ZipRecruiter

Log In

1

Claims Examiner Jobs in Raleigh, NC (NOW HIRING)

IFG Companies

Claim Examiner

Chapel Hill, NC · On-site

$80K - $100K/yr

Draft POSITION SUMMARY The primary role of the Claim Examiner ("CE") is to investigate, evaluate ... This role will keep Claims Management apprised of the status of difficult cases and be consultative ...

Sedgwick

PRN Crisis Care Triage (RN)

Raleigh, NC · On-site

Maintains communication with the customer, Client Service Director, and Claims Examiner providing timely updates on changes in injured worker status and FCM estimated time of arrival. * Communicates ...

New

Erie Insurance

Claims Facilitator

Raleigh, NC · On-site

$40K - $64K/yr

Casualty Claims Division Department of Position: Zones Dept Work from: Branch Office Salary Range: $40,121.00-$64,090.00* salary range is for thislevel and may vary based on actual level of role ...

Iatinsurancegroup

Manager, Claims Services

Raleigh, NC · Hybrid

$72K - $157K/yr

The Casualty Claims department within IAT Insurance Group has an immediate opening for a Manager of Claims Services in our Auto-PD department.The Manager is a strong technical leader with operational ...

New

IAT Insurance Group

Manager, Claims Services

Raleigh, NC · On-site

$72K - $157K/yr

The Casualty Claims department within IAT Insurance Group has an immediate opening for a Manager of Claims Services in our Auto-PD department. The Manager is a strong technical leader with ...

Erie Insurance

Claims Facilitator

Raleigh, NC

$40K - $64K/yr

Casualty Claims Division Department of Position: Zones Dept Work from: Branch Office Salary Range: $40,121.00 - $64,090.00 * salary range is for this level and may vary based on actual level of role ...

Erie Insurance

Claims Facilitator

Raleigh, NC

$40K - $64K/yr

Casualty Claims Division Department of Position: Zones Dept Work from: Branch Office Salary Range: $40,121.00 - $64,090.00 * salary range is for this level and may vary based on actual level of role ...

Erie Insurance

Claims Facilitator

Cary, NC

$40K - $64K/yr

Casualty Claims Division Department of Position: Zones Dept Work from: Branch Office Salary Range: $40,121.00 - $64,090.00 * salary range is for this level and may vary based on actual level of role ...

Erie Insurance

Claims Facilitator

Cary, NC · On-site

$40K - $64K/yr

Casualty Claims Division Department of Position: Zones Dept Work from: Branch Office Salary Range: $40,121.00 - $64,090.00 * salary range is for this level and may vary based on actual level of role ...

Erie Insurance

Claims Facilitator

Raleigh, NC · On-site

$40K - $64K/yr

Casualty Claims Division Department of Position: Zones Dept Work from: Branch Office Salary Range: $40,121.00 - $64,090.00 * salary range is for this level and may vary based on actual level of role ...

Erie Insurance

Claims Facilitator

Raleigh, NC · On-site

$40K - $64K/yr

Casualty Claims Division Department of Position: Zones Dept Work from: Branch Office Salary Range: $40,121.00 - $64,090.00 * salary range is for this level and may vary based on actual level of role ...

Elevance Health

Claims Representative I

Durham, NC · On-site

$16.23 - $24.36/hr

Claims Representative I Claims Representative I Location : This role enables associates to work virtually full-time, except for required in-person training sessions, providing maximum flexibility and ...

Sedgwick

Claims Representative, Auto

Raleigh, NC · On-site

$50K - $55K/yr

To analyze and process low to mid-level auto and transportation claims. ESSENTIAL RESPONSIBLITIES MAY INCLUDE * Processes auto property damage and lower level injury claims; assesses damage, makes ...

next page

Showing results 1-20

All JobsClaims Examiner JobsClaims Examiner Jobs in Raleigh, NC

Claims Examiner information

See Raleigh, NC salary details

$14

$28

$44

How much do claims examiner jobs pay per hour?

As of Aug 9, 2026, the average hourly pay for claims examiner in Raleigh, NC is $28.58, according to ZipRecruiter salary data. Most workers in this role earn between $21.73 and $34.13 per hour, depending on experience, location, and employer.

Is being a claims examiner hard?

Claims examiners review insurance claims to determine coverage and payment, which can involve detailed analysis and attention to accuracy. The job often requires strong organizational skills, knowledge of policies, and sometimes certification, but the difficulty varies based on experience and the complexity of claims handled.

How much do claims examiners make in the US?

Claims examiners in the US typically earn a median annual salary of around $45,000 to $65,000, depending on experience, location, and employer. Entry-level positions may start lower, while experienced examiners or those with specialized skills can earn higher wages, often supplemented with benefits and opportunities for advancement.

What is a claims examiner?

A claims examiner evaluates claim files that have been submitted by an insurance adjuster. They decide whether to authorize or deny payments and refer suspicious or complicated claims to insurance investigators. This job is a risk management position. In health insurance, examiners may have to decide if medical procedures are worth the patient’s prognosis, if someone's cause of death warrants incidental fees, or if witness interviews waive the insurance company’s liability.

What do I need to be a claims examiner?

To become a claims examiner, candidates typically need a high school diploma or equivalent, with some roles preferring an associate's or bachelor's degree in fields like insurance, finance, or healthcare. Strong analytical skills, attention to detail, and knowledge of insurance policies and claims processing are essential, along with proficiency in computer software and sometimes relevant certifications such as the Certified Claims Professional (CCP).

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

To thrive as a Claims Examiner, you need strong analytical skills, attention to detail, and a background in insurance, finance, or a related field, often supported by relevant certifications or a degree. Familiarity with claims management software, regulatory compliance systems, and industry-specific databases is typically required. Excellent communication, problem-solving abilities, and good judgment help you stand out in this position. These skills and qualities are crucial for ensuring accurate claim evaluations, minimizing risk, and maintaining customer trust.

What does a claims examiner do?

A Claims Examiner is responsible for reviewing insurance claims to determine their validity and whether they should be approved or denied. They carefully examine claim forms, supporting documents, and sometimes conduct interviews to gather additional information. Claims Examiners ensure that claims comply with policy terms and legal requirements, and may calculate the amount to be paid out. Their work helps prevent fraudulent claims and ensures fair processing for all parties involved.

What are some common challenges faced by claims examiners, and how can they be managed effectively?

Claims Examiners often encounter challenges such as reviewing complex or incomplete documentation, managing a high volume of claims, and balancing the need for accuracy with efficiency. Effective organization, strong attention to detail, and clear communication with claimants and other team members are essential for overcoming these obstacles. Additionally, staying current with industry regulations and using claims management software can help streamline the process and reduce errors.

What is the difference between Claims Examiner vs Claims Processor?

AspectClaims ExaminerClaims Processor
Required credentialsHigh school diploma or equivalent; often some insurance or claims experienceHigh school diploma or equivalent; may have basic insurance knowledge
Work environmentOffice setting, reviewing claims, making determinationsOffice setting, processing claims data, data entry
Employer and industry usageInsurance companies, government agenciesInsurance companies, third-party administrators
Common search intentUnderstanding roles, career differences, job requirementsEntry-level position, processing claims, job duties

Claims Examiners review insurance claims to determine coverage and approve or deny payments, requiring analytical skills and some insurance knowledge. Claims Processors handle the data entry and processing of claims, focusing on accuracy and efficiency. While both roles work in insurance settings and may require similar credentials, Claims Examiners have more decision-making responsibilities, whereas Claims Processors focus on data handling.

More about Claims Examiner jobs
What are the most commonly searched types of Claims Examiner jobs in Raleigh, NC? The most popular types of Claims Examiner jobs in Raleigh, NC are:
What are popular job titles related to Claims Examiner jobs in Raleigh, NC? For Claims Examiner jobs in Raleigh, NC, the most frequently searched job titles are:
What job categories do people searching Claims Examiner jobs in Raleigh, NC look for? The top searched job categories for Claims Examiner jobs in Raleigh, NC are:
What cities near Raleigh, NC are hiring for Claims Examiner jobs? Cities near Raleigh, NC with the most Claims Examiner job openings:
Claims Examiner jobs near you
Infographic showing various Claims Examiner job openings in Raleigh, NC as of August 2026, with employment types broken down into 100% Full Time. Highlights an 100% In-person job distribution, with an average salary of $59,449 per year, or $28.6 per hour.

Claim Examiner

IFG Companies

Chapel Hill, NC • On-site

$80K - $100K/yr

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Posted 17 days ago

Job description

Draft

POSITION SUMMARY

The primary role of the Claim Examiner ("CE") is to investigate, evaluate, negotiate and settle injury/damage claims in a fair and timely manner across multiple jurisdictions while applying policy coverage considerations and applicable laws and regulations. The CE will handle potentially difficult and adversarial situations professionally, maintain accurate and supporting claim files and participate in quality reviews, as required. This role will keep Claims Management apprised of the status of difficult cases and be consultative with respect to their resolution, when appropriate, and within necessary timeliness and guidelines.

POSITION RESPONSIBILITIES INCLUDING

  • Prompt reviewing of new losses and determining initial plans of action.
  • Analyzing coverage as it relates to the facts and allegations of claims and preparing Reservation of Rights and Declination of Coverage letters, as applicable.
  • Initiating contact with policyholder and claimant(s) to confirm notice of loss description and determine the scope of the investigation, as appropriate.
  • When appropriate, assigning and instructing independent adjusting firms to conduct needed investigative tasks and managing and directing activity of independent adjusting firms in any continuous investigation of claims.
  • Reporting losses timely to management and updating as necessary.
  • Evaluating claims as investigations develop and establishing and adjusting reserves, as warranted.
  • Reviewing expense bills for appropriateness, accuracy and adherence to IFG Companies’ billing guidelines and process payments.
  • Recognizing, notifying and pursuing culpable parties and seeking contributions from such parties.
  • Identifying and ensuring subrogation efforts are undertaken against responsible parties.
  • Negotiating claims to settlement.
  • Other duties, as requested.

KNOWLEDGE, SKILLS AND ABILITIES

  • Excellent written and oral communication skills.
  • Exhibit negotiation, critical thinking and problem-solving capabilities.
  • Outstanding customer service, attention to detail and multi-tasking skills.
  • Strong computer skills, including the ability to work effectively in the claims management system and strong knowledge of Microsoft applications (e.g., Outlook, Word, Excel).
  • Ability to exercise independent judgement with moderate supervision in handling claims within reserve and settlement authority.

EDUCATION, EXPERIENCE AND CERTIFICATIONS

  • Required: A bachelor's degree from an accredited U.S. college/university, with a major or coursework in insurance, economics, or related fields.
  • Required: At least two (2) years of property/casualty claims handling experience as a full-time exempt employee, preferably with a U.S. commercial insurer.
  • Required: A valid adjuster license in designated home state (or be able and willing to obtain one within sixty (60) days after hire) and the ability to obtain additional non-residential adjuster licenses.
  • Preferred: At least three (3) years of commercial general liability policy and/or garage policy experience, preferably with a U.S. commercial insurer.

PHYSICAL DEMANDS

  • Position is hybrid and requires the ability and the willingness to work in an IFG Companies office at least three (3) days per week if residing within a one-hour commuting distance.
  • Physical demands are considered those of a climate-controlled office environment with minimal physical exertion.
  • Position requires prolonged sitting, extensive utilization of computers and interactions with others in person and via phone.
  • Position requires the ability and the willingness to travel when required to meet business needs.

SALARY AND BENEFITS

The salary range for this position is $80,000 to $100,000. Additionally, the position may be eligible to earn incentive compensation.

IFG Companies offers competitive compensation and benefits, currently including medical, dental, vision, 401(k), flexible spending, short-term and long-term disability insurance, life insurance, paid parental leave, vacation and other paid time off.

WHY IFG COMPANIES

Founded in 1985, IFG Companies is one of the oldest privately held insurance groups in the United States. It combines a specialty-carrier focus with long-term stability and thinking, while promoting a culture of underwriting rigor, collaboration, strategic thinking, superior technology and strong producer partnerships.

EQUAL OPPORTUNITY

IFG Companies is an equal opportunity employer. All applicants will be considered for employment without attention to race, color, religion, sex, sexual orientation, gender identity, national origin, veteran or disability status or any other protected characteristic under applicable law.

Rev. 070426