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Medical Claims Jobs in Raleigh, NC (NOW HIRING)

Pharmacy Technician

Cary, NC · Hybrid

$17.25 - $21/hr

Apply knowledge of insurance, medical claims, and prior authorization processes when assisting patients and clinicians with coverage-related inquiries. * Demonstrate professional telephone etiquette ...

... medical claims. Responsibilities This role will provide YOU the opportunity to lead key activities during an exciting launch period of tebipenem and ibrexafungerp. The anti-infectives medical ...

Pharmacy Technician

Cary, NC · Hybrid

$17.25 - $21/hr

Apply knowledge of insurance, medical claims, and prior authorization processes when assisting patients and clinicians with coverage-related inquiries. * Demonstrate professional telephone etiquette ...

Claims Facilitator

Raleigh, NC · On-site

$60 - $80/hr

Low contributions to medical and prescription premiums. We currently pay up to 97% of employees ... Position Summary Under minimal supervision, settles claims within limits of authority. * This is an ...

Claims Facilitator

Cary, NC · On-site

$40K - $64K/yr

Claims Facilitator Date: Aug 31, 2026 Location: Cary, NC, US, 27518 Company: Erie Insurance ... Low contributions to medical and prescription premiums. We currently pay up to 97% of employees ...

Claims Facilitator

Cary, NC · On-site

$40K - $64K/yr

Casualty Claims Division Department of Position: Zone Operations Dept Work from: Raleigh Branch ... Low contributions to medical and prescription premiums. We currently pay up to 97% of employees ...

Claims Facilitator

Cary, NC · On-site

$40K - $64K/yr

Casualty Claims Division Department of Position: Zone Operations Dept Work from: Raleigh Branch ... Low contributions to medical and prescription premiums. We currently pay up to 97% of employees ...

Claims Facilitator

Raleigh, NC · On-site

$40K - $64K/yr

Casualty Claims Division Department of Position: Zones Dept Work from: Branch Office Salary Range ... Low contributions to medical and prescription premiums. We currently pay up to 97% of employees ...

Claims Facilitator

Cary, NC · On-site

$40K - $64K/yr

Casualty Claims Division Department of Position: Zones Dept Work from: Branch Office Salary Range ... Low contributions to medical and prescription premiums. We currently pay up to 97% of employees ...

Claims Facilitator

Cary, NC · On-site

$40K - $64K/yr

Casualty Claims Division Department of Position: Zones Dept Work from: Branch Office Salary Range ... Low contributions to medical and prescription premiums. We currently pay up to 97% of employees ...

Claims Facilitator

Cary, NC · On-site

$40K - $64K/yr

Casualty Claims Division Department of Position: Zones Dept Work from: Branch Office Salary Range ... Low contributions to medical and prescription premiums. We currently pay up to 97% of employees ...

Claims Facilitator

Cary, NC · On-site

$60 - $80/hr

Low contributions to medical and prescription premiums. We currently pay up to 97% of employees ... Position Summary Under minimal supervision, settles claims within limits of authority. The selected ...

Claims Facilitator Under minimal supervision, settles claims within limits of authority. The selected candidate will report to the Raleigh Branch office. The selected candidate will be required to ...

Showing results 21-40

Medical Claims information

See Raleigh, NC salary details

$5

$16

$18

How much do medical claims jobs pay per hour?

As of Sep 7, 2026, the average hourly pay for medical claims in Raleigh, NC is $16.36, according to ZipRecruiter salary data. Most workers in this role earn between $14.95 and $17.74 per hour, depending on experience, location, and employer.

What are medical claims?

Medical claims are formal requests submitted by healthcare providers or patients to insurance companies, asking for payment for medical services rendered. These claims contain detailed information about the patient, the services provided, dates of service, and relevant medical codes. Insurance companies review the claims to determine coverage and reimburse providers or patients accordingly. Accurate and timely submission of medical claims is crucial to ensure proper payment and avoid delays or denials.

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

To thrive as a Medical Claims Specialist, you need knowledge of medical terminology, insurance policies, and claims processing, typically supported by a high school diploma or relevant certification. Familiarity with claims management software, electronic health records (EHRs), and billing systems such as ICD-10 and CPT coding is essential. Attention to detail, strong organizational skills, and effective communication help ensure accuracy and resolve claim discrepancies. These skills are crucial for ensuring timely and accurate claims processing, minimizing errors, and maintaining compliance with healthcare regulations.

What are some common challenges faced in a medical claims role, and how can they be effectively managed?

Medical claims professionals often encounter challenges such as handling denied or complex claims, navigating frequent regulatory changes, and communicating with both patients and insurance providers. Staying updated with the latest healthcare regulations and payer requirements is essential to minimize claim rejections. Effective time management, attention to detail, and strong communication skills help resolve issues quickly and ensure accurate processing. Collaborating closely with billing teams and healthcare providers also aids in addressing discrepancies and expediting claim approvals.

What is the difference between Medical Claims vs Medical Billing Specialist?

AspectMedical ClaimsMedical Billing Specialist
CredentialsTypically requires knowledge of insurance policies and coding; certifications like CPC or CCS are commonRequires similar certifications; focuses on billing processes and insurance claims
Work EnvironmentHealthcare facilities, insurance companies, billing companiesMedical offices, hospitals, billing companies
Job FocusSubmitting and managing insurance claims for reimbursementPreparing and sending bills to patients and insurers, managing accounts

Medical Claims specialists primarily handle the submission and management of insurance claims to ensure healthcare providers receive payment. Medical Billing Specialists focus on creating and sending bills to patients and insurance companies, managing payments, and maintaining billing records. While both roles require knowledge of insurance processes and coding, Medical Claims roles are more centered on claims submission and follow-up, whereas Medical Billing Specialists handle the overall billing process and patient invoicing.

Is medical claims processing a stressful job?

Medical claims processing can be stressful due to tight deadlines, high accuracy requirements, and the need to handle complex or disputed claims. The job often involves detailed data entry, familiarity with insurance policies, and sometimes dealing with frustrated clients, which can contribute to stress levels. However, workload and stress vary depending on the employer and individual workload management skills.

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

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

What cities near Raleigh, NC are hiring for Medical Claims jobs?

Cities near Raleigh, NC with the most Medical Claims job openings:

Infographic showing various Medical Claims job openings in Raleigh, NC as of August 2026, with employment types broken down into 73% Full Time, 9% Part Time, 9% Temporary, and 9% Contract. Highlights an 100% In-person job distribution, with an average salary of $30,902 per year, or $14.9 per hour.

Medical Director, Anti-Infectives

GlaxoSmithKline

Durham, NC • On-site

$200 - $250/hr

Other

Medical, Retirement, PTO

Posted 5 days ago


GlaxoSmithKline rating

8.9

Company rating: 8.9 out of 10

Based on 19 frontline employees who took The Breakroom Quiz

9th of 86 rated pharmaceutical


Job description

Position Summary

Position Summary A Medical Affairs Medical Director has strong clinical and scientific training and can take on many aspects of medical affairs work (insight generation, scientific communications, external scientific engagement, provision of medical advice to internal stakeholders). The focus of the Medical Director is to provide input and expertise into the medicine strategy, develop and execute the related tactical plans, support external scientific engagement, and provide insight and deeper understanding of the data generated including recommending medical claims.

Responsibilities

These responsibilities include some of the following:

  • In partnership with US Medical Affairs Lead, responsible for the development and execution of the US Medical Affairs Plan (UMAP) and the medical sections of the launch plan.
  • For launch assets, if applicable, develop and deliver Launch Readiness materials.
  • Responsible for ensuring execution of medical tactics in collaboration with cross-functional Medical Matrix Team, this may include omnichannel activities, congresses, medical education and other relevant activities.
  • Accountable for executing advice seeking activities and collaborating with cross-functional partners to ensure all external insights are shared internally to inform medical strategy and clinical development Understands, interprets and integrates US environment needs and medical voice of the customer into medical plans ensuring the US needs for medical are represented and incorporated into the global medical work.
  • Provides input into the design of Phase IIIB/IV studies and real‑world evidence studies (RWE) to address key knowledge and evidence gaps in alignment with the integrated evidence plan (IEP).
  • Partners with Medical Communications and Training and Medical Information to serve as a strategic business partner for medical material development and communication plans to ensure materials created align with US medical strategy and business needs; Responsible for some internal medical resources creation (i.e., FAQs, Treatment Landscape).
  • Acts as a Subject Matter Expert (SME) in support of the delivery of scientific training plans.
  • Prioritizes investment in medical activities to deliver the greatest, strategically aligned, impact on patient care measured via GSK's Medical Impact Framework.
  • In collaboration with field medical, leads/contributes to appropriate US scientific engagement between GSK and external communities to advance scientific and medical understanding including the appropriate development and use of our medicines, the management of disease, and patient care.
  • Applies sound medical governance for all activities in alignment with relevant GSK policies and procedures.
  • For all deliverables, collaborates with medical experts as appropriate and cross-functional internal teams inclusive of Global Medical, Field Medical, Clinical Development, and Commercial, to ensure delivery and integrity of all assigned medical activities.
  • Supports the USMAL (US Medical Affairs Lead) or Medical Affairs TAH (Therapeutic Area Head), as needed.
Basic Qualifications
  • Advanced Scientific or Clinical Degree (e.g. PhD, PharmD, or MD).
  • 3 + years’ experience in medical affairs.
  • Medical prelaunch or launch experience.
Preferred Qualifications
  • Experience in infectious diseases, with implementation of strategies specific to appropriate antibiotic use OR antibiotic stewardship.
  • Medical Pre‑Launch and Launch experience.
  • Business Acumen – ability to analyze external environment and translate to strategy.
  • Customer focused – ability to evaluate and understand the needs of the patient and healthcare ecosystem and build a customer‑focused plan.
  • Building relationships – ability to work effectively with others, delegate appropriately and foster a culture of collaboration.
  • Enable and drive change – ability to influence to deliver results, proactively look for new opportunities and constantly anticipate the need for change.
  • Learning agility – must demonstrate deep understanding of the disease area, asset and competitive landscape.
  • Demonstrated understanding of medical affairs accountabilities for evidence generation, external engagement and advice seeking.
  • Strong organizational, planning, and business acumen skills.
  • Excellent written and verbal communications skills.
Salary & Benefits

Skills: Cross-Functional Leadership, Digital Fluency, Enterprise Thinking, High Impact Communication, Launch Excellence, Patient Impact.

If you are based in Cambridge, MA; Waltham, MA; Rockville, MD; or San Francisco, CA, the annual base salary for new hires in this position ranges $187,275 to $312,125.

The US salary ranges take into account a number of factors including work location within the US market, the candidate’s skills, experience, education level and the market rate for the role.

In addition, this position offers an annual bonus and eligibility to participate in our share based long term incentive program which is dependent on the level of the role.

Available benefits include health care and other insurance benefits (for employee and family), retirement benefits, paid holidays, vacation, and paid caregiver/parental and medical leave.

If salary ranges are not displayed in the job posting for a specific country, the relevant compensation will be discussed during the recruitment process. Please visit GSK US Benefits Summary to learn more about the comprehensive benefits program GSK offers US employees.

Why GSK?

Uniting science, technology and talent to get ahead of disease together. GSK is a global biopharma company with a purpose to unite science, technology and talent to get ahead of disease together. We aim to positively impact the health of 2.5 billion people by the end of the decade, as a successful, growing company where people can thrive. We get ahead of disease by preventing and treating it with innovation in specialty medicines and vaccines. We focus on four therapeutic areas: respiratory, immunology and inflammation; oncology; HIV; and infectious diseases - to impact health at scale. People and patients around the world count on the medicines and vaccines we make, so we’re committed to creating an environment where our people can thrive and focus on what matters most. Our culture of being ambitious for patients, accountable for impact and doing the right thing is the foundation for how, together, we deliver for patients, shareholders and our people.

GSK is an Equal Opportunity Employer. This ensures that all qualified applicants will receive equal consideration for employment without regard to race, color, religion, sex (including pregnancy, gender identity, and sexual orientation), parental status, national origin, age, disability, genetic information (including family medical history), military service or any basis prohibited under federal, state or local law.

If you are a US Licensed Healthcare Professional or Healthcare Professional as defined by the laws of the state issuing your license, GSK may be required to capture and report expenses GSK incurs, on your behalf, in the event you are afforded an interview for employment. This capture of applicable transfers of value is necessary to ensure GSK’s compliance to all federal and state US Transparency requirements. For more information, please visit the Centers for Medicare and Medicaid Services (CMS) website at https://openpaymentsdata.cms.gov/.

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About GlaxoSmithKline

Sourced by ZipRecruiter

GlaxoSmithKline is a globally recognized pharmaceutical and healthcare company based in Philadelphia, PA, USA. Originated from a merger between Glaxo Wellcome and SmithKline Beecham in 2000, the company excels in the pharmaceutical industry and holds a leading position in making medicines, vaccines, and consumer healthcare products. GSK's mission is to improve the quality of human life by enabling people to do more, feel better, and live longer. They adhere to core values of transparency, integrity, respect for people, and patient-focus, reflecting in their endeavors to conduct research and deliver innovative healthcare solutions to patients and consumers worldwide.

Industry

Scientific research and development services

Company size

10,000+ Employees

Headquarters location

Philadelphia, PA, US