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Complex Claims Director Jobs in Raleigh, NC (NOW HIRING)

Claims Director

Durham, NC ยท On-site

$130K/yr

Director, Claims FLSA: Exempt, Full Time DEPARTMENT: Claims WORKSITE: 6 West Colony Place, Durham ... Manage complex, high exposure, litigated, or escalated claims * Review and approve significant ...

Director, Claims FLSA: Exempt, Full Time DEPARTMENT: Claims WORKSITE: 6 West Colony Place, Durham ... Manage complex, high exposure, litigated, or escalated claims * Review and approve significant ...

Director, Claims FLSA: Exempt, Full Time DEPARTMENT: Claims WORKSITE: 6 West Colony Place, Durham ... Manage complex, high exposure, litigated, or escalated claims * Review and approve significant ...

Director, Claims FLSA: Exempt, Full Time DEPARTMENT: Claims WORKSITE: 6 West Colony Place, Durham ... Manage complex, high exposure, litigated, or escalated claims * Review and approve significant ...

Claims Major Case Director

Raleigh, NC ยท On-site +1

$92K - $130K/yr

IAT Insurance Group has an immediate need for a Major Case Unit Director that can report to one of ... This role is a true complex claims handling role that is tasked with managing those claims that are ...

This balance allows us to navigate complex claims with precision that enhances efficiency and ... This program offers substantive legal work, courtroom exposure, and direct mentorship with multiple ...

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Showing results 1-20

Complex Claims Director information

See Raleigh, NC salary details

$81.2K

$123.3K

$173K

How much do complex claims director jobs pay per year?

As of Jul 29, 2026, the average yearly pay for complex claims director in Raleigh, NC is $123,337.00, according to ZipRecruiter salary data. Most workers in this role earn between $102,600.00 and $137,100.00 per year, depending on experience, location, and employer.

What is the difference between Complex Claims Director vs Claims Manager?

AspectComplex Claims DirectorClaims Manager
CredentialsTypically requires a professional insurance certification (e.g., CPCU, ARM) and extensive industry experienceOften requires relevant insurance licenses and several years of claims handling experience
Work EnvironmentStrategic leadership in large insurance companies or third-party administrators, overseeing complex claimsDay-to-day claims processing and team supervision within insurance companies or agencies
Employer & Industry UsageCommonly found in large insurers, TPA firms, and corporate risk managementWidely used across insurance carriers, agencies, and claims departments

The Complex Claims Director focuses on managing and overseeing complex, high-value claims and strategic claims operations, often at a senior level. In contrast, Claims Managers handle daily claims processing, team supervision, and operational tasks. Both roles require industry-specific credentials, but the Director position emphasizes strategic oversight of complex cases.

How does a Complex Claims Director typically collaborate with legal teams and other departments during high-stakes claims investigations?

As a Complex Claims Director, collaboration with legal teams and other departments such as underwriting, risk management, and compliance is a central part of the role. Directors often lead cross-functional meetings to share critical case updates, discuss strategies for claim resolution, and ensure all regulatory and contractual requirements are met. Effective communication and coordination are essential, as these cases may involve litigation, negotiations, and extensive documentation. Building strong relationships across departments helps streamline the process and achieve the best possible outcomes for both the client and the organization.

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

To thrive as a Complex Claims Director, you need deep expertise in insurance claims management, strong analytical abilities, and a relevant bachelor's degree or higher, often with industry certifications such as CPCU or AIC. Familiarity with claims management systems, regulatory compliance tools, and advanced reporting software is typically required. Exceptional leadership, negotiation, and decision-making skills help you manage teams and resolve high-stakes claims efficiently. These competencies are crucial for ensuring accurate claim resolution, minimizing risk, and maintaining client trust in complex insurance environments.

What are Complex Claims Directors?

Complex Claims Directors are senior insurance professionals responsible for overseeing the management and resolution of intricate insurance claims, often involving large financial exposures, multiple parties, or complex legal issues. They lead a team of claims specialists, coordinate with legal counsel, and ensure that claims are handled efficiently and in compliance with company policies and regulations. Their expertise helps organizations mitigate risk and ensure fair outcomes for all parties involved.
What cities near Raleigh, NC are hiring for Complex Claims Director jobs? Cities near Raleigh, NC with the most Complex Claims Director job openings:
Infographic showing various Complex Claims Director job openings in Raleigh, NC as of July 2026, with employment types broken down into 89% Full Time, 9% Part Time, and 2% Contract. Highlights an 88% Physical, 4% Hybrid, and 8% Remote job distribution, with an average salary of $123,337 per year, or $59.3 per hour.
Claims Director

Claims Director

DAN

Durham, NC โ€ข On-site

$130K/yr

Full-time

Posted 20 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.