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Insurance Claim File Review Jobs in Texas (NOW HIRING)

Allied Solutions

Claims Investigator

Plano, TX · On-site

This position ensures that all claim documentation is thoroughly reviewed and assessed for coverage ... This position will also review database information found in systems such as Unitrac, insurance ...

Allied Solutions

Claims Investigator

Plano, TX · On-site

This position ensures that all claim documentation is thoroughly reviewed and assessed for coverage ... This position will also review database information found in systems such as Unitrac, insurance ...

CCMSI

Claim Clerk

Dallas, TX · On-site

$19 - $20/hr

File claim mail and related documents. * Set up designated claim files and complete all set up ... Medical, Dental, Vision, Life, and Disability Insurance * Retirement plans : 401(k) and Employee ...

Edge Claims

Claims Adjuster, Litigation

Westlake, TX · On-site

... the claim file through various phases of litigation. * Properly document claims files. * Review ... High school diploma, bachelor's degree preferred. * 10 or more years of Commercial Auto Insurance ...

CCMSI

Claim Clerk

Dallas, TX · On-site

$19 - $20/hr

File claim mail and related documents. * Set up designated claim files and complete all set up ... Medical, Dental, Vision, Life, and Disability Insurance * Retirement plans : 401(k) and Employee ...

CCMSI

Claim Clerk

Dallas, TX · On-site

$19 - $20/hr

File claim mail and related documents. * Set up designated claim files and complete all set up ... Medical, Dental, Vision, Life, and Disability Insurance * Retirement plans : 401(k) and Employee ...

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All JobsInsurance Claim File Review JobsInsurance Claim File Review Jobs in Texas

Insurance Claim File Review information

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$9

$20

$42

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.

Insurance Follow-Up & Medical Collections Specialist (Sugar Land, TX)

ARstrat LLC

Houston, TX • On-site

$17 - $17.50/hr

Other

Medical, Dental, Vision, Life, Retirement, PTO

This job post has expired 1 day ago. Applications are no longer accepted.

Job description

Join Our Team as a Medical Collections & Insurance Follow-Up Specialist!
Are you experienced in working accounts on the backend and navigating insurance claims to drive payment? We’re looking for someone who can manage both insurance follow-up and medical collections to help resolve accounts efficiently and accurately.
If you’re detail-oriented, know how to work claims, and can identify what’s holding up payment, this role is for you.
Potential Start Date: 7/20/2026
Location: Onsite- (Sugarland, Texas 77478)
Compensation: $17- $17.50 per hour (based on experience) + quarterly bonus eligibility
Shift: Monday – Friday, 9:00 AM – 6:00 PM
Position Requirements:
As a Medical Collections & Insurance Follow-Up Specialist, you’ll be responsible for managing delinquent accounts and ensuring timely insurance claim resolution. This role is focused on backend revenue cycle work, combining insurance follow-up and collections activities to support overall account resolution.
You’ll work directly with insurance carriers, review claims, and resolve billing issues to secure payment—while also working accounts to drive resolution and reduce outstanding balances.
Position Responsibilities:
  • Insurance Follow-Up & Claims Resolution:
    • Follow up with insurance carriers on claim status and payment resolution
    • Review accounts to identify claim issues, denials, or delays
    • Verify insurance eligibility, coverage, and claim filing status
    • Re-bill and submit corrected claims as needed
    • Request and review documentation to support claim processing
    • Identify root causes of claim issues and escalate when appropriate
    Medical Collections (Backend):
    • Work assigned accounts to resolve outstanding balances
    • Analyze account history and determine appropriate next steps for resolution
    • Ensure timely follow-up and account progression through the revenue cycle
    • Maintain accuracy in account documentation and updates
    General Responsibilities:
    • Document all account activity accurately in systems
    • Collaborate with internal billing and operations teams
    • Ensure compliance with all Federal, State, and company guidelines
    • Identify trends and recommend process improvements
Qualifications:
  • High School Diploma or GED required
  • 1–2+ years of experience in insurance follow-up, AR, or medical billing REQUIRED
  • Strong understanding of:
    • Insurance claims and denials
    • EOBs and payment posting
    • Revenue cycle processes
  • Healthcare call center or backend AR experience preferred
Requirements:
  • Strong analytical and problem-solving skills
  • Ability to manage workload and meet productivity goals
  • Experience with billing systems (EPIC a plus)
  • Proficient in Microsoft Office
  • Typing speed: 35 WPM with no more than 3 errors
  • Bilingual (Spanish) a plus
Benefits:
  • Comprehensive Health Benefits: Choose from a variety of medical, dental, and vision plans designed to support your overall well-being.
  • Life & Disability Coverage: Receive company-paid Basic Life and AD&D insurance, short-term and long-term disability coverage, with the option to purchase additional voluntary Life and AD&D benefits.
  • 401(k) Retirement Plan: Become eligible to participate in the company's 401(k) plan on the first day of the quarter following three months of continuous employment, with a company match to help you invest in your future.
  • Paid Time Off: Begin accruing PTO on your first day of employment, promoting a healthy work-life balance from the start.
  • Flexible Benefit Options: Tailor your benefits package with a variety of options to meet your individual and family needs.

Note: This job description outlines the primary duties and qualifications for the role. It is not intended to be an exhaustive list of responsibilities or working conditions.
ARStrat is an Equal Opportunity Employer and participates in E-Verify.
Equal Opportunity Employer
This employer is required to notify all applicants of their rights pursuant to federal employment laws.
For further information, please review the Know Your Rights notice from the Department of Labor.

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