, government agencies
Common Search & ComparisonClaims Processor vs Claims Examiner

Claims Processors primarily handle the data entry and initial processing of insurance claims, focusing on accuracy and efficiency. Claims Examiners review claims for validity, compliance, and coverage before approval. While both roles work within the insurance industry and require similar credentials, Claims Examiners typically perform more detailed reviews and decision-making tasks. Understanding these differences helps job seekers identify the right role based on their skills and career goals.

Do you need a degree to be a claims processor?

A degree is not typically required to become a claims processor, as most employers prioritize relevant skills such as attention to detail, communication, and familiarity with claims processing software. Many positions accept candidates with a high school diploma or equivalent, and on-the-job training is often provided. Certifications in claims or insurance can enhance job prospects but are not mandatory.

Is claims processing a stressful job?

Claims processing is often considered a routine administrative role that requires attention to detail and organizational skills. While it can involve handling high volumes of claims and meeting deadlines, stress levels vary depending on workload, workplace environment, and individual resilience. Proper training and time management can help mitigate stress in this job.
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The most popular types of Claims Processor jobs in Frisco, TX are:

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For Claims Processor jobs in Frisco, TX, the most frequently searched job titles are:

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The top searched job categories for Claims Processor jobs in Frisco, TX are:

What cities near Frisco, TX are hiring for Claims Processor jobs?

Cities near Frisco, TX with the most Claims Processor job openings:

Claims Processor jobs near you
Infographic showing various Claims Processor job openings in Frisco, TX as of August 2026, with employment types broken down into 93% Full Time, and 7% Contract. Highlights an 86% In-person, and 14% Remote job distribution, with an average salary of $37,310 per year, or $17.9 per hour.

Claims Examiner I

Guidewell

Irving, TX • On-site

Full-time

Medical, Dental, Vision

Re-posted 4 days ago

Job description


Get To Know Us!
WebTPA, a GuideWell Company, is a healthcare third-party administrator with over 30+ years of experience building unique benefit solutions and managing customized health plans.
Key position details:
  • Training Schedule: Monday to Friday 8:00am to 4:30pm Central Time
  • Training Duration: 4 weeks
  • Anticipated training class start dates: 9/14/2026 or 10/12/2026
  • Full Time position

What is your impact?
As a Claim Examiner, you will handle processing and adjudication for healthcare claims. This will include claims research where applicable and a range of claim complexity.
What Will You Be Doing:
  • Day-to-day processing of claims for accounts:
    • Responsible for processing of claims (medical, dental, vision, and mental health claims)
    • Claims processing and adjudication.
    • Claims research where applicable.
    • Reviews and processes insurance to verify medical necessities and coverage under policy guidelines (clinical edit logic).
    • Incumbents are expected to meet and/or exceed qualitative and quantitative production standards.
  • Investigation and overpayment administration:
    • Facilitate claims investigation, negotiate settlements, interpret medical records, respond to Department of Insurance complaints, and authorize payment to claimants and providers.
    • Overpayment reviews and recovery of claims overpayment; corrected financial histories of patients and service providers to ensure accurate records.
    • Utilize systems to track complaints and resolutions.
  • Other responsibilities include resolving claims appeals, researching benefits, verifying correct plan loading.

What You Must Have:
  • 2+ years related work experience.
  • Claims examiner/adjudication experience on a computerized claims payment system in the healthcare industry.
  • High school diploma or GED
  • Knowledge of CPT and ICD-10 coding required.
  • Knowledge of COBRA, HIPAA, pre-existing conditions, and coordination of benefits required.
  • Must possess proven judgment, decision-making skills and the ability to analyze.
  • Ability to learn quickly and multitask.
  • Proficiency in maintaining good rapport with physicians, healthcare facilities, clients and providers.
  • Concise written and verbal communication skills required, including the ability to handle conflict.
  • Proficiency using Microsoft Windows and Word, Excel and customized programs for medical CPT coding.
  • Review of multiple surgical procedures and establishment of reasonable and customary fees.

What We Prefer:
  • Some college courses in related fields are a plus.
  • Other experience in processing all types of medical claims helpful.
  • Data entry and 10-key by touch/sight

General Physical Demands: Sedentary work: Exerting up to 10 pounds of force occasionally to move objects. Jobs are sedentary if traversing activities are required only occasionally.
Sedentary work: Exerting up to 10 pounds of force occasionally to move objects. Jobs are sedentary if traversing activities are required only occasionally.
We are an Equal Employment Opportunity employer committed to cultivating a work experience where everyone feels like they belong and can perform at their best in pursuit of our mission. All qualified applicants will receive consideration for employment.

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