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Claims Processor Jobs in Raleigh, NC (NOW HIRING)

DAN

Claims Director

Durham, NC · On-site

$130K/yr

The Director of Claims leads claims staff, develops departmental processes and performance standards, manages complex and escalated claims matters, and collaborates with internal and external ...

Divers Alert Network

Claims Director

Durham, NC · On-site

The Director of Claims leads claims staff, develops departmental processes and performance standards, manages complex and escalated claims matters, and collaborates with internal and external ...

DAN

Claims Director

Durham, NC · Hybrid

The Director of Claims leads claims staff, develops departmental processes and performance standards, manages complex and escalated claims matters, and collaborates with internal and external ...

Divers Alert Network

Claims Director

Durham, NC · On-site

The Director of Claims leads claims staff, develops departmental processes and performance standards, manages complex and escalated claims matters, and collaborates with internal and external ...

Progressive

Claims Adjuster Trainee

Raleigh, NC · On-site

$52K - $56K/yr

In a fast-paced environment, you'll learn how to resolve a full case load of claims efficiently while managing the claims process from start to finish. You'll have the support of a collaborative team ...

Erie Insurance

Claims Facilitator

Raleigh, NC · On-site

$40K - $64K/yr

Processes first party automobile, third party clear liability automobile and low severity property claims within limits of authority. Contacts Policyholders and/or claimants, verifies coverage, sets ...

Erie Insurance

Claims Facilitator

Raleigh, NC · On-site

$40K - $64K/yr

Processes first party automobile, third party clear liability automobile and low severity property claims within limits of authority. Contacts Policyholders and/or claimants, verifies coverage, sets ...

Erie Insurance

Claims Facilitator

Raleigh, NC · On-site

$40K - $64K/yr

Processes first party automobile, third party clear liability automobile and low severity property claims within limits of authority. Contacts Policyholders and/or claimants, verifies coverage, sets ...

Erie Insurance

Claims Facilitator

Cary, NC

$40K - $64K/yr

Processes first party automobile, third party clear liability automobile and low severity property claims within limits of authority. Contacts Policyholders and/or claimants, verifies coverage, sets ...

Erie Insurance

Claims Facilitator

Cary, NC · On-site

$40K - $64K/yr

Processes first party automobile, third party clear liability automobile and low severity property claims within limits of authority. Contacts Policyholders and/or claimants, verifies coverage, sets ...

Erie Insurance

Claims Facilitator

Raleigh, NC · On-site

$40K - $64K/yr

Processes first party automobile, third party clear liability automobile and low severity property claims within limits of authority. Contacts Policyholders and/or claimants, verifies coverage, sets ...

Sedgwick

Claims Representative, Auto

Raleigh, NC · On-site

$50K - $55K/yr

Processes auto property damage and lower level injury claims; assesses damage, makes payments, and ensures claim files are properly documented and correctly coded based on the policy. * Develops and ...

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All JobsClaims Processor JobsClaims Processor Jobs in Raleigh, NC

Claims Processor information

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How much do claims processor jobs pay per hour?

As of Aug 6, 2026, the average hourly pay for claims processor in Raleigh, NC is $18.63, according to ZipRecruiter salary data. Most workers in this role earn between $15.87 and $20.10 per hour, depending on experience, location, and employer.

What is a claims processor?

A claims processor reviews insurance claims. Their responsibilities include verifying insurance policy coverage and making sure client information is accurate. After they determine there is a covered loss, a processor documents the information and makes sure all the required paperwork is complete. Other duties include modifying new or existing policies.

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

Claims Processors often encounter challenges such as managing high volumes of claims, handling complex or incomplete documentation, and meeting strict accuracy and timeliness standards. To navigate these, strong organizational skills, effective communication with colleagues and claimants, and attention to detail are crucial. Utilizing workflow management tools and maintaining open channels with supervisors and other departments can help address issues quickly and ensure claims are processed efficiently. Regular training and staying updated on policy changes also support success in this role.

Is claims processing a stressful job?

Claims processing is often considered a routine administrative role that involves reviewing and verifying insurance claims. While it can involve tight deadlines and attention to detail, the level of stress varies depending on workload, workplace environment, and individual coping skills.

What is the difference between Claims Processor vs Claims Examiner?

AspectClaims ProcessorClaims Examiner
Required CredentialsHigh school diploma or equivalent; some roles may require certificationHigh school diploma; certification often preferred
Work EnvironmentOffice setting, processing claims efficientlyOffice setting, reviewing and approving claims
Employer & Industry UsageInsurance companies, healthcare providersInsurance companies, government agencies
Common Search & ComparisonClaims Processor vs Claims Examiner

Claims Processors primarily handle the data entry and initial processing of insurance claims, focusing on accuracy and efficiency. Claims Examiners review claims for validity, compliance, and coverage before approval. While both roles work within the insurance industry and require similar credentials, Claims Examiners typically perform more detailed reviews and decision-making tasks. Understanding these differences helps job seekers identify the right role based on their skills and career goals.

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

To thrive as a Claims Processor, you need strong analytical abilities, attention to detail, and knowledge of insurance policies, typically supported by a high school diploma or associate degree. Familiarity with claims management software, data entry systems, and sometimes industry certifications like AIC (Associate in Claims) is valuable. Excellent organization, communication, and customer service skills help you efficiently resolve claims and interact with clients. These competencies ensure accuracy, minimize errors, and maintain trust in the claims process.

Do you need a degree to be a claims processor?

A claims processor typically does not need a college degree, but employers often prefer candidates with a high school diploma or equivalent. Relevant skills include attention to detail, communication, and familiarity with claims processing software, and some positions may offer on-the-job training or certification programs.

What does a claims processor do?

A Claims Processor is responsible for reviewing, evaluating, and processing insurance claims submitted by policyholders. They verify the accuracy of the information provided, ensure all required documentation is present, and determine if the claim meets the policy's terms and conditions. Claims Processors work with both customers and insurance adjusters to resolve any discrepancies and help facilitate timely payments. Their role is essential in ensuring that claims are handled efficiently and fairly.
More about Claims Processor jobs
What are the most commonly searched types of Claims Processor jobs in Raleigh, NC? The most popular types of Claims Processor jobs in Raleigh, NC are:
What are popular job titles related to Claims Processor jobs in Raleigh, NC? For Claims Processor jobs in Raleigh, NC, the most frequently searched job titles are:
What job categories do people searching Claims Processor jobs in Raleigh, NC look for? The top searched job categories for Claims Processor jobs in Raleigh, NC are:
What cities near Raleigh, NC are hiring for Claims Processor jobs? Cities near Raleigh, NC with the most Claims Processor job openings:
Claims Processor jobs near you
Infographic showing various Claims Processor job openings in Raleigh, NC as of July 2026, with employment types broken down into 87% Full Time, and 13% Contract. Highlights an 87% In-person, and 13% Remote job distribution, with an average salary of $38,748 per year, or $18.6 per hour.

Claims Processor Self-Funded

Marpai Administrators LLC

Cary, NC • Remote

$24 - $30/hr

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

This job post has expired today. Applications are no longer accepted.

Job description

Marpai Administrators is a technology company transforming the Third-Party Administration sector serving employers with self-funded health plans. Marpai Administrators (“Marpai”) is an AI-powered national TPA (third party administrator) using deep learning and machine learning to maximize population health outcomes with the greatest cost efficiency for any health plan budget. We create healthier members and a healthier bottom line. Marpai proactively targets at-risk members with meaningful clinical interventions to improve outcomes. 
 
ABOUT THE POSITION:
The Claims Processor will be responsible to for reviewing claims for accuracy, completeness, and eligibility. The Claims Processor is responsible to adjudicate claims, complete work assignments and meet established departmental metrics.  
 
WHAT YOU WILL BE DOING: 
  • Data entry of claims into system. 
  • Review, analyze adjudicate claims 
  • Validate the information on all claims to ensure there is no missing or incomplete information
  • Ability to understand and apply benefits as outlined in plan document
  • Maintain/manage all claim inventories in accordance with health plan and regulatory policies
  • Display maturity, composure and ability to operate under stressful conditions.
  • Complete daily assignments and update required spreadsheet
  • Complete end of day summary
  • Flexibility to change work direction as determined by management
  • Meet departmental standards for quality, production and attendance. 
  • Analyst is flexible and able to commit to overtime based on business needs 
  • Other duties as required
 
WHAT DO YOU NEED 
  • Associates degree preferred
  • 2+ yrs claims processing self-funded claims
  • Strong analytical, research, and communication skills.
  • Expansive knowledge of medical terminology.
  • Excellent verbal and written communication skills as well as exemplary organizational skills.
  • Work closely with leadership to assist in mitigating trends as necessary.
  • Independent judgment in decision-making and problem solving.
  • Computer skills in MS Word, Excel, PowerPoint, & Outlook at the intermediate or higher level.
  • Ability to multi-task & anticipate potential needs/problems.
  • Strong attention to detail.
  • Ability to understand and apply on-line documentation policies and procedures.
  • Excellent customer services skills including an ability to follow through, take ownership and drive all assigned tasks to completion.
  • Ability to handle large volumes of work, solve problems and manage multiple assignments while meeting critical deadlines.
  • HIPAA Compliance
 
WORK REQUIREMENTS:
  • Fast paced, dynamic work environment requiring the ability to be adaptive, innovative and flexible
  • Travel minimal
 
WHY WORK AT MARPAI?  
We have great benefits: 
  • Generous PTO
  • Medical and Prescription 
  • EAP 
  • FSA / HSA / Dependent Care
  • Dental 
  • Vision 
  • Life and Disability 
  • STD/LTD
  • Voluntary Benefits: Critical Illness, Accident, Hospital
  • 401k with Employer Match
  • LegalShield
  • Identity Theft Protection
 
Marpai is an equal opportunity workplace.  We are committed to equal opportunity regardless of race, color, religion, sex, national origin, sexual orientation, age, citizenship, marital status, disability, or veteran status.
 

This is a remote position.