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Insurance Claims Processor Jobs in Raleigh, NC (NOW HIRING)

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 ...

Global Pharma Tek

Insurance Specialist

Chapel Hill, NC · On-site

... claims processing, and of insurance policies and contracts for multiple insurance vendors. The duties of this position include filing dental insurance claims and pre-treatment estimates for privately ...

CapLeo Global

Insurance Specialist

Chapel Hill, NC · On-site

... claims processing, and of insurance policies and contracts for multiple insurance vendors. The duties of this position include filing dental insurance claims and pre-treatment estimates for privately ...

Erie Insurance

Claims Facilitator

Cary, NC · On-site

$40K - $64K/yr

At Erie Insurance, you're not just part of a Fortune 500 company; you're also a valued member of a ... Processes first party automobile, third party clear liability automobile and low severity property ...

Erie Insurance

Claims Facilitator

Cary, NC · On-site

$40K - $64K/yr

At Erie Insurance, you're not just part of a Fortune 500 company; you're also a valued member of a ... Processes first party automobile, third party clear liability automobile and low severity property ...

Erie Insurance

Claims Facilitator

Cary, NC · On-site

$40K - $64K/yr

At Erie Insurance, you're not just part of a Fortune 500 company; you're also a valued member of a ... 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 ... Performs coverage, liability, and damage analysis on all claims assignments. * Performs other ...

Sedgwick

Claims Representative, Auto

Raleigh, NC · On-site

$50K - $55K/yr

Communicates claim action/processing with insured, client, and agent or broker when appropriate ... Performs coverage, liability, and damage analysis on all claims assignments. * Performs other ...

DAN

Claims Director

Durham, NC · On-site

$130K/yr

Claims WORKSITE: 6 West Colony Place, Durham, NC REPORTS TO: EVP, Insurance Operations ... The Director of Claims leads claims staff, develops departmental processes and performance ...

Divers Alert Network

Claims Director

Durham, NC · On-site

Claims WORKSITE: 6 West Colony Place, Durham, NC REPORTS TO: EVP, Insurance Operations ... The Director of Claims leads claims staff, develops departmental processes and performance ...

New

Alchemy Financial Group

Insurance Agent

Apex, NC

$75K - $105K/yr

Provide continual service by processing insurance renewals and working to retain clients * Track insurance claims to ensure the satisfaction of all parties * Distribute policy funds after a claim has ...

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

Insurance Claims Processor information

See Raleigh, NC salary details

$11

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$33

How much do insurance claims processor jobs pay per hour?

As of Jul 16, 2026, the average hourly pay for insurance 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.

Is claims processing a stressful job?

Insurance claims processing can be stressful due to tight deadlines, high workload, and the need for accuracy in evaluating claims. The role requires attention to detail, communication skills, and sometimes working under pressure, especially during busy periods or complex cases.

What does an Insurance Claims Processor do?

An Insurance Claims Processor reviews and handles insurance claims submitted by policyholders. Their primary responsibilities include verifying information, ensuring all necessary documentation is provided, and assessing claims for accuracy and compliance with policy guidelines. They communicate with policyholders, adjusters, and healthcare providers to gather additional information if needed, and determine how much the insurance company should pay out. The role is essential for ensuring claims are processed efficiently and fairly, maintaining customer satisfaction, and preventing fraud.

How to become an insurance processor?

To become an insurance claims processor, candidates typically need a high school diploma or equivalent, along with strong organizational and communication skills. Some employers prefer candidates with experience in insurance or claims processing, and familiarity with claims management software can be beneficial. Certification is not always required but can improve job prospects and advancement opportunities.

What is the highest paid position in insurance?

In the insurance industry, executive roles such as Chief Executive Officer (CEO), Chief Underwriting Officer, and Chief Risk Officer tend to be the highest paid. These positions require extensive experience, leadership skills, and often advanced certifications, and they oversee company strategy and risk management at the highest level.

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

To thrive as an Insurance Claims Processor, you need strong attention to detail, knowledge of insurance policies and regulations, and typically a high school diploma or equivalent. Familiarity with claims management software, electronic databases, and sometimes certifications like the Associate in Claims (AIC) are common requirements. Excellent organizational skills, clear communication, and problem-solving abilities help you stand out in this role. These skills ensure accurate claim processing, effective customer service, and compliance with industry standards.

What are some common challenges faced by Insurance Claims Processors, and how can they be managed effectively?

Insurance Claims Processors often encounter challenges such as managing high volumes of claims, navigating complex policy details, and meeting strict deadlines. Staying organized and detail-oriented is key to ensuring accuracy and timely processing. Effective communication with policyholders, adjusters, and other team members also helps resolve discrepancies quickly and improves overall workflow. Many employers provide ongoing training and support to help processors stay current on regulations and best practices, which can further ease these challenges.

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

AspectInsurance Claims ProcessorInsurance Claims Adjuster
CredentialsTypically requires a high school diploma or equivalent; certifications like CPCU or AIC are a plusRequires a high school diploma; often holds certifications such as AIC or CPCU
Work EnvironmentOffice setting, processing claims dataField and office work, investigating claims
Employer & IndustryInsurance companies, third-party administratorsInsurance companies, independent adjusting firms
Primary FocusProcessing and data entry of claimsInvestigating, evaluating, and settling claims

While both roles are essential in the insurance industry, Claims Processors focus on handling claim data and documentation, whereas Claims Adjusters investigate and determine claim validity and settlement amounts. Understanding these differences helps job seekers identify the right career path within insurance claims roles.

What are popular job titles related to Insurance Claims Processor jobs in Raleigh, NC? For Insurance Claims Processor jobs in Raleigh, NC, the most frequently searched job titles are:
What job categories do people searching Insurance Claims Processor jobs in Raleigh, NC look for? The top searched job categories for Insurance Claims Processor jobs in Raleigh, NC are:
What cities near Raleigh, NC are hiring for Insurance Claims Processor jobs? Cities near Raleigh, NC with the most Insurance Claims Processor job openings:
Insurance Claims Processor jobs near you
Infographic showing various Insurance Claims Processor job openings in Raleigh, NC as of July 2026, with employment types broken down into 85% Full Time, 11% Part Time, 1% Temporary, and 3% Contract. Highlights an 85% Physical, 5% Hybrid, and 10% Remote job distribution, with an average salary of $45,162 per year, or $21.7 per hour.

Claims Consultant

Tata Consultancy Service Limited

Knightdale, NC • On-site

$48K - $55K/yr

Full-time

Medical, Dental, Vision, Retirement, PTO

Posted 5 days ago

Job description

Responsibilities:
To provide Absence case management and claim adjudications, based on medical documentation and the applicable Disability/FMLA/Paid Family Leave interpretation, including determining benefits due and making timely payments and adjustments.
Review and analyze the claim nuances, eligibility review, and type of claims (intermittent or continuous)
Review and analyze medical information (i.e. attending physician reports, medical records such as diagnostic tests, office notes, operative reports, etc.) to determine if the claimant is disabled as defined.
Approval or denial on FMLA claims as per Insurance carrier, and employers guidelines
Analyzes, approves and authorizes assigned claims and determines benefits due pursuant to US paid family law regulations.
Review claims for Not in good order cases, and work on securing missing documentations including employee, physician, or employer outreach.
Communicates clearly with the claimants and clients to set expectations on all aspects of claims process either by phone and/or written correspondence.
Reviews client critical deliverables, manages the overall workload, and second-level process escalation.
Determines benefits due, makes timely claims payments/approvals and adjustments for Workers Compensation, State Short Term Disability, and other disability offsets.
Refers cases as appropriate to team lead and clinical case management
Responsible for managing the day-to-day workload and first-level process escalation, and reviews processes for accuracy and timeliness where applicable in case of peer reviews.
Provide ideas to management on continuous improvement and service level management
Performs other duties or participates in special projects as assigned
Requirements:
1+ year of Disability/FMLA/PFL claims or insurance claims experience
Experience working with FINEOS
Working knowledge of medical terminology and documents, including APS, Diagnostic Tests, Imaging Tests reports
Knowledge of disability insurance claims, benefits administration, offsets and deductions, disability duration and medical management practices mandatory
Excellent oral and written communication, including presentation skills
Strong Analytical, decision making, problem solving, and people management skills
Computer experience with keyboarding skills and proficiency in using software applications and packages including MS Office (Excel, Word, PPT)
Willingness to embrace change in a fast paced work environment
A strong desire to continuously learn and improve
Identify escalated cases and work with Team Leader to develop a plan to address key issues.
TCS Employee Benefits Summary:
• Discretionary Annual Incentive.
• Comprehensive Medical Coverage: Medical & Health, Dental & Vision, Disability Planning & Insurance, Pet Insurance Plans.
• Family Support: Maternal & Parental Leaves.
• Insurance Options: Auto & Home Insurance, Identity Theft Protection.
• Convenience & Professional Growth: Commuter Benefits & Certification & Training Reimbursement.
• Time Off: Vacation, Time Off, Sick Leave & Holidays.
• Legal & Financial Assistance: Legal Assistance, 401K Plan, Performance Bonus, College Fund, Student Loan Refinancing.
Salary Ran ge: $48,000 - $55,000 per year

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