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Direct Claims Jobs in Raleigh, NC (NOW HIRING)

DAN

Claims Director

Durham, NC · On-site

$130K/yr

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 ...

Divers Alert Network

Claims Director

Durham, NC · On-site

Director, Claims FLSA: Exempt, Full Time DEPARTMENT: Claims WORKSITE: 6 West Colony Place, Durham, NC REPORTS TO: EVP, Insurance Operations OCCUPATIONAL SUMMARY: Responsible for the strategic ...

DAN

Claims Director

Durham, NC · Hybrid

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 ...

Divers Alert Network

Claims Director

Durham, NC · On-site

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 ...

Iatinsurancegroup

Claims Major Case Director

Raleigh, NC · 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 ...

Elevance Health

Claims Representative I

Durham, NC · On-site

$16.23 - $24.36/hr

Works under direct supervision. * Relies on others for instruction, guidance, and direction. * Work is reviewed for technical accuracy and soundness. * Codes and processes claims forms for payment ...

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All JobsDirect Claims JobsDirect Claims Jobs in Raleigh, NC

Direct Claims information

See Raleigh, NC salary details

$29.6K

$62.8K

$87.5K

How much do direct claims jobs pay per year?

As of Aug 11, 2026, the average yearly pay for direct claims in Raleigh, NC is $62,805.00, according to ZipRecruiter salary data. Most workers in this role earn between $49,600.00 and $73,400.00 per year, depending on experience, location, and employer.

What is a direct claim?

Direct claims refer to insurance claims that are filed directly by the policyholder with their own insurance company, rather than going through a third party or the at-fault party's insurer. This process is common in situations like auto accidents, where the policyholder seeks compensation for damages or losses under their own policy. Direct claims help streamline the process, reduce delays, and ensure the policyholder receives prompt assistance and settlements. They are often associated with 'first-party' insurance coverage, such as collision, comprehensive, or health insurance claims.

Can you work remotely in direct claims jobs?

Many direct claims jobs offer remote work options, especially for roles involving claims processing, customer service, or administrative tasks. Employers may require familiarity with claims management software and good communication skills, and remote positions often involve standard office hours and secure internet connections.

Do I need a degree to be a direct claims specialist?

A degree is not typically required to become a direct claims specialist, but relevant experience, knowledge of insurance policies, and strong communication skills are important. Many employers provide on-the-job training and may prefer candidates with a high school diploma or equivalent. Certifications in insurance or claims processing can enhance job prospects.

What are some common challenges faced by professionals in direct claims roles, and how can they effectively manage these challenges?

Professionals in Direct Claims often face the challenge of balancing a high volume of claims with the need for thorough investigation and timely resolution. Managing customer expectations and handling sensitive situations, such as denied claims or complex cases, can also be demanding. Effective communication, strong organizational skills, and staying updated on policy guidelines are crucial for success. Building collaborative relationships with adjusters, underwriters, and other departments helps ensure accurate and efficient claims processing.

What are the key skills and qualifications needed to thrive as a direct claims specialist?

To thrive as a Direct Claims Specialist, you need a solid understanding of insurance policies, claims processes, and relevant legal regulations, often supported by a degree in business, finance, or a related field. Familiarity with claims management software, customer relationship management (CRM) systems, and sometimes industry certifications like AIC or CPCU is typical. Exceptional attention to detail, problem-solving abilities, and strong communication skills set top performers apart in this role. These skills and qualifications ensure claims are processed accurately and efficiently, leading to customer satisfaction and minimized risk for the insurer.

What is the difference between Direct Claims vs Claims Adjuster?

AspectDirect ClaimsClaims Adjuster
CredentialsInsurance license, knowledge of policiesInsurance license, sometimes certifications like AIC or CPCU
Work EnvironmentCustomer service, office or remoteFieldwork, office, or remote
Employer & IndustryInsurance companies, agenciesInsurance companies, third-party administrators
Search & Comparison IntentUnderstanding direct claims handlingEvaluating claims adjustment roles

Direct Claims professionals primarily handle claims directly from policyholders, focusing on processing and resolving claims within the insurance company. Claims Adjusters evaluate, investigate, and settle claims, often working in the field or remotely. Both roles require insurance licensing, but Claims Adjusters may have additional certifications. While their work overlaps in claims processing, Direct Claims roles are more customer-facing, whereas Claims Adjusters focus on assessment and negotiation.

What are popular job titles related to Direct Claims jobs in Raleigh, NC? For Direct Claims jobs in Raleigh, NC, the most frequently searched job titles are:
What job categories do people searching Direct Claims jobs in Raleigh, NC look for? The top searched job categories for Direct Claims jobs in Raleigh, NC are:
What cities near Raleigh, NC are hiring for Direct Claims jobs? Cities near Raleigh, NC with the most Direct Claims job openings:
Direct Claims jobs near you
Infographic showing various Direct Claims job openings in Raleigh, NC as of August 2026, with employment types broken down into 1% As Needed, 75% Full Time, 15% Part Time, and 9% Contract. Highlights an 94% Physical, 1% Hybrid, and 5% Remote job distribution, with an average salary of $62,805 per year, or $30.2 per hour.

Claims Director

DAN

Durham, NC • On-site

$130K/yr

Full-time

Posted 27 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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