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Claim Associate Jobs in Raleigh, NC (NOW HIRING)

Elevance Health

eCOB Specialist II

Durham, NC · On-site

Reviews claim history to identify claims requiring reconciliation, whether processed or pended, as well as recovered in error. * Associate must identify the correct formulas in order to adjudicates ...

Veradigm

RCM Medical Billing Coordinator

Raleigh, NC · On-site

$19.50 - $25.25/hr

Creates claim edit report for charge entries. * Reconciles imputed payment postings and balances ... Enhancing Lives and Building Careers Veradigm believes in empowering our associates with the tools ...

Veradigm

RCM Medical Billing Coordinator

Raleigh, NC · On-site

$19.50 - $25.25/hr

Creates claim edit report for charge entries. * Reconciles imputed payment postings and balances ... Enhancing Lives and Building Careers Veradigm believes in empowering our associates with the tools ...

Allied Universal

Surveillance Investigator

Henderson, NC · On-site

$20 - $24.75/hr

As a global leader, we provide dynamic opportunities for claim investigators, SIU investigators ... Associate's Degree or higher, preferably in Criminal Justice * Security/Loss Prevention experience

Allied Universal

Surveillance Investigator

Henderson, NC

$20 - $24.75/hr

As a global leader, we provide dynamic opportunities for claim investigators, SIU investigators ... Associate's Degree or higher, preferably in Criminal Justice * Security/Loss Prevention experience

Johnstone Supply

Warehouse Associate

Raleigh, NC · On-site

$15.50 - $18.50/hr

Initiates freight claim procedure when necessary. - Checks incoming delivery contents against the packing list to verify accurate and full delivery. - Prepares the receiving reports and notes any ...

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Claim Associate information

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How much do claim associate jobs pay per hour?

As of Jul 22, 2026, the average hourly pay for claim associate in Raleigh, NC is $20.46, according to ZipRecruiter salary data. Most workers in this role earn between $17.55 and $22.21 per hour, depending on experience, location, and employer.

What are Claim Associates?

Claim Associates are professionals who handle and process insurance claims for individuals or businesses. They review claim details, gather necessary documentation, and communicate with policyholders to verify information and determine coverage. Their goal is to ensure that claims are processed efficiently and accurately according to company policies and regulations. Claim Associates may also coordinate with other departments and provide customer service throughout the claims process.

What is meant by claims associate?

A claims associate is a professional who reviews, processes, and manages insurance claims to determine coverage and settlement amounts. They often work with claimants, adjusters, and use claims management software to ensure accurate and timely resolution of claims.

What is the difference between Claim Associate vs Claims Adjuster?

AspectClaim AssociateClaims Adjuster
Required CredentialsHigh school diploma or equivalent; some roles may prefer insurance licensesHigh school diploma; state licensing often required
Work EnvironmentOffice setting, customer service interactions, data entryField and office work, investigating claims, inspecting damages
Employer & Industry UsageInsurance companies, claims processing centersInsurance companies, third-party claims firms
Common Search & ComparisonOften compared for entry-level roles in claims processingMore experienced, investigative roles in claims handling

The main difference between a Claim Associate and a Claims Adjuster lies in their responsibilities and experience level. Claim Associates typically handle initial claims processing and customer service, while Claims Adjusters investigate and evaluate claims, often requiring more experience and licensing. Both roles are essential in the insurance industry, but they differ in scope and complexity.

What are the typical challenges a Claim Associate faces when handling multiple claims simultaneously?

Claim Associates often manage several claims at once, which requires strong organizational skills and attention to detail. One common challenge is prioritizing tasks to ensure timely processing while maintaining accuracy. Additionally, balancing communication with claimants, providers, and internal teams can be demanding, especially when resolving complex cases. Building effective time management strategies and leveraging claim management software can help Claim Associates meet deadlines and reduce errors.

Can I get a claims adjuster job with no experience?

Claim associates or claims adjusters typically require some knowledge of insurance policies and claims processing, but entry-level positions often do not require prior experience. Candidates may need to complete training or obtain relevant certifications, such as the Property and Casualty (P&C) license, to qualify for the role.

Which claim adjusters make the most money?

Senior claim adjusters, especially those with specialized expertise in complex or high-value claims such as property or commercial insurance, tend to earn the highest salaries. Adjusters with certifications like the Chartered Property Casualty Underwriter (CPCU) and extensive experience generally have higher earning potential.

What do claims associates do?

Claims associates review and process insurance claims by evaluating documentation, determining coverage, and calculating payouts. They communicate with clients, adjust claims as needed, and ensure claims are handled accurately and efficiently, often using specialized claims management software.

What are the key skills and qualifications needed to thrive as a Claim Associate, and why are they important?

To thrive as a Claim Associate, you need strong analytical abilities, attention to detail, and a foundational understanding of insurance policies, typically supported by a high school diploma or equivalent. Familiarity with claims management software, document processing systems, and sometimes basic Excel skills is often required. Excellent communication, problem-solving, and customer service skills help build trust and effectively resolve client issues. These skills ensure accurate claim processing, client satisfaction, and efficient workflow in a high-volume environment.
What are the most commonly searched types of Claim jobs in Raleigh, NC? The most popular types of Claim jobs in Raleigh, NC are:
What cities near Raleigh, NC are hiring for Claim Associate jobs? Cities near Raleigh, NC with the most Claim Associate job openings:
Claim Associate jobs near you
Infographic showing various Claim Associate job openings in Raleigh, NC as of July 2026, with employment types broken down into 1% As Needed, 70% Full Time, 25% Part Time, 1% Temporary, and 3% Contract. Highlights an 97% Physical, 1% Hybrid, and 2% Remote job distribution, with an average salary of $42,561 per year, or $20.5 per hour.
eCOB Specialist II

eCOB Specialist II

Elevance Health

Durham, NC • On-site

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Posted 8 days ago

Elevance Health rating

7.7

Company rating: 7.7 out of 10

Based on 348 frontline employees who took The Breakroom Quiz

184th of 281 rated insurance

Job description

Anticipated End Date:

2026-07-26

Position Title:

eCOB Specialist II

Job Description:

eCOB Specialist II
Location: This role enables associates to work virtually full-time, except for required in-person training sessions, providing maximum flexibility and autonomy. This approach promotes productivity, supports work-life integration, and ensures essential face-to-face onboarding and skill development. Alternate locations may be considered if candidates reside within a commuting distance from an office.
Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless accommodation is granted as required by law.

The eCOB Specialist II is responsible for researching and investigating other coverage for all of the company's groups and members on multiple platforms. Fully proficient in all key areas; performs multi complex functions and interprets complex rules, laws and contracts. Accountable for end-to-end functionality on every Coordination of Benefits(COB) function including reconciliation of claim, membership and accounting.


How you will make an impact:

  • Utilizes internal queries, internal resource tools, must initiate delicate-in-nature phone calls to other carriers, members, groups, providers, attorneys, CMS and Medicaid and report to identify members who are or should be enrolled in other coverage.

  • Aides members in enrolling in Medicare when they are entitled.

  • Determines primacy on each case using a complex set of Primacy Rules as mandated by State and Federal Laws, such as CMS Primacy and NAIC rules and comparing them against the member/groups benefits.

  • Updates all of the company's membership system components with investigation results for claim coordination.

  • Ensures correct forms are provided to assist members enrolling in Medicare.

  • Reviews claim history to identify claims requiring reconciliation, whether processed or pended, as well as recovered in error.

  • Associate must identify the correct formulas in order to adjudicates impacted claims, using multiple COB Formulas for the various product types, pursuant to State and Federal Guidelines.

  • Associates in this role are expected to have the ability to multi-task, including handling calls, texts, facsimiles, and electronic queues, while simultaneously taking notes and speaking to customers.

  • Additional expectations to include but not limited to: Proficient in maintaining focus during extended periods of sitting and handling multiple tasks in a fast-paced, high-pressure environment; strong verbal and written communication skills, both with virtual and in-person interactions; attentive to details, critical thinker, and a problem-solver; demonstrates empathy and persistence to resolve caller issues completely; comfort and proficiency with digital tools and platforms to enhance productivity and minimize manual efforts.

  • Associates in this role will have a structured work schedule with occasional overtime or flexibility based on business needs, including the ability to work from the office as necessary.

  • Performs other duties as assigned.


Minimum Qualifications:

  • Requires a HS diploma or equivalent and a minimum of 2 years of claims processing and customer service and 2 years COB experience that required using NAIC & CMS COB guidelines; or any combination of education and experience which would provide an equivalent experience.


Preferred Skills, Capabilities and Experiences:

  • WGS experience strongly preferred

  • Strong organizational and time management skills preferred

Job Level:

Non-Management Non-Exempt

Workshift:

Job Family:

CLM > Claims Support

Please be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with Elevance Health. Any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health.


Who We Are

Elevance Health is a health company dedicated to improving lives and communities - and making healthcare simpler. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve.


How We Work

At Elevance Health, we are creating a culture that is designed to advance our strategy but will also lead to personal and professional growth for our associates. Our values and behaviors are the root of our culture. They are how we achieve our strategy, power our business outcomes and drive our shared success - for our consumers, our associates, our communities and our business.


We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few.


Elevance Health operates in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager, associates are required to work at an Elevance Health location at least once per week, and potentially several times per week. Specific requirements and expectations for time onsite will be discussed as part of the hiring process.


The health of our associates and communities is a top priority for Elevance Health. We require all new candidates in certain patient/member-facing roles to become vaccinated against COVID-19 and Influenza. If you are not vaccinated, your offer will be rescinded unless you provide an acceptable explanation. Elevance Health will also follow all relevant federal, state and local laws.


Elevance Health is an Equal Employment Opportunity employer, and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process should submit the following form: Accessibility Accommodation Request Form and a member of the team will be in contact. Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state, and local laws, including, but not limited to, the Los Angeles County Fair Chance Ordinance and the California Fair Chance Act.


Prospective employees required to be screened under Florida law should review the education and awareness resources at HB531 | Florida Agency for Health Care Administration.


NOTE: Workday keeps job postings active through 11:59:59 PM on the day before the listed end date. Example: If the end date is 3/13, the posting will automatically come down on 3/12 at 11:59:59 PM. In other words - the job is posted until 3/13, not through 3/13.

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About Elevance Health

Sourced by ZipRecruiter

Elevance Health is a health company dedicated to improving lives and communities - and making healthcare simpler. A Fortune 20 company with a longstanding history in the healthcare industry, we are looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve. You will thrive in a complex and collaborative environment where you take action and ownership to solve problems and lead change. Do you want to be part of a larger purpose and an evolving, high-performance culture that empowers you to make an impact?

Industry

Health care and social assistance

Company size

10,000+ Employees

Headquarters location

Indianapolis, IN, US

Year founded

2004

Social media

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