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Insurance Reviewer Jobs in Texas (NOW HIRING)

DR Horton, Inc.

Insurance Clerk

Fort Worth, TX · On-site

Actively review insurance documents (General Liability, Worker's Compensation, Professional Liability, and Auto Insurance) to ensure they meet D.R. Horton, Inc. insurance requirements. Process ...

At Home Stores LLC

Insurance Specialist

Coppell, TX · On-site

Review lease and contract insurance requirements to ensure appropriate insurance coverage and compliance. * Support annual insurance renewals by gathering underwriting information, claim summaries ...

New

At Home Stores

Insurance Specialist

Coppell, TX · On-site

Review lease and contract insurance requirements to ensure appropriate insurance coverage and compliance. * Support annual insurance renewals by gathering underwriting information, claim summaries ...

New

At Home Stores

Insurance Specialist

Coppell, TX · On-site

Review lease and contract insurance requirements to ensure appropriate insurance coverage and compliance. * Support annual insurance renewals by gathering underwriting information, claim summaries ...

New

At Home Stores LLC

Insurance Specialist

Coppell, TX · On-site

Review lease and contract insurance requirements to ensure appropriate insurance coverage and compliance. * Support annual insurance renewals by gathering underwriting information, claim summaries ...

New

Zelis

Clinical Nurse Reviewer

Plano, TX · On-site

Conduct review of facility and outpatient bills as it compares with medical records and coverage ... Experience and working knowledge of Health Insurance, Medicare guidelines and various healthcare ...

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Insurance Reviewer information

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$27

$45

How much do insurance reviewer jobs pay per hour?

As of Jul 14, 2026, the average hourly pay for insurance reviewer in Texas is $27.84, according to ZipRecruiter salary data. Most workers in this role earn between $21.06 and $34.04 per hour, depending on experience, location, and employer.

What does a claims reviewer do?

A claims reviewer evaluates insurance claims to determine their validity and ensure they comply with policy terms. They analyze documentation, assess damages or losses, and decide whether to approve, deny, or request additional information, often using specialized software and following company guidelines.

What are some common challenges faced by Insurance Reviewers and how can they be addressed?

Insurance Reviewers often encounter challenges such as interpreting complex policy language, managing high volumes of documentation, and staying updated with frequently changing regulations. To address these, many reviewers develop strong organizational skills, utilize specialized software to streamline document management, and participate in ongoing training or professional development. Collaborating closely with underwriters, claims adjusters, and legal teams also helps ensure accurate and timely policy assessments, reducing the risk of errors.

What position in insurance pays the most?

In insurance, executive roles such as Chief Underwriting Officer, Chief Risk Officer, or Chief Executive Officer typically have the highest salaries. These positions require extensive experience, leadership skills, and often advanced certifications, and they oversee large teams and strategic decision-making within insurance companies.

What skills do you need to be a medical reviewer?

A medical reviewer needs strong knowledge of medical terminology, healthcare regulations, and insurance policies. Critical thinking, attention to detail, and the ability to interpret medical records are essential skills. Often, certifications such as a Registered Nurse (RN) or Physician are required, along with experience in healthcare or insurance industries.

How to get a job as a reviewer?

To become an insurance reviewer, candidates typically need a background in insurance, healthcare, or related fields, along with strong analytical and communication skills. Relevant certifications, such as the Chartered Property Casualty Underwriter (CPCU) or insurance licenses, can improve job prospects. Gaining experience through internships or entry-level roles in insurance companies or claims departments is also beneficial.

What does an Insurance Reviewer do?

An Insurance Reviewer is responsible for evaluating insurance claims, policies, and related documents to ensure compliance with company and regulatory guidelines. They review submitted claims to determine their validity, check for completeness and accuracy, and may communicate with policyholders or healthcare providers for additional information. Insurance Reviewers help prevent fraud, reduce errors, and ensure that claims are processed fairly and efficiently. Their work is crucial in maintaining the integrity and cost-effectiveness of an insurance company's operations.

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

To thrive as an Insurance Reviewer, you need strong analytical skills, attention to detail, and a solid understanding of insurance policies and regulations, often supported by relevant experience or a degree in business or finance. Familiarity with claims management systems, insurance software, and sometimes certifications like AINS (Associate in General Insurance) are typically required. Excellent communication, problem-solving abilities, and organizational skills help you manage cases efficiently and interact with clients or colleagues. These competencies ensure accurate claim assessments, compliance with industry standards, and high-quality customer service.
What are popular job titles related to Insurance Reviewer jobs in Texas? For Insurance Reviewer jobs in Texas, the most frequently searched job titles are:
What job categories do people searching Insurance Reviewer jobs in Texas look for? The top searched job categories for Insurance Reviewer jobs in Texas are:
Insurance Reviewer jobs near you
Insurance Reviewer-Clinical

Insurance Reviewer-Clinical

The US Oncology Network

Fort Worth, TX • On-site

Full-time

Posted 14 days ago

US Oncology rating

7.4

Company rating: 7.4 out of 10

Based on 107 frontline employees who took The Breakroom Quiz

265th of 884 rated healthcare providers

Job description

Overview
The US Oncology Network is looking for an Clinical Insurance Reviewer to join our team at Texas Oncology. This full-time remote position will support the Central Imaging Scheduling Department at our 500 South Henderson Suite 400 clinic in Fort Worth, Texas. Typical work week is Monday through Friday, 8:30a - 5:00p.
This position will be either a level 1 or Sr based on candidate work experience.
As a part of The US Oncology Network, Texas Oncology delivers high-quality, evidence-based care to patients close to home. Texas Oncology is the largest community oncology provider in the country and has approximately 530 providers in 280+ sites across Texas, our founders pioneered community-based cancer care because they believed in making the best available cancer care accessible to all communities, allowing people to fight cancer at home with the critical support of family and friends nearby. Our mission is still the same today-at Texas Oncology, we use leading-edge technology and research to deliver high-quality, evidence-based cancer care to help our patients achieve "More breakthroughs. More victories." ® in their fight against cancer. Today, Texas Oncology treats half of all Texans diagnosed with cancer on an annual basis.
The US Oncology Network is one of the nation's largest networks of community-based oncology physicians dedicated to advancing cancer care in America. The US Oncology Network is supported by McKesson Corporation focused on empowering a vibrant and sustainable community patient care delivery system to advance the science, technology, and quality of care.
What does the Clinical Insurance Reviewer do? (including but not limited to)
Under general supervision, reviews in accordance to reimbursement guidelines. Obtains necessary pre-certifications and exceptions to ensure no delay in reimbursement. Researches denied services. Supports and adheres to the US Oncology Compliance Program, to include the Code of Ethics and Business Standards.
Responsibilities
The essential duties and responsibilities (including but not limited to):
  • Reviews, processes and audits the medical necessity for each patient.
  • Communicates with nursing and medical staff to inform them of any restrictions or special requirements in accordance with particular insurance plans. Provides prompt feedback to physicians and management regarding documentation issues, and payer issues.
  • Updates coding/payer guidelines for clinical staff.
  • Obtains insurance authorization and pre-certification for services. Works as a patient advocate and functions as a liaison between the patient and payer to answer reimbursement questions and avoid insurance delays.
  • Maintains a good working knowledge of authorization requirements for all payers, State and federal regulatory guidelines for coverage and authorization. Adheres to confidentiality, state, federal, and HIPPA laws and guidelines with regards to patient*s records.
  • Other duties as requested or assigned.

Qualifications
The ideal candidate for the Insurance Reviewer position will have the following background and experience:
Level 1
  • High school degree or equivalent.
  • Associates degree in Healthcare, LPN state license and registration preferred.
  • Minimum three (3) years medical insurance verification and authorization preferred.

Level Sr (in addition to level 1 requirements)
  • Minimum three (3) years medical insurance verification and authorization and two (2) years clinical review experience required.

Competencies:
  • Uses Technical and Functional Experience: Possesses up to date knowledge of the profession and industry; is regarded as an expert in the technical/functional area; accesses and uses other expert resources when appropriate.
  • Demonstrates Adaptability: Handles day to day work challenges confidently; is willing and able to adjust to multiple demands, shifting priorities, ambiguity and rapid change; shows resilience inn the face of constraints, frustrations, or adversity; demonstrates flexibility.
  • Uses Sound Judgment: Makes timely, cost effective and sound decisions; makes decisions under conditions of uncertainty.
  • Shows Work Commitment: Sets high standards of performance; pursues aggressive goals and works efficiently to achieve them.
  • Commits to Quality: Emphasizes the need to deliver quality products and/or services; defines standards for quality and evaluated products, processes, and service against those standards; manages quality; improves efficiencies.

Physical Demands:
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. While performing the duties of this job, the employee is required to be present at the employee site during regularly scheduled business hours and regularly required to sit or stand and talk or hear. Requires full range of body motion including handling and lifting patients, manual and finger dexterity, and eye-hand coordination. Requires standing and walking for extensive periods of time. Occasionally lifts and carries items weighing up to 40 lbs. Requires corrected vision and hearing to normal range.
Work Environment:
The work environment may include exposure to communicable diseases, toxic substances, ionizing radiation, medical preparations and other conditions common to an oncology/hematology clinic environment. Work will involve in-person interaction with co-workers and management and/or clients. Work may require minimal travel by automobile to office sites.

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