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Remote Claims Processing Jobs in Raleigh, NC (NOW HIRING)

Inside Claims Representative I

Cary, NC ยท On-site +1

$44.94K - $71.78K/yr

Raleigh Office- Remote Salary Range: $44,936.00 - $71,781.00 * salary range is for this level and ... Documents claim files and facilitates processing of claims in collaboration with other departments.

Inside Claims Representative I

Raleigh, NC ยท On-site +1

$44.94K - $71.78K/yr

Remote Salary Range: $44,936.00 - $71,781.00 * salary range is for this level and may vary based on ... Documents claim files and facilitates processing of claims in collaboration with other departments.

Inside Claims Representative I

Raleigh, NC ยท On-site +1

$44.94K - $71.78K/yr

Remote Salary Range: $44,936.00 - $71,781.00 * salary range is for this level and may vary based on ... Documents claim files and facilitates processing of claims in collaboration with other departments.

Experience in scripting languages including VB Script, Java Script, and Perl. Healthcare domain knowledge including experience in Claims processing. Candidates can be located anywhere in the ...

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Remote Claims Processing information

See Raleigh, NC salary details

$11

$18

$25

How much do remote claims processing jobs pay per hour?

As of May 31, 2026, the average hourly pay for remote claims processing in Raleigh, NC is $18.63, according to ZipRecruiter salary data. Most workers in this role earn between $15.87 and $20.10 per hour, depending on experience, location, and employer.

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

To thrive as a Remote Claims Processor, you need a strong understanding of insurance policies, attention to detail, and relevant experience or education in insurance or finance. Familiarity with claims management software, electronic document systems, and sometimes industry certifications like AIC (Associate in Claims) are typically required. Excellent communication, time management, and problem-solving abilities help you stand out, especially when working independently. These skills ensure accurate, timely claims resolutions and effective collaboration with clients and colleagues in a remote environment.

What are some common challenges faced in remote claims processing roles, and how can they be effectively managed?

Remote claims processing professionals often encounter challenges such as managing high volumes of claims, maintaining clear communication with team members, and ensuring data security while working from home. Effective time management and strong organizational skills are key to handling large workloads efficiently. Regular check-ins with supervisors and using secure, company-approved communication tools can help maintain collaboration and protect sensitive information. Many organizations also provide training and support to help remote processors stay up-to-date with changing regulations and best practices.

What is remote claims processing?

Remote claims processing is the evaluation and handling of insurance claims by professionals who work from locations outside of a traditional office, often from home. These processors review claim submissions, verify information, assess coverage, and authorize payments or request additional information. Remote claims processors use secure online systems and communication tools to collaborate with colleagues and clients. This role requires strong attention to detail, confidentiality, and proficiency with digital platforms. Many insurance companies now offer remote claims processing positions to increase flexibility and efficiency.

What is the difference between Remote Claims Processing vs Remote Claims Adjuster?

AspectRemote Claims ProcessingRemote Claims Adjuster
CredentialsTypically requires insurance or claims processing certificationsRequires insurance licenses and adjuster certifications
Work EnvironmentHome-based, administrative settingHome-based or field, investigative and evaluative tasks
Industry UsageInsurance companies, third-party administratorsInsurance companies, public adjusting firms
Job FocusProcessing claims, data entry, customer serviceInvestigating claims, assessing damages, settlement negotiations

Remote Claims Processing and Remote Claims Adjuster roles share similarities in industry and work environment but differ in job focus and required credentials. Claims processors handle administrative tasks and data entry, while claims adjusters evaluate damages and negotiate settlements. Both roles are essential in the insurance industry and often require specialized certifications.

What job categories do people searching Remote Claims Processing jobs in Raleigh, NC look for? The top searched job categories for Remote Claims Processing jobs in Raleigh, NC are:
What cities near Raleigh, NC are hiring for Remote Claims Processing jobs? Cities near Raleigh, NC with the most Remote Claims Processing job openings:
Supervisor, Claims- Subrogation/Workers Compensation

Supervisor, Claims- Subrogation/Workers Compensation

MagnaCare

Chapel Hill, NC โ€ข Remote

Full-time

Posted 7 days ago


Job description

About the Role
The Claims Supervisor is responsible for supervising the staff of Claim Examiners and Claim Team Leads. The expectations include providing coaching, mentoring, and training while promoting quality and superior customer service. The Claims Supervisor is accountable for identifying opportunities for enhancements and changes to workflows to increase effectiveness and productivity of the team.ย  Provides on-going feedback to the team and identifies areas for improvement and growth.ย  Must be able to make independent decisions, prioritize workload effectively and collaborate with other internal departments to assist in meeting our corporate goals.
Primary Responsibilities
  • Effectively supervise 7-12 direct reportsโ€”consisting of claim examiners and claim team leaders.
  • Provide full-time technical support to team, internal departments, vendors, and customers.
  • Distribute daily work to the team and monitor aging inventory resolution.
  • Train new hires, vendors, and existing staff as needed.
  • Research and respond to escalated issues and pertinent information on claims requiring adjudication.
  • Review and process High Dollar claims and conduct quality reviews of claims and logic changes/updates.
  • Assist Customer Service in resolving customer questions and concerns.
  • Researching and resolving client inquiries and performing client-requested claim adjustments.
  • Coach, counsel, and mentor employees to meet quality, claims accuracy, and productivity standards, and address performance and disciplinary issues.
  • Manage payroll, time sheets, employee schedules, and time off requests.
  • Support internal audits and request recoupments, as necessary.
Essential Qualifications
  • 3+ years of experience in supervisory or leadership role.
  • Advanced knowledge of Excel.
  • Strong knowledge of contracts, medical terminology, and claims processing and procedures and subrogation/workers compensation.
  • 5+ years of advanced claims adjudication experience, including facility, professional, and ancillary claims.
  • Excellent written and oral communication, interpersonal, and negotiation skills with the ability to prioritize tasks.
  • Problem-solving and organizational skills, ability to prioritize and multitask effectively.
  • Ability to establish and maintain positive work relationships with clients, coworkers, members, providers, and customers.
  • Enthusiastic attitude, cooperative team player, adaptable to new or changing circumstances.
  • Bachelor's Degree or comparable experience in the healthcare field preferred.

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