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

Claims Major Case Director

Raleigh, NC · On-site +1

$92K - $130K/yr

... remote arrangements for the ideal candidate. This role is a true complex claims handling role that ... reviewing and analyzing reports and related bills. * Identifies and addresses subrogation ...

Remote (US, Canada, UK focused) micro1 is engaging Physics Experts (Postdoc / Junior professor) to ... scientific claims as appropriate. * Deliver structured feedback designed to support iterative ...

Remote (US, Canada, UK focused) micro1 is engaging Physics Experts (Postdoc / Junior professor) to ... scientific claims as appropriate. * Deliver structured feedback designed to support iterative ...

Remote (US, Canada, UK focused) micro1 is engaging Physics Experts (Postdoc / Junior professor) to ... scientific claims as appropriate. * Deliver structured feedback designed to support iterative ...

Epic Denials Management Operator

Raleigh, NC · Remote

$17.50 - $23.25/hr

Review AR aging reports and work queues to identify unpaid and delayed claims. Follow up with third ... This is a primarily remote role supporting enterprise Epic support, with minimal travel and ...

... review and resolution of provider credentialing and claims-related matters. This position will ... While this position allows remote work, the individual must reside within the state of North ...

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Showing results 1-20

Remote Claims Reviewer information

See Raleigh, NC salary details

$29.6K

$62.8K

$87.5K

How much do remote claims reviewer jobs pay per year?

As of Aug 28, 2026, the average yearly pay for remote claims reviewer in Raleigh, NC is $62,805.00, according to ZipRecruiter salary data. Most workers in this role earn between $49,600.00 and $73,400.00 per year, depending on experience, location, and employer.

What is a remote claims reviewer?

A Remote Claims Reviewer is a professional who evaluates and processes insurance claims from a remote location, rather than working onsite at an insurance company or healthcare provider. Their primary responsibilities include reviewing submitted claims for accuracy, completeness, and compliance with policy and regulatory guidelines. They may work with various types of claims, such as health, auto, or property insurance, and often use specialized software to assess documentation and make determinations. Remote Claims Reviewers communicate with claimants, providers, and other stakeholders to gather information and resolve issues. This role requires strong attention to detail, analytical skills, and a good understanding of insurance policies and procedures.

What are the key skills and qualifications needed to thrive as a remote claims reviewer?

To thrive as a Remote Claims Reviewer, you need a solid understanding of insurance policies, claims adjudication processes, and attention to detail, typically supported by experience in claims processing or a related field. Familiarity with claims management systems, electronic documentation, and industry certifications such as AIC (Associate in Claims) are commonly required. Excellent analytical skills, strong communication, and self-motivation are critical soft skills for effective remote work and accurate claim evaluations. These skills ensure claims are processed efficiently, accurately, and in compliance with regulations, maintaining trust and minimizing financial risk.

How do remote claims reviewers effectively collaborate with other team members while working from home?

Remote Claims Reviewers typically use a combination of secure communication platforms, such as email, video conferencing, and specialized claims management systems, to stay connected with their colleagues and supervisors. Regular virtual meetings, chat channels, and collaborative document tools help facilitate discussions about complex claims, share updates, and clarify procedures. While working remotely requires proactive communication, most companies provide structured workflows and support resources to ensure claims reviewers can easily reach out for guidance or escalate issues as needed.

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

AspectRemote Claims ReviewerRemote Claims Processor
Required CredentialsHigh school diploma or equivalent; insurance knowledge often preferredHigh school diploma or equivalent; basic insurance knowledge beneficial
Work EnvironmentHome-based, independent review settingHome-based, processing claims as assigned
Employer & Industry UsageInsurance companies, third-party administratorsInsurance companies, healthcare providers
Common Search & ComparisonYesYes

The main difference is that Remote Claims Reviewers evaluate and verify claims for accuracy and compliance, often requiring insurance knowledge, while Remote Claims Processors handle the submission and initial processing of claims. Both roles are remote, industry-specific, and involve insurance-related tasks, but their focus and responsibilities differ.

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

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

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

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

Infographic showing various Remote Claims Reviewer job openings in Raleigh, NC as of June 2026, with employment types broken down into 2% Locum Tenens, 46% Full Time, 37% Part Time, 5% Temporary, and 10% Contract. Highlights an 38% Physical, 3% Hybrid, and 59% Remote job distribution, with an average salary of $62,805 per year, or $30.2 per hour.

Claims Major Case Director

Raleigh, NC • On-site, Remote

$92K - $130K/yr

Full-time

Medical, Retirement, PTO

Re-posted 3 days ago


Job description

IAT Insurance Group has an immediate need for a Major Case Unit Director that can report to one of the following IAT locations:

  • Cheshire, Connecticut
  • Raleigh, North Carolina
  • Naperville, Illinois
  • Rolling Meadows, Illinois
  • Sarasota, Florida
  • Alpharetta, Georgia
  • Virginia Beach, Virginia
  • Scottsdale, Arizona
  • Spring, Texas

This role works a hybrid schedule that requires working from the office Monday through Wednesday, with the option of working Thursday and Friday remotely.

While we prefer candidates to work from one of our listed IAT office locations, we're open to considering fully remote arrangements for the ideal candidate.

This role is a true complex claims handling role that is tasked with managing those claims that are most complex and have the greatest financial exposure under our commercial liability policies.The ideal candidate for this role will be an experienced claim professional with extensive experience handling construction defect and general liability claims including, premises and liquor liability, as well as auto and trucking claims on a national basis with value in excess of $250,000.

Responsibilities:

  • Handles highly complex exposure claims based on Claim Guidelines.
  • Directs and manages use of independent investigators, appraisers, and experts. Selects, directs and manages defense counsel including approval of budgets Develops litigation/file disposition strategy. Attends mediations, settlement conferences and trials.
  • Reports to reinsurers as required by reporting guidelines.
  • Requires interaction and alerts with our Underwriting business partners.
  • All Time Limit Demands to be escalated to management.
  • Assist Sr. Claim specialists with analysis of claim issues as needed.
  • Verifies/analyzes applicable coverage for the reported loss.
  • Establishes 24-hour contact and maintain appropriate contact with all involved stakeholders throughout the life of the claim file.
  • Investigates each claim by gathering information, conducting interviews, taking statements, conducting website research as needed, reviewing and analyzing reports and related bills.
  • Identifies and addresses subrogation/contribution/SIU opportunities.
  • Sets accurate/timely loss/expense reserves in compliance with Claim Guidelines.
  • Evaluates, negotiates, and authorizes settlements with all stakeholders within designated authority.
  • Selects, directs and manages Vendors/Counsel including approval of defense budgets.
  • Negotiates directly with claimants and claimant attorneys upon receipt of critical information.
  • Drafts correspondence, including but not limited to, coverage letters to stakeholders as required.
  • Maintains resident/nonresident adjuster licenses as required.
  • Performs other duties as assigned.

Qualifications:

Must have:

  • Bachelors' degree with a minimum of 12 years of claims handling experience in the insurance industry or equivalent.
  • Equivalent is defined as high school diploma and 16 years of relevant experience.
  • At least 8 years General Liability claim experience as well as Commercial Auto handling, which focused on claims with an exposure of $250,000 or more including both primary and excess losses.
  • Excellent coverage analysis skills with experience in drafting coverage position correspondence.
  • Extensive experience working with general liability, construction defect, garage, commercial trucking as well as identifying coverage issues.
  • Experience handling litigated files and direction of defense counsel.
  • Excellent negotiation skills which would be handled primarily by the file handler.
  • Ability to travel, average 4 days a month.
  • Licensure as required by respective states.
  • Ability to analyze data, utilize sound judgment to draw conclusion and make supported decisions.
  • Authorized to work in the United States and must note require, now or in the future, VISA sponsorship for employment purposes

Preferred to have:

  • CPCU and other insurance related studies
  • Construction Defect claim handling experience

Compensation:

Please note, that the annual gross salary range associated with this posting is $92,800 - $130,000.Actual salaries will vary based on factors such as a candidate's qualifications, skills, competencies, and geographical location related to this specific role. The total compensation will include a base salary, performance-based bonus opportunities, 401(K) match, profit-sharing opportunities, and more.

To view details of our full benefits, please visithttps://www.iatinsurancegroup.com/careers/benefits

 

IAT Insurance Group is the largest private, family-owned property and casualty insurer in the U.S. Insurance Answers Together is how we define IAT, in letter and in spirit. We work together to provide solutions for people and businesses. We collaborate internally and with our partners to provide the best possible insurance and surety options for our customers.

At IAT, we're committed to driving and building an open and supportive culture for all. Our employees propel IAT forward - driving innovation, stable partnerships and growth. That's why we continue to build an engaging workplace culture to attract and retain the best talent.

We offer comprehensive benefits like:

  • 26 PTO Days (Entry Level) + 12 Company Holidays = 38 Paid Days Off
  • 7% 401(k) Company Match and additional Profit Sharing
  • Hybrid work environment
  • Numerous training and development opportunities to assist you in furthering your career
  • Healthcare and Wellness Programs
  • Opportunity to earn performance-based bonuses
  • College Loan Assistance Support Plan
  • Educational Assistance Program
  • Mentorship Program
  • Dress for Your Day Policy

All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran. We maintain a drug-free workplace and participate in E-Verify.