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Insurance Claim Review Jobs in Texas (NOW HIRING)

... insurance brokerage, and a real estate owned company. We have office locations in Dallas, TX, ... Prepare management reports summarizing claim review outcomes, payment accuracy, and performance ...

Coordinating and conducting claim review meetings for selected accounts; Visiting client sites to ... insurance and renewal data for marketing. S/he secures the renewal of existing business with ...

RoundPoint tracks all aspects of insurance, including both claim processing and data monitoring ... Ability to observe details at close range, such as viewing a computer screen, reviewing documents ...

Partner with insurance carriers, TPAs, medical providers, and legal counsel to ensure effective claim management. * Participate in claim review meetings and provide recommendations for claim ...

... claim and premium payments. Claims Management * Oversee insurance claims handling, including ... Review insurance requirements in contracts with vendors and clients, in consultation with Legal ...

Clinical Nurse Reviewer

Plano, TX · On-site

$59K - $75K/yr

Conduct prompt claim review to support internal inventory management to achieve greatest possible ... Experience and working knowledge of Health Insurance, Medicare guidelines and various healthcare ...

Conduct regular follow-up with insurance companies to check on claim statuses and resolve outstanding issues. * Review and appeal denied claims as necessary, adhering to deadlines and requirements.

... insurance company personnel and other vendor and third parties Knowledge of claims including participation in claim reviews Risk Management background is desired All inquiries will be kept ...

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Insurance Claim Review information

See Texas salary details

$11

$21

$40

How much do insurance claim review jobs pay per hour?

As of Jul 31, 2026, the average hourly pay for insurance claim review in Texas is $21.90, according to ZipRecruiter salary data. Most workers in this role earn between $16.35 and $23.94 per hour, depending on experience, location, and employer.

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

AspectInsurance Claim ReviewInsurance Adjuster
CredentialsTypically requires insurance or claims processing certificationsRequires licensing and adjuster certifications
Work EnvironmentOffice-based, reviewing claims remotely or on-siteFieldwork, inspecting damages, meeting clients
Employer & Industry UsageInsurance companies, third-party claims servicesInsurance companies, independent adjusting firms
Search & Comparison IntentUnderstanding claim review roles, job dutiesAssessing damage, settling claims

Insurance Claim Review professionals focus on evaluating and verifying insurance claims, often working in an office setting. Insurance Adjusters, on the other hand, inspect damages firsthand and negotiate settlements. Both roles require insurance-related certifications but differ in work environment and responsibilities.

What are the key skills and qualifications needed to thrive as an Insurance Claim Review Specialist, and why are they important?

To thrive as an Insurance Claim Review Specialist, you typically need a strong understanding of insurance policies, claims processes, and relevant regulations, often backed by a degree in business, finance, or a related field. Familiarity with claims management software, document management systems, and sometimes certifications such as AIC (Associate in Claims) are commonly required. Attention to detail, analytical thinking, and effective communication are critical soft skills for evaluating claims and interacting with policyholders. These skills ensure accurate, timely, and fair claim resolutions that uphold company standards and customer satisfaction.

What is insurance claim review?

Insurance claim review is the process by which insurance companies evaluate claims submitted by policyholders to determine their validity and the extent of coverage. Claims reviewers carefully examine documentation, such as medical records, police reports, or repair estimates, to ensure all policy requirements are met. This process helps prevent fraud, ensures claims are paid accurately, and maintains the integrity of the insurance system. Claim reviewers may also communicate with claimants, request additional information, or work with other professionals to make informed decisions.

What are some common challenges faced in an Insurance Claim Review role, and how can they be managed effectively?

One of the most common challenges in Insurance Claim Review is managing a high volume of claims while maintaining accuracy and compliance with regulatory standards. Claims can often be complex, requiring careful analysis of policy terms, medical or incident documentation, and communications with policyholders or third parties. Effective time management, attention to detail, and strong communication skills are essential. Collaborating closely with other departments, such as underwriting and legal, can also help resolve ambiguous cases more efficiently. Ongoing training and keeping up with changes in industry regulations further support success in this role.
Infographic showing various Insurance Claim Review job openings in Texas as of July 2026, with employment types broken down into 80% Full Time, 18% Part Time, 1% Temporary, and 1% Contract. Highlights an 87% Physical, 4% Hybrid, and 9% Remote job distribution, with an average salary of $45,544 per year, or $21.9 per hour.

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Re-posted 7 days ago


Job description

Selene Holdings is a multiple-lines business financial services firm with a mortgage servicing company, a loan diligence company, a title company, an insurance brokerage, and a real estate owned company. We have office locations in Dallas, TX, Jacksonville, FL, and Salt Lake City, UT. Founded in 2007 to address needs in the mortgage industry, Selene strives to provide amazing client and borrower experiences. A positive attitude coupled with proven creative thinking and actions are all attributes we seek in every one of our employees. If you want to make a difference, then Selene is the place for you!

The Hazard Claims Review Specialist is responsible for reviewing residential property damage claims to ensure claim payments accurately align with documented damages, policy coverage, adjuster findings, and repair estimates. This role analyzes damage reports, adjuster inspections, contractor estimates, and claim settlements to identify discrepancies, overpayments, underpayments, or potential compliance issues. The specialist develops tracking and reporting tools, collaborates with internal stakeholders and third-party vendors, and supports quality assurance efforts across the hazard claims process.

Key Responsibilities

Claims Review and Analysis

  • Review residential property damage reports, adjuster reports, inspection findings, photographs, and repair estimates.
  • Validate that claim payments are consistent with documented damages and approved scope of repairs.
  • Compare adjuster assessments against contractor estimates and settlement amounts.
  • Identify discrepancies, payment variances, duplicate charges, scope inconsistencies, and potential overpayments or underpayments.
  • Ensure claims are processed in accordance with company guidelines, investor requirements, and applicable regulations.
  • Escalate questionable claims, exceptions, or potential fraud indicators to management and appropriate stakeholders.

Claims Quality Control

  • Perform detailed quality assurance reviews of completed claims files.
  • Verify supporting documentation is complete, accurate, and properly retained.
  • Monitor claim trends, recurring issues, and process deficiencies.
  • Recommend process improvements to enhance claim accuracy and operational efficiency.
  • Support internal and external audit requests related to hazard claims activities.

Reporting and Analytics

  • Develop, maintain, and distribute claim tracking reports and dashboards.
  • Monitor claim lifecycle metrics, payment trends, vendor performance, and exception reporting.
  • Analyze claim data to identify operational risks and opportunities for process improvement.
  • Prepare management reports summarizing claim review outcomes, payment accuracy, and performance metrics.
  • Utilize Excel, reporting tools, and claims systems to track key performance indicators (KPIs).

Vendor Management

  • Coordinate with adjusters, inspectors, contractors, restoration companies, and other third-party vendors.
  • Review vendor estimates and supporting documentation for reasonableness and accuracy.
  • Monitor vendor performance against service-level agreements and quality standards.
  • Resolve documentation deficiencies and payment-related discrepancies with vendors.
  • Facilitate communication between vendors and internal business units to ensure timely claim resolution.

Stakeholder Collaboration

  • Partner with Claims, Loss Draft, Risk Management, Loan Servicing, Quality Assurance, and Compliance teams.
  • Communicate claim review findings and recommendations to management.
  • Support process improvement initiatives and special projects.
  • Assist with training efforts related to claim review standards and best practices.

Qualifications

Education

  • Bachelor's degree in Business, Insurance, Risk Management, Finance, Construction Management, or related field preferred.
  • Equivalent combination of education and experience may be considered.

Experience

  • 3+ years of experience in property insurance claims, hazard claims, loss draft administration, property inspection review, mortgage servicing, or related field.
  • Experience reviewing residential property damage assessments and insurance claim settlements.
  • Familiarity with adjuster reports, repair estimates, contractor bids, and property restoration processes.

Knowledge and Skills

  • Strong understanding of residential property insurance claims and damage assessment.
  • Knowledge of roofing, structural, water, fire, wind, hail, and disaster-related property damages.
  • Ability to analyze claim documentation and identify inconsistencies.
  • Advanced proficiency in Microsoft Excel, including pivot tables, reporting, and data analysis.
  • Strong analytical, problem-solving, and decision-making skills.
  • Excellent written and verbal communication skills.
  • Experience with claims management systems and reporting platforms preferred.
  • Ability to manage multiple priorities in a fast-paced environment.

Preferred Qualifications

  • Property and Casualty (P&C) insurance experience.
  • Adjuster license or insurance certification preferred.
  • Experience in mortgage servicing, loss draft administration, or investor claims oversight.
  • Knowledge of Xactimate or similar estimating software.
  • Experience with vendor management and performance monitoring.

Key Performance Indicators (KPIs)

  • Claims review accuracy rate.
  • Percentage of payment variances identified and resolved.
  • Turnaround time for claim reviews.
  • Vendor compliance and performance metrics.
  • Reporting accuracy and timeliness.
  • Reduction in claim payment errors and exceptions.
  • Audit and quality assurance results.
Why Selene?

Benefits
Selene Finance LP is committed to the total wellbeing of its employees and therefore offers one of the best benefits packages available in the industry today, which includes:

  • Paid Time Off (PTO)

  • Medical, Dental &Vision

  • Employee Assistance Program

  • Flexible Spending Account

  • Health Savings Account

  • Paid Holidays

  • Company paid Life Insurance

  • Matching 401(k) Plan


The job requirements listed above are representative of the knowledge, skills, and/or abilities required. This job description is not an inclusive list of all duties and responsibilities of this position. Incumbents will be required to follow any other job-related instructions and to perform any other job-related duties requested by any person authorized to give instructions or assignments. Selene reserves the right to amend and change responsibilities to meet business and organizational needs.

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