... 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 ...
... 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 ...
Insurance Claims Specialist
Dallas, TX · On-site
... 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 ...
Insurance Claims Specialist
Dallas, TX · On-site
... 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 ...
Insurance claims management and related activities, e.g., initial reporting, claim development ... claim reviews, generation of loss runs, recurring incident report reviews. * Perform other duties ...
Insurance claims management and related activities, e.g., initial reporting, claim development ... claim reviews, generation of loss runs, recurring incident report reviews. * Perform other duties ...
Commercial Lines Insurance Account Manager
Dallas, TX · Hybrid
$70K - $80K/yr
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 ...
Quick apply
Commercial Lines Insurance Account Manager
Dallas, TX · Hybrid
$70K - $80K/yr
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 ...
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 ...
Complex Claims Specialist III - D&O And FI E&O Insurance
Dallas, TX · Remote
$60 - $90/hr
... reviewing and interpreting policy language and partnering with coverage counsel as needed, estimating potential claim valuation, and following company's claim handling protocols. • Leads all ...
Posted today
Complex Claims Specialist III - D&O And FI E&O Insurance
Dallas, TX · Remote
$60 - $90/hr
... reviewing and interpreting policy language and partnering with coverage counsel as needed, estimating potential claim valuation, and following company's claim handling protocols. • Leads all ...
Posted today
Insurance Specialist
Coppell, TX · On-site
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 ...
Insurance Specialist
Coppell, TX · On-site
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 ...
Commercial Lines Insurance Account Manager
Houston, TX · Hybrid
$75K - $90K/yr
Insurance - Senior Commercial Line Account Manager (Mid to Large Market Construction Risks ... Coordinating and conducting claim review meetings for selected accounts; Visiting client sites to ...
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Commercial Lines Insurance Account Manager
Houston, TX · Hybrid
$75K - $90K/yr
Insurance - Senior Commercial Line Account Manager (Mid to Large Market Construction Risks ... Coordinating and conducting claim review meetings for selected accounts; Visiting client sites to ...
Participates in insurer claim file reviews and conducts regular internal claim reviews * Coordinate with insurance claim teams, holding them accountable for providing superior claim management ...
Participates in insurer claim file reviews and conducts regular internal claim reviews * Coordinate with insurance claim teams, holding them accountable for providing superior claim management ...
Global Cargo Claims Specialist
Houston, TX · On-site
Participates in insurer claim file reviews and conducts regular internal claim reviews * Coordinate with insurance claim teams, holding them accountable for providing superior claim management ...
Global Cargo Claims Specialist
Houston, TX · On-site
Participates in insurer claim file reviews and conducts regular internal claim reviews * Coordinate with insurance claim teams, holding them accountable for providing superior claim management ...
Workers' Compensation Specialist
$40K - $70K/yr
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 ...
Workers' Compensation Specialist
$40K - $70K/yr
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 ...
Insurance Risk Manager (Remote)
Dallas, TX · On-site +1
... claim and premium payments. Claims Management * Oversee insurance claims handling, including ... Review insurance requirements in contracts with vendors and clients, in consultation with Legal ...
Insurance Risk Manager (Remote)
Dallas, TX · On-site +1
... 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 ...
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 ...
Insurance Follow Up Representative
Leon Valley, TX · Hybrid
$20 - $23/hr
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.
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Insurance Follow Up Representative
Leon Valley, TX · Hybrid
$20 - $23/hr
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.
DME Pharmacy Billing Specialist
Austin, TX · On-site
$18.75 - $25.25/hr
... review documentation, resolve claim issues, and communicate effectively with internal pharmacy teams, medical professionals, and insurance carriers. Great New Career Opportunity in Long-Term Care ...
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DME Pharmacy Billing Specialist
Austin, TX · On-site
$18.75 - $25.25/hr
... review documentation, resolve claim issues, and communicate effectively with internal pharmacy teams, medical professionals, and insurance carriers. Great New Career Opportunity in Long-Term Care ...
Worker's Compensation AR Collections Specialist-Remote anywhere in the state of Texas (2091)
Houston, TX · Remote
$19.25 - $24.50/hr
... claim corrections, reconciliation, Insurance refunds/credit balances, customer service, and follow-up. This includes reviewing claim information to ensure accuracy and provide feedback to the ...
Worker's Compensation AR Collections Specialist-Remote anywhere in the state of Texas (2091)
Houston, TX · Remote
$19.25 - $24.50/hr
... claim corrections, reconciliation, Insurance refunds/credit balances, customer service, and follow-up. This includes reviewing claim information to ensure accuracy and provide feedback to the ...
Claims Analyst - Commercial Insurance
Richardson, TX · On-site
$65K - $80K/yr
Review and analyze insurance policies to address coverage-related questions and concerns at the time of a claim/possible claim, placement/renewal, and/or otherwise. * Review and analyze complaints ...
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Claims Analyst - Commercial Insurance
Richardson, TX · On-site
$65K - $80K/yr
Review and analyze insurance policies to address coverage-related questions and concerns at the time of a claim/possible claim, placement/renewal, and/or otherwise. * Review and analyze complaints ...
Commercial Lines Account Manager
Dallas, TX · Hybrid
$70K - $80K/yr
... 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 ...
Quick apply
Commercial Lines Account Manager
Dallas, TX · Hybrid
$70K - $80K/yr
... 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 ...
Senior Claims Analyst - Hospital Bill Review
Plano, TX · On-site +1
Review high-cost and catastrophic claims (typically $100K+) to identify overpayments, contract ... loss insurance, including specific/aggregate deductibles, laser provisions, and how claim ...
Senior Claims Analyst - Hospital Bill Review
Plano, TX · On-site +1
Review high-cost and catastrophic claims (typically $100K+) to identify overpayments, contract ... loss insurance, including specific/aggregate deductibles, laser provisions, and how claim ...
Insurance Follow-Up & Medical Collections Specialist (Sugar Land, TX)
Houston, TX · On-site
$17 - $17.50/hr
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 ...
Insurance Follow-Up & Medical Collections Specialist (Sugar Land, TX)
Houston, TX · On-site
$17 - $17.50/hr
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 ...
Insurance Claim Review information
See Texas salary details
$11.87 - $14.44
8% of jobs
$16.15 is the 25th percentile. Wages below this are outliers.
$14.44 - $17
25% of jobs
The median wage is $18.95 / hr.
$17 - $19.57
22% of jobs
$19.57 - $22.13
15% of jobs
$23.30 is the 75th percentile. Wages above this are outliers.
$22.13 - $24.70
11% of jobs
$24.70 - $27.26
5% of jobs
$27.26 - $29.83
3% of jobs
$29.83 - $32.39
3% of jobs
$32.39 - $34.96
3% of jobs
$34.96 - $37.52
3% of jobs
$37.52 - $40.09
1% of jobs
$11
$21
$40
How much do insurance claim review jobs pay per hour?
What is the difference between Insurance Claim Review vs Insurance Adjuster?
| Aspect | Insurance Claim Review | Insurance Adjuster |
|---|---|---|
| Credentials | Typically requires insurance or claims processing certifications | Requires licensing and adjuster certifications |
| Work Environment | Office-based, reviewing claims remotely or on-site | Fieldwork, inspecting damages, meeting clients |
| Employer & Industry Usage | Insurance companies, third-party claims services | Insurance companies, independent adjusting firms |
| Search & Comparison Intent | Understanding claim review roles, job duties | Assessing 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?
What is insurance claim review?
What are some common challenges faced in an Insurance Claim Review role, and how can they be managed effectively?

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.
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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