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Medical Claims Manager Jobs in Spring, TX (NOW HIRING)

Tata Consultancy Service Limited

Claims Consultant

Houston, TX · On-site

$48K - $55K/yr

  • Medical

  • Dental

  • Vision

  • Retirement

  • PTO

To provide Absence case management and claim adjudications, based on medical documentation and the ... Approval or denial on FMLA claims as per Insurance carrier, and employers guidelines Analyzes ...

North American Risk Services, Inc. (NARS)

Be Seen First

Claims Advocate

Houston, TX · Remote

$78K - $95K/yr

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

... Medical, Dental & Vision Insurance - effective on start date o 401k o Paid Time Off Program o ... Litigation Management · Reserves · Reporting Requirements · Resolution Qualification ...

Team1Medical

Medical Benefits and Claims Specialist

Houston, TX

$19.69/hr

  • Medical

  • Dental

  • Vision

  • Retirement

Medical Benefits and Claims Specialist | $1 9.69 per hour | Monday-Friday, 8AM-5PM | Fully On-site ... Accurately document all interactions in our customer relationship management (CRM) system. * Handle ...

TEEMA

Workers Compensation Claims Examiner

Houston, TX · On-site

$36 - $41/hr

Senior Workers' Compensation Claims Examiner (Texas Licensed ) We are seeking an experienced ... Coordinate medical treatment and manage related billing activity * Establish and maintain accurate ...

Chubb

ESIS Claims Representative, WC

Houston, TX · On-site

Utilize medical cost containment measures to control loss dollar pay-out. Review status of claims and develop strategies to effectively manage to conclusion. Consistent delivery of superior customer ...

North American Risk Services, Inc. (NARS)

Be Seen First

Bodily Injury Claims Adjuster - Commercial Transportation

Houston, TX · Remote

$60K - $80K/yr

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

Associate BI Claims Adjusters * Needs Commercial Transportation Experience Working From Home ... medical care (as appropriate), litigation management, damage assessment, settlement negotiations ...

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All JobsMedical Claims JobsMedical Claims Manager JobsMedical Claims Manager Jobs in Spring, TX

Medical Claims Manager information

See Spring, TX salary details

$31.1K

$78.2K

$123.7K

How much do medical claims manager jobs pay per year?

As of Aug 18, 2026, the average yearly pay for medical claims manager in Spring, TX is $78,187.00, according to ZipRecruiter salary data. Most workers in this role earn between $60,500.00 and $93,400.00 per year, depending on experience, location, and employer.

What does a medical claims manager do?

A Medical Claims Manager oversees the processing of insurance claims related to healthcare services. They ensure that claims are handled efficiently, accurately, and in compliance with industry regulations. Their responsibilities include supervising claims staff, reviewing and resolving complex claims issues, and coordinating with healthcare providers and insurance companies. Medical Claims Managers also work to identify and prevent fraudulent claims and improve overall claims processing procedures.

What are the key skills and qualifications needed to thrive as a medical claims manager?

To thrive as a Medical Claims Manager, you need a strong background in healthcare administration, claims processing, and knowledge of insurance regulations, typically supported by a bachelor's degree in a related field. Familiarity with claims management systems, billing software, and certification such as Certified Professional Coder (CPC) are often required. Exceptional attention to detail, problem-solving abilities, and effective communication set top performers apart. These skills ensure accurate claims processing, regulatory compliance, and efficient resolution of disputes, which are critical for organizational success.

What are some common challenges medical claims managers face when overseeing claims processing teams?

Medical Claims Managers often encounter challenges such as keeping up with changing healthcare regulations, ensuring accurate and timely claims processing, and managing workflow during periods of high claim volume. They must also address discrepancies or denials efficiently and provide ongoing training to team members to maintain compliance and quality standards. Effective communication with insurance carriers, healthcare providers, and internal teams is crucial to resolving issues and streamlining operations.

What are popular job titles related to Medical Claims Manager jobs in Spring, TX?

For Medical Claims Manager jobs in Spring, TX, the most frequently searched job titles are:

What job categories do people searching Medical Claims Manager jobs in Spring, TX look for?

The top searched job categories for Medical Claims Manager jobs in Spring, TX are:

What cities near Spring, TX are hiring for Medical Claims Manager jobs?

Cities near Spring, TX with the most Medical Claims Manager job openings:

Medical Claims Manager jobs near you

Billing Associate (Onsite, Pediatric Development Clinic)

Pediatrix

Shenandoah, TX • On-site

Full-time

Medical, Dental, Vision, Life, Retirement

Re-posted 21 days ago

Pediatrix rating

6.5

Company rating: 6.5 out of 10

Based on 45 frontline employees who took The Breakroom Quiz

604th of 888 rated healthcare providers

Job description

Overview
The Billing Associate is responsible for ensuring the accurate and timely processing of billing and medical claims within the ambulatory practice setting. This role supports the revenue cycle by verifying insurance coverage, posting charges,submitting clean claims, reviewing front-end denials, and posting time-of-service payments. The Billing Associate collaborates closely with Corporate RCM, clinical teams, and administrative staff to ensure compliance with payer guidelines and corporate policies.
Responsibilities
Charge Entry and Claims Processing
  • Review reports, encounter forms, fee tickets, and medical records to accurately capture, enter or accept charges.
  • Verify patient and insurance information before claim submission.
  • Ensure all necessary documentation, authorizations, and codes are complete prior to claim submission.
  • Validate accuracy of CPT, ICD-10, and modifier codes before claim submission.
  • Post patient payments accurately in the practice management system.
  • Balance batches and reconcile payments against system reports.
Insurance Verification and Authorization
  • Verify patient insurance eligibility and benefits prior to appointments or procedures.
  • Obtain and document pre-authorizations and referrals required for specialist services.
  • Communicate with patients and providers regarding coverage limitations and out-of-pocket costs.
  • Maintain updated knowledge of payer-specific requirements and medical necessity policies for specialty procedures.
  • Update patient records with accurate insurance and demographic information.
Patient Account Support
  • Respond to patient billing inquiries courteously and professionally.
  • Escalate billing discrepancies or issues to RCM as needed.
Billing Reports and Compliance
  • Run, review, and work all daily, weekly, and monthly billing reports.
  • Manage and resolve worklog tasks and claims manager edits, ensuring timely review, correction, and documentation.
  • Assist with internal audits and quality control reviews of billing data.
  • Participate in SOX review process and ensure unresolved items are addressed per policy.
  • Ensure billing practices comply with HIPAA, CMS, and payer-specific regulations.
  • Maintain confidentiality and secure handling of patient and financial data.
  • Stay current with coding updates (ICD-10, CPT, HCPCS) and insurance billing guidelines relevant to the specialty.
Collaboration and Support
  • Identify trends in denials or claim errors and communicate recurring issues to the Billing Manager or Practice Administrator for process improvement.
  • Coordinate with front-desk staff and clinical teams to resolve billing-related issues.
  • Provide feedback to providers regarding documentation requirements for accurate billing.
  • Participate in departmental meetings and contribute to process improvement initiatives.
  • Assist with end-of-month reporting and reconciliation as needed.

Qualifications
Education:
  • High school diploma or equivalent required; associate's degree or certification in medical billing and coding preferred.

Experience Industry: Healthcare
Experience:
  • 2+ years of medical billing experience, preferably in a specialist or ambulatory practice setting
  • Working knowledge of CPT, ICD-10, and HCPCS coding required
  • Strong understanding of commercial and government payer policies and claim workflows required
  • Proficiency with electronic health record (EHR) and practice management preferred

Skills/Abilities:
  • Excellent attention to detail, analytical, and problem-solving skills
  • Effective communication and customer service abilities

Benefits and Compensation
Take great care of the patient, every day and every way.TM At Pediatrix & Obstetrix, that's not only our motto at work each day; it's also how we view our employees and their families. We know that our greatest asset is YOU.
We take pride in offering comprehensive benefits in a vast array of plans that fit your life and lifestyle, supporting your health and overall well-being. Benefits offered include, but are not limited to: Medical, Dental, Vision, Life, Disability, Healthcare FSA, Dependent Care FSA and HSAs, as well as a 401k plan and Employee Stock Purchase Program. Some benefits are provided at no cost, while others require a cost share between employees and the company. Employees may also select voluntary plans and pay for these benefits through convenient payroll deductions. Our benefit programs are just one of the many ways Pediatrix & Obstetrix helps our employees take care of themselves and their families.
About Us
Pediatrix Medical Group is one of the nation's leading providers of highly specialized health care for women, babies and children. Since 1979, Pediatrix has grown from a single neonatology practice to a national, multispecialty medical group. Pediatrix-affiliated clinicians are committed to providing coordinated, compassionate and clinically excellent services to women, babies and children across the continuum of care, both in hospital settings and office-based practices. The group's high-quality, evidence-based care is bolstered by significant investments in research, education, quality-improvement and safety initiatives.
Please Note: Fraudulent job postings/job scams are becoming increasingly common. All genuine Pediatrix job postings can be found through the Pediatrix Careers site: www.pediatrix.com/careers.
#PedNC
Pediatrix is an Equal Opportunity Employer
All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability or veteran status.

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