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Claims Risk Manager Jobs in Raleigh, NC (NOW HIRING)

DAN

Claims Director

Durham, NC · Hybrid

This role ensures timely, accurate, and compliant claims handling while promoting exceptional customer service, effective risk management, and continuous operational improvement. The Director of ...

Divers Alert Network

Claims Director

Durham, NC · On-site

This role ensures timely, accurate, and compliant claims handling while promoting exceptional customer service, effective risk management, and continuous operational improvement. The Director of ...

UNC HEALTH

Director of Risk Management

Chapel Hill, NC · On-site

... claims. Establishes methods, policies, and protocols to avoid, reduce, and minimize risk. • ... Provides clinical risk management consultation to all physician and employees insured by the LITF.

Duke Health

Liability Insurance Manager

Durham, NC · On-site

Research, evaluate, and make recommendations regarding current and state of the art trends in risk financing, loss control and claims management strategies. * Assist with professional liability ...

Duke University

Liability Insurance Manager

Durham, NC · On-site

Research, evaluate, and make recommendations regarding current and state of the art trends in risk financing, loss control and claims management strategies. * Assist with professional liability ...

Duke Health

Liability Insurance Manager

Durham, NC · On-site

Research, evaluate, and make recommendations regarding current and state of the art trends in risk financing, loss control and claims management strategies. * Assist with professional liability ...

Sedgwick

Claims Representative, Auto

Raleigh, NC · On-site

$50K - $55K/yr

Management retains the discretion to add or to change the duties of the position at any time As ... Sedgwick is the world's leading risk and claims administration partner, which helps clients thrive ...

Dragonfly Pond Works

Safety & Fleet Manager

Raleigh, NC · On-site

$80K/yr

Point of contact for all safety and worker's compensation claims including injury, equipment and vehicle incidents. Compliance & Risk Management * Oversee driver qualification files and ensure all ...

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Showing results 21-40

All JobsClaims Risk JobsClaims Risk Manager JobsClaims Risk Manager Jobs in Raleigh, NC

Claims Risk Manager information

See Raleigh, NC salary details

$34K

$85.4K

$135.1K

How much do claims risk manager jobs pay per year?

As of Jul 24, 2026, the average yearly pay for claims risk manager in Raleigh, NC is $85,408.00, according to ZipRecruiter salary data. Most workers in this role earn between $66,100.00 and $102,100.00 per year, depending on experience, location, and employer.

How does a Claims Risk Manager typically collaborate with other departments to minimize organizational risk?

A Claims Risk Manager works closely with departments such as underwriting, legal, compliance, and operations to identify potential risk exposures and implement effective mitigation strategies. They often participate in cross-functional meetings to review claims trends, share insights, and develop risk management policies. This collaborative approach ensures that the organization proactively addresses risks, maintains regulatory compliance, and continually improves claims processes for better outcomes.

What is the difference between Claims Risk Manager vs Claims Adjuster?

AspectClaims Risk ManagerClaims Adjuster
CredentialsTypically requires a bachelor’s degree in risk management, insurance, or related field; certifications like CPCU or ARM are commonRequires a high school diploma or bachelor’s degree; insurance licenses may be needed depending on state
Work EnvironmentOffice-based, strategic planning, risk assessment, policy developmentField or office-based, investigating claims, assessing damages, negotiating settlements
Industry UsageUsed across insurance companies, risk management firms, and large corporationsPrimarily in insurance companies, adjusting claims for auto, property, or health insurance

The Claims Risk Manager focuses on identifying and mitigating risks related to claims, developing policies, and overseeing risk strategies. In contrast, a Claims Adjuster handles the day-to-day investigation and settlement of individual claims. Both roles are essential in the insurance industry but differ in scope and responsibilities.

What are the key skills and qualifications needed to thrive as a Claims Risk Manager, and why are they important?

To thrive as a Claims Risk Manager, you need expertise in insurance claims processes, risk assessment, and regulatory compliance, typically backed by a bachelor’s degree in a relevant field and experience in claims management. Familiarity with claims management systems, risk modeling software, and certifications such as CPCU (Chartered Property Casualty Underwriter) or ARM (Associate in Risk Management) are often required. Strong analytical thinking, attention to detail, and effective communication skills help you investigate claims and collaborate with stakeholders. These skills enable accurate risk evaluation, minimize losses, and ensure the organization’s compliance and financial stability.

What does a Claims Risk Manager do?

A Claims Risk Manager is responsible for identifying, assessing, and managing risks associated with insurance claims within an organization. They analyze claims data to detect patterns, prevent fraudulent activity, and develop strategies to minimize financial losses. Additionally, they work closely with claims adjusters, legal teams, and other departments to ensure compliance with regulations and to optimize claims processes. Their goal is to protect the company from unnecessary losses while ensuring legitimate claims are handled efficiently.
What are popular job titles related to Claims Risk Manager jobs in Raleigh, NC? For Claims Risk Manager jobs in Raleigh, NC, the most frequently searched job titles are:
What job categories do people searching Claims Risk Manager jobs in Raleigh, NC look for? The top searched job categories for Claims Risk Manager jobs in Raleigh, NC are:
Claims Risk Manager jobs near you
Claims Director

Claims Director

DAN

Durham, NC • Hybrid

Full-time

Posted 15 days ago

Job description

TITLE: Director, Claims

FLSA: Exempt, Full Time

DEPARTMENT: Claims

WORKSITE: 6 West Colony Place, Durham, NC

REPORTS TO: EVP, Insurance Operations


OCCUPATIONALSUMMARY:

Responsible for the strategic leadership, operational management, and oversight of the organization's claims department. This role ensures timely, accurate, and compliant claims handling while promoting exceptional customer service, effective risk management, and continuous operational improvement. 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 stakeholders to support organizational objectives.


DUTIES/RESPONSIBILITIES:

  • Lead and inspire a service-focused team.
  • Oversee the intake, investigation, evaluation, reserving, and resolution of claims.
  • Ensure claims are handled in accordance with policy provisions, company guidelines, regulatory requirements, and industry standards.
  • Manage complex, high exposure, litigated, or escalated claims
  • Review and approve significant coverage determinations, settlement authority, and denial recommendations where applicable.
  • Develop and implement claims handling strategies, workflows, and best practices.
  • Establish department goals, KPIs, and performance standards.
  • Oversee quality assurance and audit processes for claims handling activities.
  • Identify operational, legal, and financial risks within the claims process and implement corrective actions.
  • Assist in the development and implementation of reservation of rights letters, coverage position letters, and claims procedures.
  • Monitor claim reserves, loss trends, and financial exposure.
  • Assist with budgeting and forecasting related to claims operations.
  • Ensure appropriate expense management and vendor performance standards.
  • Maintain positive relationships with insureds, brokers, members, partners, and external stakeholders.
  • Collaborate cross-functionally with underwriting, operations, finance, and customer service teams.
  • Provide claims reporting and operational updates to executive leadership.
  • Other duties as assigned.


EDUCATION

  • Bachelor's degree or equivalent experience required
  • 10+ years of relevant claims experience
  • 2+ years leadership within a claims management role
  • Valid adjusters license or ability to obtain such


REQUIRED KNOWLEDGE, SKILLS & ABILITIES

  • Knowledge of the scuba diving industry
  • Deep knowledge and experience with captive insurance companies, risk retention groups, accident and health and trip/travel programs
  • Knowledge of Trip/Travel Insurance
  • Excellent interpersonal communication, organization, and management skills
  • Superior project management skills with proven ability to plan, lead and track projects from concept through implementation
  • Ability to manage timelines and milestones to ensure timely reporting and closures
  • Self-motivated with strong attention to details and problem-solving skills
  • Proficient with Microsoft Office Suite and experienced or adaptable to claims management platforms

Hybrid work arrangement is available with this role, 2 days remote and 3 days in office, post the 90-day probationary period.

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