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Claims Processor Associate Jobs in North Carolina

Judi Health

Claims Adjudication Associate

Charlotte, NC · Hybrid

$17.25 - $23.50/hr

Judi Health is seeking a self-driven Claims Adjudication Associate to support the Medical claims ... This individual will be responsible for maintaining the operational adjudication process, member ...

Capital Rx

Claims Adjudication Associate

Charlotte, NC · On-site

$82K - $103K/yr

Judi Health is seeking a self-driven Claims Adjudication Associate to support the Medical claims ... This individual will be responsible for maintaining the operational adjudication process, member ...

Capital Rx

Claims Adjudication Associate

Charlotte, NC · On-site

$82K - $103K/yr

Judi Health is seeking a self-driven Claims Adjudication Associate to support the Medical claims ... This individual will be responsible for maintaining the operational adjudication process, member ...

Judi Health

Claims Adjudication Associate

Charlotte, NC · On-site

$82K - $103K/yr

Judi Health is seeking a self-driven Claims Adjudication Associate to support the Medical claims ... This individual will be responsible for maintaining the operational adjudication process, member ...

Judi Health

Claims Adjudication Associate

Charlotte, NC · On-site

$82K - $103K/yr

Judi Health is seeking a self-driven Claims Adjudication Associate to support the Medical claims ... This individual will be responsible for maintaining the operational adjudication process, member ...

Kintegra Health

Medical Claims Supervisor

Gastonia, NC · On-site

... processing of claims and resolution of claims-related issues. Specifications Education : Bachelor's degree preferred; associate degree in healthcare administration, business administration, health ...

Pacificlife

Operations Claims Specialist

Charlotte, NC · On-site

$26/hr

Operations Claims Associate: 0-2 years of operations or insurance-related experience * Operations Claims Specialist: 2-3+ years of claims processing experience with demonstrated proficiency * Sr. ...

Greystar

Casualty Claims Associate

Charlotte, NC

$17.25 - $23.50/hr

Casualty Claims Associate Full time Charlotte, North Carolina | Atlanta, Georgia Apply Now Save Job ... Knowledge of Claim Handling & Claim processes and procedures Knowledge of laws, legal codes ...

Greystar

Senior Casualty Claims Associate

Charlotte, NC · On-site

$17.25 - $23.50/hr

Senior Casualty Claims Associate Full time Charlotte, North Carolina | Atlanta, Georgia Apply Now ... Knowledge of Claim Handling & Claim processes and procedures Knowledge of laws, legal codes ...

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Claims Processor Associate information

What does a claims processor associate do?

A Claims Processor Associate is responsible for reviewing, processing, and verifying insurance claims to ensure they are accurate and comply with policy guidelines. They investigate claim details, communicate with policyholders or medical providers for additional information, and enter claim data into company systems. Their role is crucial in ensuring timely and accurate payments or denials, helping both insurance companies and clients. Attention to detail, strong organizational skills, and excellent communication abilities are important for success in this position.

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

To thrive as a Claims Processor Associate, you need strong attention to detail, analytical skills, and a high school diploma or equivalent, with some employers preferring experience in insurance or healthcare. Familiarity with claims management software, data entry systems, and basic office applications is typically required. Excellent organizational skills, clear communication, and the ability to work efficiently under deadlines are essential soft skills for this role. These abilities ensure accurate claims processing, minimize errors, and support timely service for clients and providers.

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

Claims Processor Associates often encounter challenges such as handling a high volume of claims, navigating complex policy details, and meeting strict deadlines. Successfully managing these challenges requires strong organizational skills, attention to detail, and the ability to prioritize tasks effectively. Collaborating closely with team members and regularly communicating with supervisors can also help resolve discrepancies and ensure accuracy. Most organizations provide training and support to help associates stay updated on procedures and regulatory requirements, fostering a supportive work environment.

Is claims processing a stressful job?

Claims processing can be a stressful job due to tight deadlines, high volume of claims, and the need for accuracy. It often requires attention to detail, strong organizational skills, and the ability to handle complex or difficult cases. However, workload and stress levels vary depending on the employer and work environment.

What are the most commonly searched types of Claims Processor jobs in North Carolina?

The most popular types of Claims Processor jobs in North Carolina are:

What are popular job titles related to Claims Processor Associate jobs in North Carolina?

For Claims Processor Associate jobs in North Carolina, the most frequently searched job titles are:

What job categories do people searching Claims Processor Associate jobs in North Carolina look for?

The top searched job categories for Claims Processor Associate jobs in North Carolina are:

What cities in North Carolina are hiring for Claims Processor Associate jobs?

Cities in North Carolina with the most Claims Processor Associate job openings:

Claims Processor Associate jobs near you
Infographic showing various Claims Processor Associate job openings in North Carolina as of August 2026, with employment types broken down into 100% Full Time. Highlights an 100% In-person job distribution.

Claims Adjudication Associate

Charlotte, NC • Hybrid

Judi Health
See more jobs at Judi Healthexternal

$17.25 - $23.50/hr

Full-time

Re-posted 17 days ago

Job description

Location: Hybrid 3 days in Charlotte office

Position Summary: 

Judi Health is seeking a self-driven Claims Adjudication Associate to support the Medical claims adjudication workflow for JUDI Health, our enterprise health platform. 

In year one, this individual will train on the JUDI Medical adjudication system. This individual will be responsible for maintaining the operational adjudication process, member, and provider escalated inquiry management, subrogation, stop-loss, recoupment and adjustment flows, and adhering to standard and contractual claims processing SLAs. 

In year two, this individual will be responsible for managing and servicing new and existing clients of JUDI's Medical Claims Adjudication platform. This individual will be expected to maintain an in-depth understanding of the evolving capabilities of JUDI and our medical network support and client base. Exceptional communication skills and attention to detail are critical for communicating with internal and external stakeholders to build holistic support for medical claims processing. 

Position Responsibilities: 

  • Review, assess, and make decisions on medical claims submitted by networks, claimants, or other parties.  
  • Provide support to Customer Care representatives in relation to claims and benefits questions from Members and Providers. 
  • The Claims Adjudicator reviews the facts of each case and applies the applicable laws, regulations, and policy provisions to determine the appropriate claim outcome.  
  • The Claims Adjudicator must be knowledgeable of the claims process, laws, and policies, as well as possess excellent communication skills and a commitment to providing outstanding customer service.  
  • Manually adjudicate claims received via 837 EDI file, HIPAA 1500 or UB-04 forms, or direct member reimbursement submissions via superbill submission. 
  • Adhere to standard SLA's regarding number or percentage of claims processed per day 
  • Assist in management of claims related mail workflows including Appeals, subrogation, payments, and stop-loss. 
  • Build and maintain trusting relationships with clients through superior customer service. 
  • Assist in communications throughout the implementation process, including detailed and strategic guidance for adjudication infrastructure, processing, reporting, inquiry management, and complex claim situations/requests. 
  • Proactively identify execution risks and mitigation strategies. 
  • Identify and drive efficiencies to automate adjudication flows and reduce risk. 
  • Certain times of year may require meeting participation, service support or other requirements outside of standard business hours, including weekends. 
  • Responsible for adherence to the Judi Health Code of Conduct including reporting of noncompliance. 

Minimum Qualifications: 

  • Bachelors degree strongly preferred 
  • Experience managing a team of direct reports 
  • 1+ years of work experience at a health plan, claims adjudicator, or TPA 
  • Well-versed in Benefit determinations 
  • Well-versed in impact of claims processing and adjudication in regards to COB, Adjustments, Appeals, and member/provider inquiries 
  • Act as a patient advocate, protecting privacy and confidentiality issues. 
  • Track record of leading cross-functional initiatives, driving high performance, meeting deadlines, and executing on deliverables 
  • Exceptional project / time management, prioritization, and organizational skills to ensure customer satisfaction 
  • Ability to shift between competing priorities and meet organizational goals 
  • Proficient in Microsoft office Suite and willing to adapt to software such as Jira, Miro, Confluence, Github, and AWS Redshift 
  • Excellent verbal, written, interpersonal and presentation skills 
  • Ability to work effectively with virtual teams 

Preferred Qualifications: 

  • Medicare/Medicaid experience preferred 

Apply