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Insurance Benefits Claims Processor Jobs in Raleigh, NC

Marpai Administrators LLC

Claims Processor

Raleigh, NC · On-site

$16.50 - $21/hr

The Claims Processor is responsible to adjudicate claims, complete work assignments and meet ... We have great benefits: Generous PTO Medical and Prescription EAP FSA / HSA / Dependent Care Dental ...

New

Marpai Administrators LLC

Claims Processor

Cary, NC · Remote

$24 - $30/hr

The Claims Processor is responsible to adjudicate claims, complete work assignments and meet ... Ability to understand and apply benefits as outlined in plan document * Maintain/manage all claim ...

CapLeo Global

Insurance Specialist

Chapel Hill, NC · On-site

... claims processing, and of insurance policies and contracts for multiple insurance vendors. The ... This position answers questions from patients and providers regarding dental insurance benefits ...

Global Pharma Tek

Insurance Specialist

Chapel Hill, NC · On-site

... claims processing, and of insurance policies and contracts for multiple insurance vendors. The ... This position answers questions from patients and providers regarding dental insurance benefits ...

Erie Insurance

Claims Facilitator

Cary, NC · On-site

$40K - $64K/yr

That's why Erie Insurance offers you an exceptional benefits package, including: * Premier health ... Processes first party automobile, third party clear liability automobile and low severity property ...

Erie Insurance

Claims Facilitator

Cary, NC

$40K - $64K/yr

That's why Erie Insurance offers you an exceptional benefits package, including: * Premier health ... Processes first party automobile, third party clear liability automobile and low severity property ...

Erie Insurance

Claims Facilitator

Cary, NC · On-site

$40K - $64K/yr

That's why Erie Insurance offers you an exceptional benefits package, including: * Premier health ... Processes first party automobile, third party clear liability automobile and low severity property ...

Erie Insurance Group

Claims Facilitator

Cary, NC · On-site

Processes first party automobile, third party clear liability automobile and low severity property ... Handles inquiries from Policyholders, Agents, insurance carriers, claimants and others. * Enters ...

eTeam

Insurance Specialist

Chapel Hill, NC · On-site

... claims processing, and the policies and contracts of multiple insurance vendors. The ... responsibilities of this role include filing dental insurance claims and pre-treatment estimates ...

Erie Insurance

Claims Facilitator

Cary, NC · On-site

$40K - $64K/yr

That's why Erie Insurance offers you an exceptional benefits package, including: * Premier health ... Processes first party automobile, third party clear liability automobile and low severity property ...

Erie Insurance

Claims Facilitator

Cary, NC · Hybrid

$40K - $64K/yr

That's why Erie Insurance offers you an exceptional benefits package, including: * Premier health ... Processes first party automobile, third party clear liability automobile and low severity property ...

Sedgwick

Claims Representative, Auto

Raleigh, NC · On-site

$50K - $55K/yr

Communicates claim action/processing with insured, client, and agent or broker when appropriate ... A comprehensive benefits package is offered including but not limited to, medical, dental, vision ...

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All JobsInsurance Benefits Claims Processor JobsInsurance Benefits Claims Processor Jobs in Raleigh, NC

Insurance Benefits Claims Processor information

See Raleigh, NC salary details

$11

$21

$33

How much do insurance benefits claims processor jobs pay per hour?

As of Jul 3, 2026, the average hourly pay for insurance benefits claims processor in Raleigh, NC is $21.71, according to ZipRecruiter salary data. Most workers in this role earn between $17.74 and $24.76 per hour, depending on experience, location, and employer.

What is the difference between Insurance Benefits Claims Processor vs Insurance Claims Adjuster?

AspectInsurance Benefits Claims ProcessorInsurance Claims Adjuster
CredentialsHigh school diploma or equivalent; certifications varyHigh school diploma; licensing or certification often required
Work EnvironmentOffice setting, processing claims dataField and office, investigating claims
Industry UsageUsed across insurance companies for processing claimsUsed for evaluating and settling claims
Primary FocusProcessing and verifying insurance benefits claimsAssessing damages and determining claim validity

Insurance Benefits Claims Processors primarily handle the administrative side of claims, focusing on data entry and verification. Insurance Claims Adjusters evaluate claims on-site or remotely, investigating damages and making settlement decisions. Both roles are essential in the insurance industry but differ in responsibilities and work environment.

What does an Insurance Benefits Claims Processor do?

An Insurance Benefits Claims Processor is responsible for reviewing, evaluating, and processing insurance claims submitted by policyholders. They verify information, determine coverage eligibility, and ensure that all documentation meets company and regulatory standards. Their work helps ensure that valid claims are paid promptly and accurately, while also identifying any errors or fraudulent activity. Claims processors often communicate with policyholders, healthcare providers, and other parties to gather necessary information or clarify details related to a claim.

What are some common challenges faced by Insurance Benefits Claims Processors and how can they be addressed?

Insurance Benefits Claims Processors often encounter challenges such as managing high volumes of claims, interpreting complex policy details, and ensuring compliance with regulatory requirements. Staying organized, using workflow management tools, and maintaining strong attention to detail can help address these issues. Regular communication with team members and ongoing training on policy updates also play a key role in overcoming these challenges. Collaboration with other departments, such as underwriting and customer service, is essential for resolving discrepancies and providing accurate claim resolutions.

What are the key skills and qualifications needed to thrive as an Insurance Benefits Claims Processor, and why are they important?

To thrive as an Insurance Benefits Claims Processor, you need strong attention to detail, analytical abilities, and a solid understanding of insurance policies, often supported by a high school diploma or relevant certification. Familiarity with claims management software, data entry systems, and standard office applications is typically required. Excellent communication, organizational skills, and problem-solving abilities help professionals excel when interacting with clients and resolving complex claims. These skills ensure accurate and timely claims processing, customer satisfaction, and compliance with industry regulations.
What are popular job titles related to Insurance Benefits Claims Processor jobs in Raleigh, NC? For Insurance Benefits Claims Processor jobs in Raleigh, NC, the most frequently searched job titles are:
What job categories do people searching Insurance Benefits Claims Processor jobs in Raleigh, NC look for? The top searched job categories for Insurance Benefits Claims Processor jobs in Raleigh, NC are:
What cities near Raleigh, NC are hiring for Insurance Benefits Claims Processor jobs? Cities near Raleigh, NC with the most Insurance Benefits Claims Processor job openings:
Insurance Benefits Claims Processor jobs near you

Claims Processor

Marpai Administrators LLC

Raleigh, NC • On-site

$16.50 - $21/hr

Other

Medical, Dental, Vision, Life, Retirement, PTO

Posted 2 days ago

Job description

Marpai Administrators is a technology company transforming the Third-Party Administration sector serving employers with self-funded health plans. Marpai Administrators (“Marpai”) is an AI-powered national TPA (third party administrator) using deep learning and machine learning to maximize population health outcomes with the greatest cost efficiency for any health plan budget. We create healthier members and a healthier bottom line. Marpai proactively targets at-risk members with meaningful clinical interventions to improve outcomes.

ABOUT THE POSITION:

The Claims Processor will be responsible to for reviewing claims for accuracy, completeness, and eligibility. The Claims Processor is responsible to adjudicate claims, complete work assignments and meet established departmental metrics.

WHAT YOU WILL BE DOING:

Data entry of claims into system.

Review, analyze adjudicate claims

Validate the information on all claims to ensure there is no missing or incomplete information

Ability to understand and apply benefits as outlined in plan document

Maintain/manage all claim inventories in accordance with health plan and regulatory policies

Display maturity, composure and ability to operate under stressful conditions.

Complete daily assignments and update required spreadsheet

Complete end of day summary

Flexibility to change work direction as determined by management

Meet departmental standards for quality, production and attendance.

Analyst is flexible and able to commit to overtime based on business needs

Other duties as required

WHAT DO YOU NEED

Associates degree preferred

2+ yrs claims processing

Strong analytical, research, and communication skills.

Expansive knowledge of medical terminology.

Excellent verbal and written communication skills as well as exemplary organizational skills.

Work closely with leadership to assist in mitigating trends as necessary.

Independent judgment in decision-making and problem solving.

Computer skills in MS Word, Excel, PowerPoint, & Outlook at the intermediate or higher level.

Ability to multi-task & anticipate potential needs/problems.

Strong attention to detail.

Ability to understand and apply on-line documentation policies and procedures.

Excellent customer services skills including an ability to follow through, take ownership and drive all assigned tasks to completion.

Ability to handle large volumes of work, solve problems and manage multiple assignments while meeting critical deadlines.

HIPAA Compliance

WORK REQUIREMENTS:

Fast paced, dynamic work environment requiring the ability to be adaptive, innovative and flexible

Travel minimal

WHY WORK AT MARPAI?

We have great benefits:

Generous PTO

Medical and Prescription

EAP

FSA / HSA / Dependent Care

Dental

Vision

Life and Disability

STD/LTD

Voluntary Benefits: Critical Illness, Accident, Hospital

401k with Employer Match

LegalShield

Identity Theft Protection

Marpai is an equal opportunity workplace. We are committed to equal opportunity regardless of race, color, religion, sex, national origin, sexual orientation, age, citizenship, marital status, disability, or veteran status.

This is a remote position.

Apply