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Claims Executive Jobs in Raleigh, NC (NOW HIRING)

AVE Staffing

Labor & Employment Associate

Raleigh, NC · Hybrid

$160K - $200K/yr

Senior Employee Benefits & Executive Compensation (ERISA) Attorney Location: Raleigh, NC (On-site ... Represent employers and corporate management in state and federal courts against claims involving ...

Socket.dev

Human Resources Manager

Raleigh, NC · On-site

$80 - $100/hr

The HR Manager will work closely with operational and executive leadership and serve as a key ... Manage FMLA, ADA accommodations, unemployment claims, required HR reporting, recordkeeping, and ...

New

Socket.dev

CHIEF FINANCIAL OFFICER

Raleigh, NC · On-site

$150 - $200/hr

Reporting directly to and partnering closely with the Chief Executive Officer (CEO), the CFO will ... Direct claims denial management, appeals processes, and resolution of billing discrepancies.

New

ADP, Inc.

Human Resources Manager

Raleigh, NC · On-site

$100 - $125/hr

The HR Manager will work closely with operational and executive leadership and serve as a key ... Manage FMLA, ADA accommodations, unemployment claims, required HR reporting, recordkeeping, and ...

New

Habitat For Humanity Of Durham

BI Analyst

Durham, NC · On-site

$100 - $125/hr

This role combines advanced data analysis, dashboard development, healthcare claims expertise, and ... executive decision-making. This role is responsible for translating complex healthcare data into ...

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All JobsClaims JobsClaims Executive JobsClaims Executive Jobs in Raleigh, NC

Claims Executive information

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How much do claims executive jobs pay per hour?

As of Sep 9, 2026, the average hourly pay for claims executive in Raleigh, NC is $20.46, according to ZipRecruiter salary data. Most workers in this role earn between $17.50 and $22.21 per hour, depending on experience, location, and employer.

What does a claims executive do?

A Claims Executive is responsible for managing and processing insurance claims on behalf of clients or an insurance company. Their duties typically include investigating claims, reviewing policy details, assessing liability, negotiating settlements, and ensuring that claims are handled efficiently and in compliance with company policies and legal standards. They act as a liaison between claimants, insurers, and other parties involved to ensure fair and prompt resolution of claims. Strong communication, analytical, and negotiation skills are essential for this role.

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

To thrive as a Claims Executive, you need a solid understanding of insurance policies, claims processing, and risk assessment, often supported by a degree in business, finance, or a related field. Familiarity with claims management software, policy administration systems, and relevant industry certifications like CII or AIC are typically required. Strong negotiation, analytical thinking, and effective communication skills help you excel in handling complex claims and client relationships. These skills ensure accurate, efficient claims resolution and maintain trust between clients and the organization.

What are the main challenges a claims executive typically encounters, and how can they effectively address them?

Claims Executives often face the challenge of balancing customer satisfaction with organizational policy, especially when handling complex or disputed claims. They must manage high workloads and tight deadlines, requiring strong organizational and time-management skills. Effective communication and negotiation are crucial for resolving disputes amicably. Staying updated on industry regulations and internal processes also helps Claims Executives make fair and accurate decisions. Building collaborative relationships with underwriters, legal teams, and clients can further streamline claim resolutions.

What is the difference between Claims Executive vs Claims Adjuster?

AspectClaims ExecutiveClaims Adjuster
CredentialsTypically requires a bachelor's degree in insurance, business, or related field; certifications like CPCU are commonOften requires a high school diploma or equivalent; certifications like AIC or CPCU are advantageous
Work EnvironmentOffice-based, client-facing, and administrative roles within insurance companiesField-based or office-based, investigating claims and assessing damages
Employer & Industry UsageUsed in insurance companies, corporate claims departmentsCommonly employed by insurance firms, adjusting claims on-site or remotely

While both Claims Executives and Claims Adjusters work within the insurance industry, Claims Executives typically handle higher-level administrative and strategic tasks, whereas Claims Adjusters focus on investigating and settling individual claims. Understanding these differences helps job seekers identify roles aligned with their skills and career goals.

What are the most commonly searched types of Claims jobs in Raleigh, NC?

The most popular types of Claims jobs in Raleigh, NC are:

What are popular job titles related to Claims Executive jobs in Raleigh, NC?

For Claims Executive jobs in Raleigh, NC, the most frequently searched job titles are:

What job categories do people searching Claims Executive jobs in Raleigh, NC look for?

The top searched job categories for Claims Executive jobs in Raleigh, NC are:

What cities near Raleigh, NC are hiring for Claims Executive jobs?

Cities near Raleigh, NC with the most Claims Executive job openings:

Claims Executive jobs near you
Infographic showing various Claims Executive job openings in Raleigh, NC as of August 2026, with employment types broken down into 1% Internship, 85% Full Time, 10% Part Time, and 4% Contract. Highlights an 84% Physical, 5% Hybrid, and 11% Remote job distribution, with an average salary of $42,561 per year, or $20.5 per hour.

Account Executive -Workers Compensation

Chapel Hill, NC • On-site

Brighton Health Plan Solutions, LLC
201 - 500 employees
Learn more about Brighton Health Plan Solutions, LLCexternal

Full-time

Medical, Vision

Posted 28 days ago

Job description

About The Role
Brighton Health Plan Solutions is seeking an experienced Account Executive with deep expertise in medical payments for workers’ compensation and automobile insurance claims, PPO network strategies, and bill review  organizations. This role is primarily focused on client retention, relationship management, new sales and ensuring long-term client success across a portfolio of self-funded and fully insured accounts. As the internal advocate for assigned clients, the Account Executive partners closely with internal operations, clinical, network, and vendor teams to deliver seamless service, provide proactive communication, and drive sustained partnership value.
Primary Responsibilities
  • Own the day-to-day client relationship for an assigned book of business, including self-funded employer groups, TPAs, bill review companies, PPO networks and commercial carriers.
  • Lead efforts to ensure client satisfaction, retention, and renewal, addressing client needs proactively and effectively.
  • Communicate proactively with clients to anticipate needs, provide timely updates, and deliver actionable insights.
  • Coordinate with Operations, Network Management, Analytics, Finance, Marketing, and Customer Service to ensure timely execution and resolution of client needs.
  • Develop a deep understanding of each client’s strategic business objectives, benefit needs, and market position.
  • Identify, escalate, and resolve customer service, operational, financial, and network-related issues, ensuring ownership through completion.
  • Advocate for client needs across Brighton Health to ensure solutions are aligned with client expectations and long-term strategic goals.
  • Leverage data and analytics to deliver insights and recommendations that strengthen client outcomes, improve retention, and expand engagement.
  • Lead the development and execution of strategies to expand client engagement with Brighton Health’s networks, point solutions, and integrated services, including oversight of complex workflows, vendor integrations, and operational connectivity across the ecosystem.
  • Maintain and update all client-related activities.
  • Represent Brighton Health at client meetings and industry conferences (20%+ travel required).
  • Support the implementation of new services, account launches, and system integrations for assigned clients.
  • Stay informed on Brighton Health products, services, and industry trends to provide strategic guidance to clients.
  • Develop a pipeline of new sales opportunities, including but not limited to selling additional services to existing customers, and take action to execute on and meet sales goals.
Essential Qualifications
  • Bachelor’s degree in a related field.
  • Minimum 5 years of experience in account management, client success, or a related field, with required experience in a PPO, bill review, carrier or TPA environment, preferably in the New York and New Jersey markets.
  • Proven track record in client retention and relationship management.
  • Excellent communication, interpersonal, and problem-solving skills with a client-first mindset.
  • Strong organizational and time-management skills, with the ability to manage multiple priorities.
  • Proficiency in Salesforce and Microsoft Office Suite (Excel, Word, PowerPoint, Outlook).
  • Ability to travel 20%+.
About
At Brighton Health Plan Solutions, LLC, our people are committed to the improvement of how healthcare is accessed and delivered. When you join our team, you’ll become part of a diverse and welcoming culture focused on encouragement, respect and increasing diversity, inclusion and a sense of belonging at every level. Here, you’ll be encouraged to bring your authentic self to work with all of your unique abilities.
Brighton Health Plan Solutions partners with self-insured employers, Taft-Hartley Trusts, health systems, competing PPOs, bill review companies,  providers, carriers and  TPAs, and enables them to solve the problems facing today’s healthcare with our flexible and cutting-edge medical management and PPO services. Our unique perspective stems from decades of health plan management expertise, our proprietary provider networks, and innovative technology platform. As a healthcare enablement company, we unlock opportunities that provide clients with the customizable tools they need to enhance the member experience, improve health outcomes and achieve their healthcare goals and objectives. Together with our trusted partners, we are transforming the health plan experience with the promise of turning today’s challenges into tomorrow’s solutions.
Come be a part of the Brightest Ideas in Healthcare™.
Company Mission
Transform the health plan experience – how health care is accessed and delivered – by bringing outstanding products and services to our partners.
Company Vision
Redefine health care quality and value by aligning the incentives of our partners in powerful and unique ways.
JOB ALERT FRAUD:  We have become aware of scams from individuals, organizations, and internet sites claiming to represent Brighton Health Plan Solutions in recruitment activities in return for disclosing financial information.  Our hiring process does not include text-based conversations or interviews and never requires payment or fees from job applicants. All of our career opportunities are regularly published and updated brighonthps.com Careers section.  If you have already provided your personal information, please report it to your local authorities. Any fraudulent activity should be reported to: recruiting@brightonhps.com
 

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