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Direct Claims Jobs in Raleigh, NC (NOW HIRING)

AbbVie

Director, Construction API

Durham, NC · On-site

$160K/yr

Purpose: The Director of Construction provides senior leadership and owner's oversight for all ... Review and evaluate contractor change requests and claims, Negotiate commercial impacts and ensure ...

Hedrick Gardner

2027 Summer Law Clerk

Raleigh, NC

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 ...

Builders Mutual

Director of Underwriting

Raleigh, NC · On-site

Your WORK as the Director of Underwriting will make a difference as you: * Develop and execute a ... Collaborate closely with Sales, Product, and Claims to ensure alignment between underwriting ...

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Showing results 1-20

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 Jul 23, 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 are direct claims?

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.

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, and why are they important?

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 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 $62,805 per year, or $30.2 per hour.

Billing & Collections Specialist I

MED-EL Corporation

Durham, NC • On-site

$17.25 - $23.50/hr

Full-time

Posted 6 days ago

Job description

Description:

We're looking for a detail-oriented Billing & Collections Specialist I to join our Revenue Cycle team. In this role, you'll help ensure timely and accurate reimbursement by managing accounts receivable, resolving billing issues, and supporting the overall revenue cycle process. You'll collaborate with internal teams, insurance payers, and customers to research and resolve account issues while delivering excellent customer service.

This is an excellent opportunity for someone with revenue cycle or medical billing experience who enjoys problem-solving, working in a collaborative environment, and making a direct impact on organizational success.


Key Responsibilities
  • Respond promptly and professionally to internal and external billing inquiries.
  • Collaborate with cross-functional teams to resolve billing questions and support revenue cycle operations.
  • Research and resolve account discrepancies and payment issues.
  • Follow up on outstanding accounts receivable, insurance claims, appeals, and payer denials.
  • Communicate billing processes and reimbursement information to customers and stakeholders.
  • Process payer-related issues through to resolution.
  • Maintain accurate account information and ensure the integrity of revenue cycle records.
  • Support the movement of accounts throughout the revenue cycle process.


This position reports to the Revenue Cycle Manager or Revenue Cycle Supervisor.

Requirements:
  • Understanding of insurance reimbursement methodologies.
  • Familiarity with CPT, HCPCS, and ICD-10 coding.
  • Experience with electronic claims filing and medical billing systems.
  • Understanding of and commitment to HIPAA regulations and patient confidentiality.
  • At least one year of experience in revenue cycle, medical billing, or collections.
  • Durable Medical Equipment (DME) industry experience.
  • Experience working with revenue cycle management systems.