Claims Processor I

Builders Mutual Insurance Company; Raleigh (NC); Hybrid; USD 42,000 - 54,000; Full time

Benefits offered by this job

Competitive compensation with bonus

3 weeks of PTO to start

37.5-hour workweek

Builders University

Volunteer Time Off

Comprehensive benefits

Job summary

Builders Mutual Insurance Company seeks a Claims Processor I to support the claims department. This hybrid role in Raleigh involves two days in the office and three days remote, with training across claims support tasks and strong focus on customer experience.

You will handle document indexing, reporting, EOB preparation, and inbound calls while supporting the claims team and maintaining service standards. 2+ years of related experience preferred; strong MS Office and CRM skills are a plus.

Qualifications

• High school diploma or equivalent is required.
• At least 2 years of customer service/support experience and/or two years of commercial insurance and/or claims experience or an equivalent combination of education and experience.
• Proficiency with MS Office and Outlook; familiarity with policy processing or imaging/CRM systems is a plus.
• Excellent customer relationship management skills are required.
• Ability to learn quickly and adapt to a changing environment.

Responsibilities

• Adhere to the Claims Support schedule to ensure call service levels are met and customer satisfaction remains high.
• Index documents accurately and meet monthly goals.
• Prepare and submit reports and letters on time per jurisdictional requirements.
• Respond to inbound calls from internal and external customers with timely, quality service.
• Process mail and EDI-related items for claims processing as directed.

Skills

Customer service

Communication

CRM systems

MS Office

Education

High school diploma or equivalent

Tools

MS Office

Outlook

Imaging systems

CRM systems

Job description

At Builders Mutual, we believe in the power of teamwork to get the job done right. Every day, our team delivers comprehensive commercial insurance and trusted safety solutions to protect and advance the unique needs of the contractor community. Rooted in teamwork, inclusion, expertise, and community, we work together to serve better, achieve more, and build lasting impact.

The OPPORTUNITY

Leverage your claims experience and join our team as a Claims Processor I! This role will receive cross-functional training in various claims support tasks such as: cataloguing incoming electronic documents for the entire claims department, preparing and sending daily, weekly, monthly claims reports. This role will respond to inbound calls with the goal of providing an exceptional customer experience. Because the success of our company is rooted in teamwork, the way we care about the people we work with and serve, this hybrid role will work in our Raleigh office two days a week with the flexibility to work from home the remaining three days.

Your WORK as a Claims Processor will make a difference as you:

• Adhere to the Claims Support schedule to ensure call service levels are met and customer satisfaction remains high.
• Index documents accurately and consistently attain monthly goal.
• Prepare reports and letters, completing and submitting them on time based on jurisdictional requirements.
• Initiate offsite check printing and prepare EOB's daily.
• Respond to inbound calls from both internal and external customers and handle appropriately in a timely manner.
• Process unidentified mail, agent mailings and underwriting return envelopes to proper resolution.
• Investigate provider inquiries regarding bills and payments, providing EOBs as requested.
• Report any challenges, defects with workflows to Claims Support Supervisor
• Demonstrate proficiency with systems (ImageRight, Advanced Claims, phone system).
• Issues payments for claims file expenses as directed.
• Process Entity Entry (I-9) to ensure compliance.
• Assist in training team members.
• Photocopying claim files, cataloguing medical records and electronic claim file data including EDI and other similar items.
• Performs data entry functions as directed by Adjusters and Claim Services Manager

Skills and Experience to Get the Job Done Right:

• High school diploma or equivalent
• At least 2 years of customer service/support experience and/or two years of commercial insurance and/or claims experience or an equivalent combination of education and experience.
• PC Computer skills (MS Office, Outlook); knowledge of policy processing systems, imaging systems and/or CRM systems is a plus.
• Excellent customer relationship management skills required.
• Ability to learn quickly and adapt to changing environment.
• Solid customer focus and soft skills

Your Employee Experience at Builders Mutual:

At Builders Mutual, we're intentional about creating a workplace where people can do meaningful work, feel supported by leaders who care, and grow their careers with confidence. Great workplaces don't just happen - they're built with intention. You'll also be part of a team where people show up as themselves, support one another, and take pride in what we're building together.

We support you with:

• Competitive compensation and a performance bonus program
• 3 weeks of PTO to start, plus your birthday off
• A 37.5-hour workweek, with Fridays ending at 2:30 PM
• Professional development through Builders University
• Everyday Wins recognition with swag and extra time off
• 8 paid Volunteer Time Off (VTO) hours to give back
• Comprehensive benefits that support your wellbeing today and your future tomorrow