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

On Call Counsel

Remote Litigation Attorney

Raleigh, NC · Remote

$41.75 - $43.75/hr

... claims and improvements in special education services and payment processes. This initiative ... Remote Work Skills : Dedicated workspace, reliable Wi‐Fi, and comfort with virtual tools like ...

Erie Insurance

Inside Claims Representative I

Cary, NC · 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.

Erie Insurance

Inside Claims Representative I

Raleigh, NC · 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.

Erie Insurance

Inside Claims Representative I

Raleigh, NC · 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.

Lumenalta

Business Analyst - Healthcare

Raleigh, NC · Remote

$90K - $120K/yr

Process Mapping & Optimization: Analyze current‐state workflows (e.g., claims processing ... This is a fully remote position ; however, candidates must be based in regions that align with the ...

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Remote Claims Processor information

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How much do remote claims processor jobs pay per hour?

As of May 31, 2026, the average hourly pay for remote claims processor 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 Does a Remote Claims Processor Do?

The job duties of a remote claims processor revolve around working to process insurance claims. You typically work from home or another remote location. Your responsibilities start with assessing the claimant's insurance policy and coverage. You review documents and records related to the claim and decide on approval or denial of the claim. A processor also prepares the paperwork necessary for the insurer to process the case for the client. You also have customer service duties, such as answering patient questions and telling them about the claim status. Processors can work with medical insurance, property insurance, or casualty insurance.

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 strong attention to detail, analytical skills, and a solid understanding of insurance policies, often supported by a high school diploma or relevant experience. Familiarity with claims management software, Microsoft Office Suite, and sometimes industry certifications like AIC (Associate in Claims) are typically required. Excellent written communication, time management, and problem-solving abilities help you stand out in this role. These skills ensure accurate and efficient claims handling, customer satisfaction, and compliance with regulatory standards in a remote work environment.

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

Remote Claims Processors often encounter challenges such as managing high volumes of claims, maintaining accuracy without in-person supervision, and communicating effectively with team members across different locations. To address these, it's essential to develop strong organizational skills, utilize digital tools for tracking and documentation, and participate actively in virtual team meetings. Proactively seeking feedback and staying updated on policy changes can also enhance efficiency and reduce errors in a remote setting.

What is the difference between Remote Claims Processor vs Remote Claims Examiner?

AspectRemote Claims ProcessorRemote Claims Examiner
Required CredentialsHigh school diploma or equivalent; some roles may require insurance or claims processing certificationsHigh school diploma or equivalent; often requires licensing or certification in insurance claims examination
Work EnvironmentHome-based or remote office; primarily computer and phone workHome-based or remote; involves reviewing and analyzing insurance claims
Industry UsageInsurance, healthcare, government agenciesInsurance companies, healthcare providers, government agencies
Common Search/ComparisonYesYes

Remote Claims Processors and Remote Claims Examiners both work in the insurance industry, often remotely, handling claims. While both roles require similar credentials and work environments, Claims Examiners typically perform more detailed analysis and may require specific licensing. Understanding these differences helps job seekers identify the right position based on their skills and certifications.

More about Remote Claims Processor jobs
What are popular job titles related to Remote Claims Processor jobs in Raleigh, NC? For Remote Claims Processor jobs in Raleigh, NC, the most frequently searched job titles are:
What job categories do people searching Remote Claims Processor jobs in Raleigh, NC look for? The top searched job categories for Remote Claims Processor jobs in Raleigh, NC are:
What cities near Raleigh, NC are hiring for Remote Claims Processor jobs? Cities near Raleigh, NC with the most Remote Claims Processor job openings:
Remote Claims Processor jobs near you
Supervisor, Claims- Subrogation/Workers Compensation

Supervisor, Claims- Subrogation/Workers Compensation

MagnaCare

Chapel Hill, NC • 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.  Provides on-going feedback to the team and identifies areas for improvement and growth.  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 reports—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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