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Claims Processor Jobs in Raleigh, NC (NOW HIRING)

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 ...

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 ...

Claim Assistant

Chapel Hill, NC · On-site

$50K - $52K/yr

The role of a CA is to assist in the claims process, which can include tasks such as data entry, document management, and customer service. This individual is responsible for providing support to and ...

Inside Claims Representative I

Raleigh, NC · On-site +1

$44K - $71K/yr

Documents claim files and facilitates processing of claims in collaboration with other departments. Assigns outside experts when necessary to assist in investigation and in support of potential ...

Documents claim files and facilitates processing of claims in collaboration with other departments. Assigns outside experts when necessary to assist in investigation and in support of potential ...

Documents claim files and facilitates processing of claims in collaboration with other departments. Assigns outside experts when necessary to assist in investigation and in support of potential ...

Data Entry, Medical Records, Health Care, Insurance Claims Processing and Proof Reading/Editing of Documents * Ability to stay organized while working quickly. Strong attention to detail is also ...

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Claims Processor information

See Raleigh, NC salary details

$11

$18

$25

How much do claims processor jobs pay per hour?

As of Jul 16, 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 jobs pay 500,000 a year in the US?

Claims processors typically do not earn $500,000 annually; such high salaries are usually associated with executive roles, specialized medical professionals, or successful entrepreneurs. High-paying jobs often require advanced skills, extensive experience, or ownership of a business. Most claims processing roles have salaries well below this threshold.

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.

Is claim adjusting a dying field?

Claims processing is a stable field that involves reviewing and settling insurance claims, often requiring attention to detail and knowledge of insurance policies. While automation and AI tools are increasingly used to streamline tasks, the need for human claims adjusters remains, especially for complex cases and customer interactions.

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 role of a claims processor?

A claims processor reviews and evaluates insurance claims to determine their validity and the appropriate payout. They verify information, ensure compliance with policies, and process payments using claims management software, often working within strict deadlines. Attention to detail and knowledge of insurance policies are essential for this role.

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, and why are they important?

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.

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.
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 cities near Raleigh, NC are hiring for Claims Processor jobs? Cities near Raleigh, NC with the most Claims Processor job openings:
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 80% In-person, and 20% Remote job distribution, with an average salary of $38,748 per year, or $18.6 per hour.
Claims Representative , Auto

Claims Representative , Auto

Sedgwick

Raleigh, NC • On-site

$50K - $55K/yr

Other

Medical, Dental, Vision, Life, Retirement, PTO

This job post has expired 2 days ago. Applications are no longer accepted.


Sedgwick rating

7.5

Company rating: 7.5 out of 10

Based on 315 frontline employees who took The Breakroom Quiz

190th of 281 rated insurance


Job description

By joining Sedgwick, you'll be part of something truly meaningful. It’s what our 33,000 colleagues do every day for people around the world who are facing the unexpected. We invite you to grow your career with us, experience our caring culture, and enjoy work-life balance. Here, there’s no limit to what you can achieve.

Newsweek Recognizes Sedgwick as America’s Greatest Workplaces National Top Companies

Certified as a Great Place to Work®

Fortune Best Workplaces in Financial Services & Insurance

Claims Representative , Auto

PRIMARY PURPOSE OF THE ROLE: 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 payments, and ensures claim files are properly documented and correctly coded based on the policy.

  • Develops and maintains action plans to ensure state required contract deadlines are met and to move the file towards prompt and appropriate resolution.

  • Identifies and pursues subrogation opportunities; secures and disposes of salvage.

  • Communicates claim action/processing with insured, client, and agent or broker when appropriate.

  • Maintains professional client relations.

  • Performs coverage, liability, and damage analysis on all claims assignments.

  • Performs other duties as assigned.

  • Supports the organization's quality program(s).

QUALIFICATIONS

  • Education: Bachelor's degree from an accredited college or university preferred. Secure and maintain the State adjusting licenses as required for the position.

  • Familiarity with personal and commercial lines policies and endorsements

  • Ability to review and assess Property Damage estimates, total loss evaluations, and related expenses to effectively negotiate first and third party claims.

  • Knowledge of total loss processing, State salvage forms and title requirements, preferred

  • Excellent oral and written communication, including presentation skills

  • PC literate, including Microsoft Office products

  • Analytical and interpretive skills

  • Strong organizational skills

  • Good interpersonal skills

  • Ability to work in a team environment

  • Ability to meet or exceed Service Expectations

Work environment requirements include –

Physical: Computer keyboarding

Auditory/visual: Hearing, vision and talking

Mental: Clear and conceptual thinking ability; excellent judgement and discretion; ability to meet deadlines.

When applicable and appropriate, consideration will be given to reasonable accommodations.

The statements contained in this document are intended to describe the general nature and level of work being performed by a colleague assigned to this description. They are not intended to constitute a comprehensive list of functions, duties, or local variances. Management retains the discretion to add or to change the duties of the position at any time

As required by law, Sedgwick provides a reasonable range of compensation for roles that may be hired in jurisdictions requiring pay transparency in job postings. Actual compensation is influenced by a wide range of factors including but not limited to skill set, level of experience, and cost of specific location. For the jurisdiction noted in this job posting only, the range of starting pay for this role is $50,000 to $55,000 . A comprehensive benefits package is offered including but not limited to, medical, dental, vision, 401k and matching, PTO, disability and life insurance, employee assistance, flexible spending or health savings account, and other additional voluntary benefits.

Sedgwick is an Equal Opportunity Employer and a Drug-Free Workplace.

If you're excited about this role but your experience doesn't align perfectly with every qualification in the job description, consider applying for it anyway! Sedgwick is building a diverse, equitable, and inclusive workplace and recognizes that each person possesses a unique combination of skills, knowledge, and experience. You may be just the right candidate for this or other roles.

Sedgwick is the world’s leading risk and claims administration partner, which helps clients thrive by navigating the unexpected. The company’s expertise, combined with the most advanced AI-enabled technology available, sets the standard for solutions in claims administration, loss adjusting, benefits administration, and product recall. With over 33,000 colleagues and 10,000 clients across 80 countries, Sedgwick provides unmatched perspective, caring that counts, and solutions for the rapidly changing and complex risk landscape. For more, see sedgwick.com


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