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Medicaid Claims Processing Jobs in Texas (NOW HIRING)

ADPMN INC

System Analyst

Austin, TX

Experience with Medicaid Claims Processing. * Experience in business objectives, problem-solving, and identifying solutions. * Proficiency in reviewing, analyzing, and evaluating user requirements ...

University Health

Claims Auditor

San Antonio, TX

$19.55 - $29.75/hr

Identifies processor and phone representative training needs that can be used to improve performance. Requires knowledge of claims processing for HCFA and UB92 for both commercial and Medicaid ...

University Health

Claims Auditor

San Antonio, TX · On-site

$19.55 - $29.75/hr

Identifies processor and phone representative training needs that can be used to improve performance. Requires knowledge of claims processing for HCFA and UB92 for both commercial and Medicaid ...

University Health

Claims Auditor

San Antonio, TX · On-site

$19.55 - $29.75/hr

Identifies processor and phone representative training needs that can be used to improve performance. Requires knowledge of claims processing for HCFA and UB92 for both commercial and Medicaid ...

Addison Group

Remote Medicaid Collector

Mesquite, TX · On-site +1

$23 - $26/hr

... claims from research through final resolution. This role requires someone who understands the full Medicaid billing and collections process and can identify why a claim has not paid correctly ...

New

University Health

Claims Supervisor

San Antonio, TX · On-site

$20.80 - $34.75/hr

... claims processing unit and the assigned staff. Responds to issues escalated through the claim ... Medicaid, Medicare and Commercial claims experience is required. Three (3) or more years ...

University Health

Claims Supervisor

San Antonio, TX · On-site

$25.10 - $40.25/hr

... claims processing unit and the assigned staff. Responds to issues escalated through the claim ... Medicaid, Medicare and Commercial claims experience is required. Three (3) or more years ...

University Health

Claims Supervisor

San Antonio, TX

$25.10 - $40.25/hr

... claims processing unit and the assigned staff. Responds to issues escalated through the claim ... Medicaid, Medicare and Commercial claims experience is required. Three (3) or more years ...

University Health

Claims Supervisor

San Antonio, TX

$25.10 - $40.25/hr

... claims processing unit and the assigned staff. Responds to issues escalated through the claim ... Medicaid, Medicare and Commercial claims experience is required. Three (3) or more years ...

University Health

Claims Supervisor

San Antonio, TX · On-site

... claims processing unit and the assigned staff. Responds to issues escalated through the claim ... Medicaid, Medicare and Commercial claims experience is required. Three (3) or more years ...

University Health

Claims Supervisor

San Antonio, TX · On-site

... claims processing unit and the assigned staff. Responds to issues escalated through the claim ... Medicaid, Medicare and Commercial claims experience is required. Three (3) or more years ...

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Medicaid Claims Processing information

What is a Medicaid claims processing job?

A Medicaid Claims Processing job involves reviewing, verifying, and processing healthcare claims submitted by providers seeking reimbursement for services rendered to Medicaid beneficiaries. Workers in this role ensure claims comply with state and federal regulations, identify errors or discrepancies, and communicate with healthcare providers to resolve issues. They may also use specialized software to input and track claims, process denials or appeals, and ensure timely and accurate payments. Strong attention to detail, knowledge of Medicaid policies, and proficiency with healthcare billing codes are essential for success in this role.

What are the key skills and qualifications needed to thrive in Medicaid claims processing?

Success in Medicaid Claims Processing requires excellent attention to detail, a thorough understanding of healthcare billing procedures, and familiarity with Medicaid regulations and insurance guidelines. Proficiency in medical billing software, claims management systems, and sometimes industry certifications such as Certified Professional Coder (CPC) is beneficial. Strong organizational skills, problem-solving abilities, and effective written and verbal communication help individuals excel in this role. These skills and qualifications are crucial for ensuring accurate, timely claims processing and compliance with ever-evolving Medicaid requirements.

What are some typical challenges faced in Medicaid claims processing, and how can I prepare for them?

One of the main challenges in Medicaid Claims Processing is staying up-to-date with frequently changing policies, billing codes, and compliance requirements, which can vary by state and program. Professionals in this role must pay close attention to detail to avoid errors and denials, often working with tight deadlines and large volumes of claims. To prepare, it's helpful to become familiar with Medicaid guidelines, maintain strong organizational habits, and proactively seek out updates in regulations or coding standards. Collaborating with other team members, such as care coordinators and billing specialists, is essential to ensure claims are accurate and properly documented. Ongoing learning and adaptability are key for long-term success in this dynamic environment.

How to get a job as a Medicaid Claims Processing specialist?

To become a Medicaid Claims Processing specialist, candidates typically need a high school diploma or equivalent, with some roles requiring postsecondary education or certifications in healthcare administration or related fields. Relevant skills include knowledge of healthcare billing, claims processing software, and federal Medicaid policies; experience in healthcare or insurance is often preferred. Applying through healthcare organizations, government agencies, or insurance companies and demonstrating attention to detail and familiarity with claims systems can improve job prospects.

Is a Medicaid claims processing job in demand?

Medicaid claims processing jobs are in steady demand due to ongoing healthcare coverage needs and the complexity of processing claims. These roles often require knowledge of healthcare regulations and claims management software, making them essential in healthcare administration and insurance companies.

What are the most commonly searched types of Medicaid Claims Processing jobs in Texas?

The most popular types of Medicaid Claims Processing jobs in Texas are:

What are popular job titles related to Medicaid Claims Processing jobs in Texas?

For Medicaid Claims Processing jobs in Texas, the most frequently searched job titles are:

What job categories do people searching Medicaid Claims Processing jobs in Texas look for?

The top searched job categories for Medicaid Claims Processing jobs in Texas are:

What cities in Texas are hiring for Medicaid Claims Processing jobs?

Cities in Texas with the most Medicaid Claims Processing job openings:

Medicaid Claims Processing jobs near you
Infographic showing various Medicaid Claims Processing job openings in Texas as of August 2026, with employment types broken down into 92% Full Time, and 8% Contract. Highlights an 84% In-person, 8% Hybrid, and 8% Remote job distribution.

COB Claims Trainer - Remote

Gainwell Technologies LLC

Houston, TX • On-site

$47K - $67K/yr

Other

Medical, Life, Retirement, PTO

Posted 12 days ago

Gainwell Technologies rating

7.8

Company rating: 7.8 out of 10

Based on 81 frontline employees who took The Breakroom Quiz

137th of 245 rated software companies

Job description

Great companies need great teams to propel their operations. Join the group that solves business challenges and enhances the way we work and grow. Working at Gainwell carries its rewards. You'll have an incredible opportunity to grow your career in a company that values your contributions and puts a premium on work flexibility, learning, and career development.
Summary
The COB Claims Trainer, Professional is responsible for developing, maintaining, and delivering technical training for Coordination of Benefits (COB), Medicaid Reclamation, commercial medical claims processing, appeals, auditing procedures, reimbursement methodologies, and related operational requirements. This position supports claims operations by ensuring employees understand complex requirements, apply procedures consistently, and complete accurate, compliant work.
This role requires strong technical claims knowledge, effective training and facilitation skills, sound judgment, and the ability to translate complex claims policies, operational procedures, quality findings, and research outcomes into practical training solutions for new and existing employees.
Your role in our mission
  • Develop, maintain, and deliver training programs covering Coordination of Benefits (COB), Medicaid Reclamation, commercial medical claims processing, appeals, auditing procedures, and reimbursement methodologies.
  • Facilitate virtual instructor-led training, onboarding programs, re courses, workshops, and one-on-one coaching sessions for new and existing employees.
  • Create and maintain training materials, job aids, process documentation, presentations, assessments, knowledge checks, and standard operating procedures.
  • Translate complex claims policies, procedures, and regulatory requirements into clear, practical learning solutions.
  • Evaluate learner performance through assessments, observations, and practical exercises, providing coaching and feedback to support success.
  • Partner with operations leaders, quality teams, auditors, and subject matter experts to identify training needs and ensure content reflects current business processes.
  • Analyze quality reviews, audit findings, and operational trends to identify knowledge gaps and develop targeted training solutions.
  • Research policy updates, reimbursement changes, system enhancements, and operational requirements to ensure training content remains current and accurate.
  • Update training programs based on changes to Medicaid regulations, client requirements, reimbursement guidelines, and internal processes.
  • Serve as a technical resource for employees and leaders regarding COB and Medicaid claims processing procedures.
  • Support continuous improvement initiatives by measuring training effectiveness and recommending enhancements to curriculum, delivery methods, and learning resources.
  • Perform other auxiliary functions as necessary to support departmental and operational needs.

What we're looking for
  • Significant professional experience as a medical claims examiner, claims auditor, claims processor, or subject matter expert within a healthcare claims environment.
  • Strong knowledge of Medicaid claims processing, Coordination of Benefits (COB), reimbursement methodologies, claims recovery, Medicaid reclamation, and related operational procedures.
  • 3+ years of documented experience in Medicaid reclamation processes, including overpayment identification, recovery efforts, reimbursement reconciliation, and compliance with Medicaid regulations.
  • Previous supervisory, team lead, coaching, training, or employee development experience, with the ability to develop technical training materials, process documentation, job aids, and standard operating procedures.
  • Excellent presentation, facilitation, communication, and interpersonal skills with the ability to effectively train, mentor, and coach employees in a virtual environment.

What you should expect in this role
  • Fully remote opportunity within the United States.
  • Standard Monday through Friday schedule, generally 8:00 a.m. to 5:00 p.m. Central Time, with flexibility to support training events as needed.
  • Frequent collaboration with claims operations, quality, audit, training, and leadership teams.
  • Delivery of virtual training, coaching sessions, assessments, and ongoing employee development activities.
  • Use of video conferencing, presentation technology, claims systems, workflow tools, and reporting resources to support learning and performance.
  • Opportunity to influence operational excellence by improving employee knowledge, accuracy, consistency, and compliance.
  • Work in a dynamic healthcare environment supporting Medicaid and commercial claims operations.
  • Compliance with all client, company, privacy, security, and healthcare program requirements.

The deadline to submit applications for this posting is September 6, 2026.
#LI-REMOTE #LI-JA1 #LI-CM1
The pay range for this position is $47,000.00 - $67,200.00 per year, however, the base pay offered may vary depending on geographic region, internal equity, job-related knowledge, skills, and experience among other factors. Put your passion to work at Gainwell. You'll have the opportunity to grow your career in a company that values work flexibility, learning, and career development. All salaried, full-time candidates are eligible for our generous, flexible vacation policy, a 401(k) employer match, comprehensive health benefits , and educational assistance. We also have a variety of leadership and technical development academies to help build your skills and capabilities.
We believe nothing is impossible when you bring together people who care deeply about making healthcare work better for everyone. Build your career with Gainwell, an industry leader. You'll be joining a company where collaboration, innovation, and inclusion fuel our growth. Learn more about Gainwell at our company website and visit our Careers site for all available job role openings.
Gainwell Technologies is an Equal Opportunity Employer, where all qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, gender (including pregnancy, childbirth, or related medical condition), age, sexual orientation, status as a protected veteran, status as an individual with a disability, or other applicable legally protected characteristics. Gainwell Technologies defines "wages" and "wage rates" to include "all forms of pay, including, but not limited to, salary, overtime pay, bonuses, stock, stock options, profit sharing and bonus plans, life insurance, vacation and holiday pay, cleaning or gasoline allowances, hotel accommodations, reimbursement for travel expenses, and benefits.

What Gainwell Technologies employees say

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Hours and flexibility

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About Gainwell Technologies

Sourced by ZipRecruiter

With Health and Cost outcomes that pierce Inequities and Impact Economies, the success of our Nation’s Federal Medicaid program is inextricably tied to the Prosperity of Communities, States and the Nation as a whole. We think that deserves Respect and a Commitment from Innovators who can help those who operate within and around health and human services evolve to meet their goals. At Gainwell, that’s our Sole focus. Built across more than Five Decades, Gainwell has intentionally seized opportunities to advance its digitally enabled services to meet Agencies, Health plans and MCOs where they are on their modernization journeys and propel them into the future of Healthcare. Equally important to our Expanding Technologies and Results. We bring ideas that bring policies to life.

Industry

Health care and social assistance

Company size

10,000+ Employees

Headquarters location

Irving, TX, US

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