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Claims Processor Jobs in Raleigh, NC (NOW HIRING)

Elevance Health

Claims Representative I

Durham, NC · On-site

$16.23 - $24.36/hr

Codes and processes claims forms for payment ensuring all information is supplied before eligible payments are made. * Researches and analyzes claims issues. Minimum Qualifications: * Requires HS ...

Elevance Health

Claims Representative I

Durham, NC · On-site

$16.23 - $24.36/hr

Codes and processes claims forms for payment ensuring all information is supplied before eligible payments are made. * Researches and analyzes claims issues. Minimum Qualifications: * Requires HS ...

IFG Companies

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 ...

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All JobsClaims Processor JobsClaims Processor Jobs in Raleigh, NC

Claims Processor information

See Raleigh, NC salary details

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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.

Director of Claims, Workers' Compensation

Builders Mutual

Raleigh, NC • On-site

Full-time

Posted 14 days ago

Job description

Description
At Builders Mutual, we believe in the power of teamwork to get the job done right. For more than 40 years, we've helped protect and advance the construction community through commercial insurance, safety expertise, and trusted partnership. Our success has always been built on strong relationships-with our customers, agency partners, and one another.
Rooted in teamwork, expertise, inclusion, and community, we're committed to creating an environment where people do meaningful work, feel supported by leaders who care, and grow their careers with confidence.
The Opportunity
We are seeking a Director of Claims, Workers' Compensation for a hybrid role based in Raleigh, NC. This position will guide the financial and operational performance of our multi-state Workers' Compensation claims portfolio while helping translate enterprise claims strategy into day-to-day execution across a team of adjusters, supervisors, and support staff.
You'll partner closely with the Vice President of Claims on loss trend analysis, business case development, budget planning, and readiness for expansion into new states. You'll also share Workers' Compensation claims insights with Underwriting, Actuarial, and executive leadership; identify emerging risks and cost drivers; recommend data-supported solutions; and lead implementation from concept through measurable results.
Your work as the Director of Workers' Compensation Claims will make a difference as you:
  • Own the financial performance of the Workers' Compensation portfolio, including loss ratio, reserve adequacy, and claim duration targets.
  • Partner with the VP of Claims to develop and execute annual department strategy, operating plans, and budgets.
  • Conduct portfolio-level loss trend analyses to identify severity drivers, emerging exposures, and state-level outliers.
  • Provide technical leadership on complex and catastrophic claims, including reserve/settlement authority and litigation strategy.
  • Assess and build claims operational readiness to support planned expansion into new state markets.
  • Leverage claims data and predictive analytics to inform reserving, litigation, and settlement strategies.
  • Lead, coach, and develop a high-performing claims team, fostering a culture of technical excellence and accountability.
  • Drive adoption of innovative solutions, including AI-assisted analytics and automation, to enhance file handling efficiency.
  • Govern third-party vendor relationships (SIU, medical management, defense counsel) for performance and cost-effectiveness.
  • Collaborate cross-functionally with Underwriting, Actuarial, and Legal to address service, profitability, and litigation risk.

Travel Requirements: At least 10-15% for meetings, industry conferences, and state regulatory or vendor engagements.
Skills and experience to get the job done right:
• Bachelor's degree preferred and minimum of 10 years of insurance company claims experience, or an equivalent combination of education and experience. Completed industry designations such as AIC, CPCU are a plus.
• Five (5) or more years of progressive management experience in a Workers' Compensation claims operations environment. Prior construction-related, multi-jurisdictional Workers' Compensation claims management experience is preferred.
• Demonstrated ability to own financial results, including loss ratio and reserve accuracy, and to translate data analysis into actionable strategy.
• Sound judgment, initiative, and ownership in leading complex, multi-jurisdictional claims and cross-functional projects.
• Strong verbal and written communication skills, including the ability to present findings and recommendations to executive leadership.
• Ability to design and map claims workflows for greater efficiency, and to lead process or technology change.
• Demonstrated executive presence and ability to influence senior leadership through data-driven recommendations
Work With Us
At Builders Mutual, we're intentional about creating a workplace where people can do meaningful work, feel supported by leaders who care, and grow their careers with confidence.
As a member of our leadership team, you'll help shape the employee experience, strengthen organizational capability, and support the future of our company. You'll work alongside colleagues who value expertise, teamwork, inclusion, and community while making a meaningful impact on our people, our customers, and our business.
Builders Mutual is an Equal Opportunity Employer.

Apply