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Medical Claims Jobs in Spring, TX (NOW HIRING)

Privia Health

Medical Claims Billing Specialist

Houston, TX · On-site

$24/hr

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

The Medical Claims Specialist will take steps necessary to resolve all claim issues or questions that escalate to the RCM team. Resolution of SalesForce cases and management of issues and the team ...

MET Healthcare Solutions

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Medical Claims Eligibility Specialist II-Hybrid

Houston, TX · On-site

$23 - $25/hr

  • Medical

  • Retirement

  • PTO

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 ...

Privia Health

Medical Claims Billing Specialist

Houston, TX

$24/hr

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

The Medical Claims Specialist will take steps necessary to resolve all claim issues or questions that escalate to the RCM team. Resolution of SalesForce cases and management of issues and the team ...

Privia Health

Medical Claims Billing Specialist

Houston, TX

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

The Medical Claims Specialist will take steps necessary to resolve all claim issues or questions that escalate to the RCM team. Resolution of SalesForce cases and management of issues and the team ...

IQVIA

Medical Biller/Claims Processing

Houston, TX · Remote

$23/hr

Receive medical claims from healthcare providers (HCPs) or patients and ensure all required supporting documentation is provided. * Interpret Explanation of Benefits (EOB) and CMS-1500 forms.

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 ...

RemX

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COI/Eligibiity Specialist II

Houston, TX · On-site

$22/hr

  • Medical

  • Dental

  • Vision

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

North American Risk Services, Inc. (NARS)

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Claims Advocate

Houston, TX · Remote

$78K - $95K/yr

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

Claims Advocate · Work From Home · Professional Growth Opportunities · Comprehensive Benefits o Medical, Dental & Vision Insurance - effective on start date o 401k o Paid Time Off Program o ...

Team1Medical

Medical Benefits and Claims Specialist

Houston, TX · On-site

$19.69/hr

  • Medical

  • Dental

  • Vision

  • Retirement

Medical Benefits and Claims Specialist | $1 9.69 per hour | Monday-Friday, 8AM-5PM | Fully On-site | Temporary What Matters Most: * Competitive pay range of $19.69 per hour, based on work experience.

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Medical Claims information

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How much do medical claims jobs pay per hour?

As of Aug 17, 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.

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.

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.

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 August 2026, with employment types broken down into 1% As Needed, 77% Full Time, 17% Part Time, and 5% Contract. Highlights an 96% Physical, 1% Hybrid, and 3% Remote job distribution, with an average salary of $31,146 per year, or $15 per hour.

Medical Claims Billing Specialist

Privia Health

Houston, TX • On-site

$24/hr

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Re-posted 3 days ago

Privia Health rating

6.7

Company rating: 6.7 out of 10

Based on 7 frontline employees who took The Breakroom Quiz

Job description

Company Description
Privia Health™ is a technology-driven, national physician enablement company that collaborates with medical groups, health plans, and health systems to optimize physician practices, improve patient experiences, and reward doctors for delivering high-value care in both in-person and virtual settings. The Privia Platform is led by top industry talent and exceptional physician leadership, and consists of scalable operations and end-to-end, cloud-based technology that reduces unnecessary healthcare costs, achieves better outcomes, and improves the health of patients and the well-being of providers.
Job Description
*This position is a hybrid full-time role that requires in office on Tuesdays and Thursdays at 1200 Binz St Suite 1490 Houston TX 77004. Mon, Wed, and Fri are typically work from home but subject to change for internal meetings, trainings, and conferences.*
Under the direction of the Manager of Revenue Cycle Management, the Medical Claims Specialist (AR Manager) is responsible for complete, accurate and timely processing of all designated claims, reviewing and responding to daily correspondence from physician practices in a timely manner, answering incoming SalesForce cases and providing information as requested or properly authorized. The Medical Claims Specialist will take steps necessary to resolve all claim issues or questions that escalate to the RCM team. Resolution of SalesForce cases and management of issues and the team resolving the cases is a key element in this role.
Primary Job Duties:
  • Denial management - investigating denial sources, resolving and appealing denials which may include contacting payer representatives
  • Makes independent decisions regarding claim adjustments, resubmission, appeals, and other claim resolution techniques
  • Collaborate with internal teams (Performance, Operations, Sales) as well as care center staff when appropriate
  • Works closely with our Revenue Optimization team, to support efforts to ensure reimbursement is in line with payer contract agreements.
  • Work directly with practice consultants or physicians to ensure optimal revenue cycle functionality
  • Drive toward achievement of department's daily and monthly Key Performance Indicators (KPIs), requiring a team focused approach to attainment of these goals
  • Other duties as assigned

Qualifications
  • Education: High School diploma
  • 3+ years medical claims experience in a physician medical billing office
  • Must understand the drivers of revenue cycle optimal performance and be able to investigate and resolve complex claims.
  • Advanced Microsoft Excel skills (ex: pivot tables, VLOOKUP, sort/filtering, formulas) preferred
  • Must understand Explanation of Benefit (EOB) statements
  • Google Suite experience preferred
  • Athena EMR experience preferred
  • Must provide accessibility to private, quiet work space with high-speed internet to effectively work remotely for days not in the office
  • Comfortable speaking in front of groups
  • Excellent written and verbal communication
  • Willingness to train and mentor other team members
  • Self-starter with great time management skills
  • Ability to work independently and multi-task in a fast paced environment
  • Problem solver with good analytical skills and solution-oriented approach
  • Independent decision maker with strong research skills
  • Must comply with HIPAA rules and regulations

The hourly range for this role is $24/hr - 26.45/ hr in base pay and exclusive of any bonus or benefits (medical, dental, vision, life, and pet insurance, 401K, paid time off, and other wellness programs). This role is also eligible for an annual bonus targeted at 10% based on performance in the role. The base pay offered will be determined based on relevant factors such as experience, education, and geographic location.
Additional Information
All your information will be kept confidential according to EEO guidelines.
Technical Requirements (for remote workers only, not applicable for onsite/in office work):
In order to successfully work remotely, supporting our patients and providers, we require a minimum of 5 MBPS for Download Speed and 3 MBPS for the Upload Speed. This should be acquired prior to the start of your employment. The best measure of your internet speed is to use online speed tests like https://www.speedtest.net/. This gives you an update as to how fast data transfer is with your internet connection and if it meets the minimum speed requirements. Work with your internet provider if you have questions about your connection. Employees who regularly work from home offices are eligible for expense reimbursement to offset this cost.
Privia Health is committed to creating and fostering a work environment that allows and encourages you to bring your whole self to work. We understand that healthcare is local and we are better when our people are a reflection of the communities that we serve. Our goal is to encourage people to pursue all opportunities regardless of their age, color, national origin, physical or mental (dis)ability, race, religion, gender, sex, gender identity and/or expression, marital status, veteran status, or any other characteristic protected by federal, state or local law.

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