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Full Time Claims Quality Analyst Jobs in Raleigh, NC

DAN

Claims Coordinator

Durham, NC · Hybrid

Non-Exempt, Full Time Department: Claims Primary Worksite: 6 West Colony Place, Durham, NC Supervisory Responsibilities: None Reports to: Claims, QA & Compliance Officer JOB SUMMARY The Claims ...

DAN

Claims Coordinator

Durham, NC · On-site

$50K - $55K/yr

Non-Exempt, Full Time Department: Claims Primary Worksite: 6 West Colony Place, Durham, NC Supervisory Responsibilities: None Reports to: Claims, QA & Compliance Officer JOB SUMMARY The Claims ...

DAN

Claims Director

Durham, NC · On-site

$130K/yr

Exempt, Full Time DEPARTMENT: Claims WORKSITE: 6 West Colony Place, Durham, NC REPORTS TO: EVP, ... Oversee quality assurance and audit processes for claims handling activities. * Identify ...

DAN

Claims Director

Durham, NC · Hybrid

Exempt, Full Time DEPARTMENT: Claims WORKSITE: 6 West Colony Place, Durham, NC REPORTS TO: EVP, ... Oversee quality assurance and audit processes for claims handling activities. * Identify ...

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Full Time Claims Quality Analyst information

See Raleigh, NC salary details

$14

$26

$50

How much do full time claims quality analyst jobs pay per hour?

As of Sep 1, 2026, the average hourly pay for full time claims quality analyst in Raleigh, NC is $26.63, according to ZipRecruiter salary data. Most workers in this role earn between $19.62 and $30.62 per hour, depending on experience, location, and employer.

What is the difference between Full Time Claims Quality Analyst vs Part Time Claims Quality Analyst?

AspectFull Time Claims Quality AnalystPart Time Claims Quality Analyst
Work HoursTypically 35-40 hours per weekLess than 30 hours per week
ResponsibilitiesFull scope of claims review, quality assurance, and process improvementFocused on specific claims or tasks, limited scope
CredentialsUsually requires similar certifications (e.g., CPC, CPC-A)Same certifications often required
Work EnvironmentOffice or remote, full-time schedulePart-time, flexible hours, similar environment

Full Time Claims Quality Analysts work full-time hours with comprehensive responsibilities in claims review and quality assurance, while Part Time Claims Quality Analysts have reduced hours with focused tasks. Both roles often require similar certifications and work in comparable environments, but differ mainly in hours and scope of duties.

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

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

What are popular job titles related to Full Time Claims Quality Analyst jobs in Raleigh, NC?

For Full Time Claims Quality Analyst jobs in Raleigh, NC, the most frequently searched job titles are:

What job categories do people searching Full Time Claims Quality Analyst jobs in Raleigh, NC look for?

The top searched job categories for Full Time Claims Quality Analyst jobs in Raleigh, NC are:

What cities near Raleigh, NC are hiring for Full Time Claims Quality Analyst jobs?

Cities near Raleigh, NC with the most Full Time Claims Quality Analyst job openings:

Full Time Claims Quality Analyst jobs near you
Infographic showing various Full Time Claims Quality Analyst job openings in Raleigh, NC as of August 2026, with employment types broken down into 1% As Needed, 77% Full Time, 17% Part Time, 4% Contract, and 1% Nights. Highlights an 93% Physical, 2% Hybrid, and 5% Remote job distribution, with an average salary of $55,384 per year, or $26.6 per hour.

Claims Coordinator

DAN

Durham, NC • Hybrid

Full-time

Posted 26 days ago

Job description

Claims Coordinator
POSITION OVERVIEW


FLSA: Non-Exempt, Full Time


Department: Claims


Primary Worksite: 6 West Colony Place, Durham, NC


Supervisory Responsibilities: None


Reports to: Claims, QA & Compliance Officer


JOB SUMMARY


The Claims Coordinator is responsible for overseeing and efficiently processing member benefit and insurance claims. You will work closely with insurance carriers, members, and healthcare providers to ensure that claims are handled in a timely and accurate manner.
Supports DAN members throughout the claims process by coordinating with insurance carriers and facilitating timely and accurate claim handling. Calculates applicable benefits and prepares claim recommendations for underwriter review and final determination.


Common duties include reviewing claim forms, verifying information, contacting members and providers to gather additional information, developing recommendations, and forwarding claims to carriers for payment. The Claims Coordinator will also assist with subrogation and the coordination of claims among carriers.


CORE RESPONSIBILITIES


Verify coverage, calculate benefit payments, and communicate claim determinations to members and providers.
Review and validate claim submissions for accuracy, completeness, and compliance with applicable requirements.
Coordinate with members, insurance adjusters, and other stakeholders to obtain required documentation and information.
Review, compile, and organize claim documentation for submission to the appropriate carrier.
Process claims in a timely manner while maintaining accurate and complete records within the department's claims management system.
Prepare claim recommendations (pay/deny) and forward processed claims to the appropriate carrier for determination.
Communicate with DAN and program assistance partners regarding complex, urgent, or ongoing cases.
Support members by helping ensure needed care and services are provided promptly and professionally; guide members through the claims process and assist in resolving issues or discrepancies.
Serve as a liaison between DAN Medical Services, DAN Claims, and third-party assistance companies for emergent cases and situations requiring coordinated support.
Participate in a rotating on-call schedule, including providing 24-hour emergency benefit verification support.
Pursue subrogation opportunities and other potential reimbursement avenues through third-party carriers.
Adhere to all policies and procedures outlined in the DAN Employee Handbook.
Perform additional duties and responsibilities as assigned.


MINIMUM QUALIFICATIONS
Bachelor's degree or a minimum of 5 years of experience in claims, customer service, or a related field
Proficiency in Microsoft Office applications
Strong verbal and written communication skills, including professional phone etiquette
Excellent organizational, time management, and problem-solving abilities with strong attention to detail
Ability to handle sensitive information with confidentiality and professionalism.
Ability to obtain and maintain required insurance licensing (training and associated costs provided by DSI


Work Environment
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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