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Medical Claims Jobs in Spring, TX (NOW HIRING)

Professional Healthcare Solutions, LLC

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RN/Medical Claims Analyst

Houston, TX · Remote

$32.50 - $34/hr

Responsibilities may include additional research on medical claims data and other sources of information to identify problems and utilize a variety of tools to detect situations of potential fraud ...

RemX

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COI/Eligibiity Specialist II

Houston, TX · On-site

$22/hr

Requires experience with Medical Insurance Collections, Claims Billing or No Surprise Act. Responsibilities: * Analyze Explanation of Benefits (EOB) and payment remittance documents submitted by ...

CareSet Systems

SAS Statistician

Houston, TX · On-site

$95K/yr

Decode 10+ years of Medicare claims for 50 million patients to extract insights about patients, providers and healthcare journeys for pharmaceutical, biotech and medical device companies. You will be ...

Ccfs

Risk Claims Manager

Houston, TX · Remote

$85K - $95K/yr

Risk Claims Manager Department: Compliance Job Status: Exempt Compensation: Direct Reports: Yes ... Thorough understanding of complex medical treatments, treatment outcomes, tort, venue, and ...

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All JobsMedical Claims JobsMedical Claims Jobs in Spring, TX

Medical Claims information

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How much do medical claims jobs pay per hour?

As of Aug 5, 2026, the average hourly pay for medical claims in Spring, TX is $14.97, according to ZipRecruiter salary data. Most workers in this role earn between $13.70 and $16.25 per hour, depending on experience, location, and employer.

What are medical claims?

Medical claims are formal requests submitted by healthcare providers or patients to insurance companies, asking for payment for medical services rendered. These claims contain detailed information about the patient, the services provided, dates of service, and relevant medical codes. Insurance companies review the claims to determine coverage and reimburse providers or patients accordingly. Accurate and timely submission of medical claims is crucial to ensure proper payment and avoid delays or denials.

How to become a medical claims examiner?

To become a medical claims examiner, candidates typically need a high school diploma or equivalent, with some roles requiring postsecondary education or certification in health insurance or medical billing. Relevant skills include attention to detail, knowledge of medical terminology, and familiarity with claims processing software; certifications such as the Certified Medical Claims Examiner (CMCE) can enhance job prospects.

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

To thrive as a Medical Claims Specialist, you need knowledge of medical terminology, insurance policies, and claims processing, typically supported by a high school diploma or relevant certification. Familiarity with claims management software, electronic health records (EHRs), and billing systems such as ICD-10 and CPT coding is essential. Attention to detail, strong organizational skills, and effective communication help ensure accuracy and resolve claim discrepancies. These skills are crucial for ensuring timely and accurate claims processing, minimizing errors, and maintaining compliance with healthcare regulations.

What are some common challenges faced in a medical claims role, and how can they be effectively managed?

Medical claims professionals often encounter challenges such as handling denied or complex claims, navigating frequent regulatory changes, and communicating with both patients and insurance providers. Staying updated with the latest healthcare regulations and payer requirements is essential to minimize claim rejections. Effective time management, attention to detail, and strong communication skills help resolve issues quickly and ensure accurate processing. Collaborating closely with billing teams and healthcare providers also aids in addressing discrepancies and expediting claim approvals.

What is the difference between Medical Claims vs Medical Billing Specialist?

AspectMedical ClaimsMedical Billing Specialist
CredentialsTypically requires knowledge of insurance policies and coding; certifications like CPC or CCS are commonRequires similar certifications; focuses on billing processes and insurance claims
Work EnvironmentHealthcare facilities, insurance companies, billing companiesMedical offices, hospitals, billing companies
Job FocusSubmitting and managing insurance claims for reimbursementPreparing and sending bills to patients and insurers, managing accounts

Medical Claims specialists primarily handle the submission and management of insurance claims to ensure healthcare providers receive payment. Medical Billing Specialists focus on creating and sending bills to patients and insurance companies, managing payments, and maintaining billing records. While both roles require knowledge of insurance processes and coding, Medical Claims roles are more centered on claims submission and follow-up, whereas Medical Billing Specialists handle the overall billing process and patient invoicing.

Is medical claims processing a stressful job?

Medical claims processing can be stressful due to tight deadlines, high accuracy requirements, and the need to handle complex or disputed claims. The job often involves detailed data entry, familiarity with insurance policies, and sometimes dealing with frustrated clients, which can contribute to stress levels. However, workload and stress vary depending on the employer and individual workload management skills.
What are the most commonly searched types of Medical Claims jobs in Spring, TX? The most popular types of Medical Claims jobs in Spring, TX are:
What are popular job titles related to Medical Claims jobs in Spring, TX? For Medical Claims jobs in Spring, TX, the most frequently searched job titles are:
What job categories do people searching Medical Claims jobs in Spring, TX look for? The top searched job categories for Medical Claims jobs in Spring, TX are:
What cities near Spring, TX are hiring for Medical Claims jobs? Cities near Spring, TX with the most Medical Claims job openings:
Medical Claims jobs near you
Infographic showing various Medical Claims job openings in Spring, TX as of July 2026, with employment types broken down into 89% Full Time, 9% Part Time, and 2% Contract. Highlights an 88% Physical, 4% Hybrid, and 8% Remote job distribution, with an average salary of $31,146 per year, or $15 per hour.

Medical Claims Eligibility Specialist II-Hybrid

MET Healthcare Solutions

Houston, TX • On-site

$23 - $25/hr

Full-time

Medical, Retirement, PTO

Re-posted 3 days ago

Job description

MET Healthcare Solutions is seeking a Medical Claims Eligibility Specialist II to join our fast-paced organization. The Medical Claims Eligibility Specialist II will be responsible for analyzing level II claims information to determine eligibility in the dispute resolution process in accordance with established federal regulations and company policies and procedures.

Responsibilities of the Medical Claims Eligibility Specialist II may include but are not limited to:

· Analyze Explanation of Benefits (EOB) and payment remittance documents submitted by healthcare providers and insurance carriers to determine which level II claims are eligible for the dispute resolution process.

· Compose correspondence in accordance with regulatory requirements (and internal policies in procedures) in a clear, concise, and grammatically correct manner.

· Communicate (via email) with healthcare providers and health plans to obtain information necessary to determine the eligibility of the claims. 

·  Relay the status of all claim submissions utilizing multiple different operating systems.

· Stay up to date on industry specific regulations, ensuring that appropriate strategies are in place.

· Maintain electronic files for all claims determined eligible.

These responsibilities are a condensed list of the full scope of the job description and are subject to change depending on the company’s demand.

· Experience reviewing all types of medical claims, EOBs, and payment remittances (e.g. HCFA 1500, Outpatient/Inpatient UB92, Surgery, Anesthesia, high dollar complicated claims, COB and DRG/RCC pricing).

· Understanding of insurance reimbursement rules.

· Ability to work at a high level and display high attention to detail.

· Ability to work across multiple operating systems.

· Ability to maintain confidentiality and professionalism in difficult situations.

· Strong written and verbal communication skills with the ability to explain reasoning effectively.

This Medical Claims Eligibility Specialist II position is offered as a hybrid position (after in office training) to those candidates that meet all the position requirements and continue to meet the daily expectations.

This is a full-time position, Monday-Friday from 8am-5pm. Please only apply if you are able to meet these requirements weekly.

Education:

  • Bachelor's (Required)

Experience:

  • Healthcare Claims Analysis: 2 years (Required)

License/Certification:

  • Billing and Coding Certification (Preferred)

Company Description

A healthcare management group, URAC-accredited as an independent review organization (IRO). Over 20 years of experience helping control costs, and mitigate regulatory compliance by providing superior administrative and medical expert services to improve the quality of healthcare functions nationwide. Making a difference in healthcare.