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Insurance Claim File Review Jobs in Texas (NOW HIRING)

E-Solutions

Claim Operator

Plano, TX · On-site

Review new submissions to ensure all required documentation and claim details are included File and manage shortage claims based on shortage investigation report, theft notification, and/or warehouse ...

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Insurance Claim File Review information

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How much do insurance claim file review jobs pay per hour?

As of Sep 1, 2026, the average hourly pay for insurance claim file review in Texas is $20.36, according to ZipRecruiter salary data. Most workers in this role earn between $15.91 and $23.94 per hour, depending on experience, location, and employer.

What is an insurance claim file review?

An Insurance Claim File Review is a detailed evaluation of insurance claim documents and files to ensure accuracy, compliance, and proper processing. Professionals in this role review submitted claims, verify information, assess the validity of the claim, and determine if all required documentation is present. They may also check for potential fraud, ensure adherence to company policies, and make recommendations regarding claim approval or denial. This process is critical to maintaining the integrity of the claims system and minimizing losses for the insurance provider.

What are the key skills and qualifications needed to thrive as an insurance claim file reviewer?

To thrive as an Insurance Claim File Reviewer, you need a keen understanding of insurance policies, claims processes, and regulatory compliance, often backed by relevant experience or an insurance-related certification. Familiarity with claims management systems, document management software, and industry-specific databases is typical for the role. Attention to detail, analytical thinking, and strong written communication are vital soft skills that help ensure accuracy and clarity in claim assessments. These skills are crucial for efficiently evaluating claims, reducing errors, and ensuring fair and prompt claim resolutions.

What are some common challenges faced by professionals in insurance claim file review, and how can these be managed effectively?

Professionals in Insurance Claim File Review often encounter challenges such as interpreting complex policy language, managing large caseloads, and ensuring compliance with constantly evolving regulations. Staying organized and leveraging claim management software can help streamline the review process and reduce errors. Regular training and collaboration with legal, medical, and adjuster teams also play a key role in addressing ambiguities and maintaining accuracy in claim determinations.

What is the difference between Insurance Claim File Review vs Insurance Claims Adjuster?

AspectInsurance Claim File ReviewInsurance Claims Adjuster
Primary RoleReview and analyze insurance claim files for accuracy and completenessInvestigate, evaluate, and settle insurance claims
Required CredentialsTypically claims or insurance certifications, sometimes a background in insurance or claims processingAdjuster license, insurance certifications, relevant experience
Work EnvironmentOffice-based, primarily reviewing documents and dataField and office work, including site visits and interviews
Industry UsageCommon in insurance companies, third-party claims review firmsWidely used in insurance companies, claims departments

While both roles involve working with insurance claims, the Insurance Claim File Review focuses on analyzing claim documentation for accuracy, whereas the Insurance Claims Adjuster actively investigates and settles claims. The review role is more document-centric, often office-based, and requires specific certifications, while adjusters may work in the field and handle the entire claims process.

How to become an insurance claim file review?

To become an insurance claim file reviewer, candidates typically need a background in insurance, claims processing, or related fields, along with strong attention to detail and analytical skills. Relevant certifications such as the Certified Claims Professional (CCP) or knowledge of claims management software can enhance job prospects. Usually, employers require a high school diploma or higher education and prior experience in claims or insurance adjusting.

What are popular job titles related to Insurance Claim File Review jobs in Texas?

For Insurance Claim File Review jobs in Texas, the most frequently searched job titles are:

What job categories do people searching Insurance Claim File Review jobs in Texas look for?

The top searched job categories for Insurance Claim File Review jobs in Texas are:

Insurance Claim File Review jobs near you
Infographic showing various Insurance Claim File Review job openings in Texas as of August 2026, with employment types broken down into 94% Full Time, and 6% Contract. Highlights an 89% In-person, 3% Hybrid, and 8% Remote job distribution, with an average salary of $42,352 per year, or $20.4 per hour.

Senior Claims Analyst/Claims Manager, Commercial Auto

Starr Insurance Companies

Dallas, TX • On-site

Full-time

Posted 21 days ago

Job description

Join Starr, a global leader in commercial insurance with over a century of expertise. We empower our employees to innovate, make impactful decisions, and build lasting client relationships worldwide. At Starr, you'll work in an entrepreneurial culture alongside accessible leaders, leveraging our financial strength and vast industry experience to deliver solutions for our clients, no matter how complex. Grow your career with a rapidly growing company that invests in its people and their ability to drive real progress.

Applicable Locations: Atlanta, Philadelphia or Dallas (on-site)

Essential Job Functions

  • Providing management oversight to Third Party Administrators commercial auto property damage and bodily injury claims personnel by monitoring the claims online using the Third Party Administrators' claim systems.
  • Reviewing monthly loss run trends, reportable claims and/ or problematic claims.
  • Provide excellent claim service to external clients and internal partners.
  • Participate in claim file reviews with insureds, brokers and Third Party Administrator's claim personnel.
  • Interface with underwriting on claim status, exposures and other factors impacting their risks.
  • Review and approve Third Party Administrator's monthly claim handling fees.
  • Prepare internal management reports for claims with net exposure to Starr Indemnity & Liability Company in excess of $250,000 or as required.
  • Lead negotiations during case dispositions.
  • Perform other duties as required by management including reinsurance and subrogation.

Requirements

  • Eight+ years' experience in relevant litigation, handling claims or overseeing TPAs. Demonstrated success managing litigation, evaluating, and negotiating commercial auto claims involving both property damage and bodily injury exposures.
  • Strong communication (verbal and written) and interpersonal skills.
  • 15% Travel is required and will vary depending on business needs and caseload.
  • Working knowledge of Microsoft Word and Excel.
  • Ability to manage time effectively, set priorities, and meet deadlines.
  • Insurance Adjuster License
  • Bachelor's degree

Starr is an equal opportunity employer, which means we'll consider all suitably qualified applicants regardless of gender identity or expression, ethnic origin, nationality, religion or beliefs, age, sexual orientation, disability status or any other protected characteristic. We recruit and develop our people based on merit and we're committed to creating an inclusive environment for all employees. We offer first class training and development opportunities to all employees. Our aim is to grow our own talent and bring out the best in people.

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