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Claims Representative Associate Jobs in Raleigh, NC

AVE Staffing

Commercial Litigation Associate

Raleigh, NC · Hybrid

$160K - $185K/yr

Direct the lifecycle of complex business disputes, evaluating claims and executing comprehensive ... Conduct adversarial depositions of key witnesses, fact witnesses, and corporate representatives ...

AVE Staffing

Labor & Employment Associate

Raleigh, NC · Hybrid

$160K - $200K/yr

... Associate Attorney with specialized experience in executive compensation and employee benefits ... Represent employers and corporate management in state and federal courts against claims involving ...

AVE Staffing

Employment Litigation Associate

Durham, NC · On-site

$160K - $200K/yr

... claims. * Restrictive Covenants & IP: Litigate disputes involving non-compete agreements, non ... Represent clients before regulatory agencies including the EEOC, Department of Labor (DOL), OSHA ...

Dal-Tile

CSR Warehouse Associate II (FT)

Morrisville, NC · On-site

$13.50 - $18.75/hr

As the Customer Service/Warehouse Associate II will need someone responsible for providing a ... claims. * Operates forklift equipment. * Maintains a clean and organized facility by sweeping ...

Addison Group

Case Manager

Raleigh, NC · On-site

$19.50 - $25/hr

Establish, maintain, and follow up on insurance claims while ensuring accuracy and adherence to ... Associate's degree preferred. Equivalent relevant experience may be considered. * Spanish fluency ...

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All JobsClaims Representative Associate JobsClaims Representative Associate Jobs in Raleigh, NC

Claims Representative Associate information

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How much do claims representative associate jobs pay per hour?

As of Sep 3, 2026, the average hourly pay for claims representative associate in Raleigh, NC is $20.40, according to ZipRecruiter salary data. Most workers in this role earn between $16.59 and $22.45 per hour, depending on experience, location, and employer.

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

To thrive as a Claims Representative Associate, you need strong analytical skills, attention to detail, and knowledge of insurance policies, typically supported by a high school diploma or relevant work experience. Familiarity with claims management software, customer relationship management (CRM) systems, and basic office tools is essential. Excellent communication, problem-solving, and customer service skills help you effectively handle inquiries and resolve disputes. These skills ensure accurate claim processing, customer satisfaction, and efficient operations within the insurance industry.

What are some common challenges claims representative associates face when handling claims?

Claims Representative Associates often encounter challenges such as managing high caseloads, navigating complex policy details, and addressing discrepancies in documentation. Balancing efficiency with attention to detail is crucial, as errors can impact claim outcomes and customer satisfaction. Additionally, collaborating with policyholders, providers, and internal teams to resolve issues and provide clear communication requires strong interpersonal skills and resilience, especially when dealing with sensitive or disputed claims.

What is the difference between Claims Representative Associate vs Claims Adjuster?

AspectClaims Representative AssociateClaims Adjuster
Required CredentialsHigh school diploma or equivalent; some roles may prefer insurance licensesHigh school diploma; state licensing often required
Work EnvironmentOffice setting, customer service interactions, administrative tasksField or office, investigating claims, inspecting damages
Employer & Industry UsageInsurance companies, government agenciesInsurance companies, third-party administrators
Common Search & ComparisonClaims Representative Associate vs Claims Adjuster

The Claims Representative Associate typically handles customer inquiries, processes claims, and provides administrative support within insurance companies. In contrast, Claims Adjusters investigate claims, inspect damages, and determine claim validity. While both roles require similar credentials and work in the insurance industry, Claims Adjusters often have more technical responsibilities and fieldwork. Understanding these differences helps job seekers identify the right role based on their skills and career goals.

How much do claims representative associates make in the US?

Claims representative associates in the US typically earn an average annual salary of around $45,000 to $55,000, depending on experience, location, and employer. Entry-level positions may start lower, while experienced claims reps with specialized skills can earn higher wages and bonuses.

What do claims representative associates do?

Claims representative associates evaluate insurance claims by reviewing reports, documentation, and policy details to determine coverage and liability. They communicate with claimants, investigate claims, and process payments or denials, often using claims management software. Strong attention to detail and knowledge of insurance policies are essential for this role.

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

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

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

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

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

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

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

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

Claims Representative Associate jobs near you
Infographic showing various Claims Representative Associate job openings in Raleigh, NC as of August 2026, with employment types broken down into 1% As Needed, 68% Full Time, 28% Part Time, 1% Temporary, and 2% Contract. Highlights an 97% Physical, 1% Hybrid, and 2% Remote job distribution, with an average salary of $42,435 per year, or $20.4 per hour.

Customer Service Representative PBM

Marpai Administrators LLC

Cary, NC • Remote

$18 - $20/hr

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

This job post has expired 1 day ago. Applications are no longer accepted.

Job description


Marpai Administrators (Subsidiary of Marpai Inc. (NASDAQ: MRAI)) 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 Customer Service Representative (CSR) reports to the Customer Service Supervisor to help healthcare providers and members with prescription and insurance questions. The CSR must maintain positive, empathetic, and professional attitude through verbal or written communication. 
 
 
WHAT YOU WILL BE DOING: 
  • Member Support: Answer inquiries regarding drug formularies, copays, deductibles, network pharmacies, and prescription benefit coverage.
  • Pharmacy & Provider Coordination: Assist network pharmacies with claims processing, eligibility checks, and securing prior authorizations.
  • Problem Resolution: Investigate and resolve complaints or coverage rejections, ensuring first-call resolution while maintaining empathy.
  • Documentation & Compliance: Accurately log call details in CRM and ticketing systems while strictly adhering to HIPAA privacy standards.
  • Quality & Metrics: Meet call-center performance standards, such as Average Handle Time (AHT) and Schedule Adherence.
  • Other duties as required
 
WHAT DO YOU NEED: 
  • High school diploma or GED required; associate or bachelor’s degree preferred.
  • Strong customer service and communication skills
  • Ability to navigate multiple software platforms simultaneously.
  • Active listening, problem-solving, and ability to deescalate stressful situations.
  • Attention to detail and accuracy
  • Ability to maintain confidentiality
 
PREFERED EXPERIENCE: 
  • 1–2 years of customer service experience in healthcare or pharmacy setting
  • Experience handling insurance claims or medical billing preferred
  • State issued pharmacy technician registration preferred.

WORK REQUIREMENTS: 
  • 100% Remote 
  • Flexibility to work 8 am – 8 pm
  • Must have high speed internet connection
  • Must have professional, confidential, isolated work area.
  • This position is in a typical office environment that requires prolonged sitting in front of a computer.  
 
 WHY WORK AT MARPAI?  
We have great benefits: 
  • Generous PTO
  • Medical and Prescription 
  • Health and Wellness Programs 
  • 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.