Senior Claims Support Analyst
Claim processor job in Livonia, MI
Why AAA Life AAA Life is a respected and trusted American brand that has been focusing on Life Insurance and Annuity Products since 1969. At AAA Life we have over 1.8 million policies where we take pride in earning the trust of our policyholders who understand our promise to be there for them - and their families - when we're needed most. By joining the AAA Life team, you are joining a company that genuinely cares about helping each other, with a devotion to protect the lives of those around us. We embrace a diverse, equitable, inclusive culture where all associates can feel a sense of belonging and use their unique talents and perspective to influence, innovate, motivate, and thrive.
The Senior Claims Support Analyst supports both the Claims and Treasury functions by ensuring the efficient flow of funds, accuracy of claims payments, and continuous improvement of claims financial processes. This role combines analytical and operational expertise to maintain regulatory compliance, improve claims payment accuracy, and optimize cash management procedures.
The analyst develops, monitors, and reports on key performance metrics, reconciles payment and claims data, supports quality reviews, and collaborates cross-functionally with Finance, Treasury, and Claims Leadership to streamline processes and improve financial integrity in claims operations.
Responsibilities
What You'll Do
* Perform analytical reviews of claims payment and financial transactions to ensure accuracy, compliance, and adherence to internal controls and resolve related issues.
* Compile and interpret data for claims-related financial and operational reports, including accuracy trends, payment reconciliation, and reserve management.
* Maintain and analyze spreadsheets and databases used for claims funding, payment tracking, and financial reconciliations.
* Partner with Treasury to forecast cash needs related to claims payouts and ensure adequate liquidity for daily claim obligations.
* Develop and maintain process documentation and financial models to improve claims funding and payment accuracy.
* Conduct quality audits for all claim types (Life, Annuity, A&H) to verify regulatory compliance and identify opportunities for improvement.
* Support service recovery and resolution for escalated claim issues; provide data and analysis for Department of Insurance or external audit responses.
* Collaborate with Finance to analyze trends, variances, and reconciliation discrepancies; recommend corrective actions.
* Identify and implement process improvements to reduce manual handling, improve automation, and enhance data accuracy.
* Prepare and present claims financial metrics and insights to management, highlighting process efficiencies and control improvements.
* Serve as liaison for audit-related requests (internal, reinsurer, or regulatory) and provide supporting documentation.
* Provide training, guidance, and feedback to claims staff on financial procedures and quality standards.
* Ensure compliance with MAR, internal audit requirements, and fair claims practices regulations.
Qualifications
What You Offer:
* Bachelor's Degree in Business, Finance, Accounting, or related field (or equivalent work experience).
* Minimum 5 years of experience in Claims Operations, Treasury Support, or related insurance field.
* Strong understanding of claims processing systems, payment workflows, and audit requirements.
* Proficiency in Microsoft Excel, Access, and financial modeling; familiarity with COGNOS or similar reporting tools preferred.
* Demonstrated experience in data analysis, reconciliation, and process improvement.
* Excellent communication and collaboration skills, with the ability to work effectively across departments.
* Strong organizational and time-management skills with attention to detail.
* Ability to manage multiple priorities in a fast-paced, deadline-driven environment.
What We offer:
* A collaborative, energetic work environment where you can put your passion for people to work
* Medical, Dental, Vision, Life and Disability coverage available day one
* Pension Plan
* Performance-based incentive plan
* 401k available with a Company match
* Holidays and Paid Time Off
* AAA Basic Membership
#LI-Hybrid
While performing the duties of this job, the employee is frequently required to stand, walk, sit, use hands to finger, handle, or feel, talk, hear and concentrate. Specific vision abilities required by this job include close vision, distance vision, depth perception, and ability to adjust focus.
This job requires the ability to perform duties contained in the job description for this position, including, but not limited to, the above requirements. Reasonable accommodation will be made for otherwise qualified applicants as needed to enable them to fulfill these requirements.
We are committed to ensuring equal employment opportunities for all job applicants and employees. Employment decisions are based upon job-related reasons regardless of an applicant's race, color, religion, sex, sexual orientation, gender identity, age, national origin, disability, marital status, genetic information, protected veteran status, or any other status protected by law.
Auto-ApplyBilingual Claims Examiner
Claim processor job in Troy, MI
HealthCare Support Staffing, Inc. (HSS), is a proven industry-leading national healthcare recruiting and staffing firm. HSS has a proven history of placing talented healthcare professionals in clinical and non-clinical positions with some of the largest and most prestigious healthcare facilities including: Fortune 100 Health Plans, Mail Order Pharmacies, Medical Billing Centers, Hospitals, Laboratories, Surgery Centers, Private Practices, and many other healthcare facilities throughout the United States. HealthCare Support Staffing maintains strong relationships with top providers in healthcare and can assure healthcare professionals they will receive fast access to great career opportunities that best fit their expertise. Connect with one of our Professional Recruiting Consultants today to see how a conversation can turn into a long-lasting and rewarding career!
Job Description:
Are you an experienced Claims Representative looking for a new opportunity with a prestigious healthcare company? Do you want the chance to advance your career by joining a rapidly growing company? If you answered “yes" to any of these questions - this is the position for you!
Daily Responsibilities:
• Resolves Provider Reconsideration Requests (PRR) from providers relating to claims payment and requests for claim adjustments
• Researches claims processing guidelines, provider contracts, fee schedules and system configurations to determine root cause of payment error
• Identifies potential Provider problems through a proactive approach in which data is mined and trended to identify and prevent provider problem areas
Qualifications
Hours for this Position:
• Mon-Fri 8am-4:30pm
Advantages of this Opportunity:
• Competitive salary, negotiable based on relevant experience
• Acquire new skills and learn new knowledge
• Fun and positive work environment
Qualifications/ Requirements:
• Must be bilingual in Spanish
• Claims, Appeals, Denials experience for an insurance company or hospital or medical office or financial company
• HS Diploma/GED
Additional Information
Interested in hearing more about this great opportunity?
If you are interested in applying to this position, please click Apply Now and email your resume to Michael Grifon.
Bodily Injury Claims Specialist
Claim processor job in Troy, MI
We offer a merit-based work-from-home program based on job responsibilities. After initial training in-person, you could have the flexibility of work-from-home time as defined by the leadership team. Auto-Owners Insurance, a top-rated insurance carrier, is seeking a motivated individual to join our Claims department as a Bodily Injury Claims Representative. The position requires the person to:
* Assemble facts, determine coverage, evaluate the amount of loss, analyze legal liability, make payments in accordance with coverage, damage and liability determination, and perform other functions or duties to properly adjust the loss.
* Study insurance policies, endorsements, and forms to develop an understanding of insurance coverage.
* Follow claims handling procedures and participate in claim negotiations and settlements.
* Deliver a high level of customer service to our agents, insureds, and others.
* Devise alternative approaches to provide appropriate service, dependent upon the circumstances.
* Meet with people involved with claims, sometimes outside of our office environment.
* Handle investigations by telephone, email, mail, and on-site investigations.
* Maintain appropriate adjuster's license(s), if required by statute in the jurisdiction employed, within the time frame prescribed by the Company or statute.
* Handle complex and unusual exposure claims effectively through on-site investigations and through participation in mediations, settlement conferences, and trials.
* Handle confidential information according to Company standards and in accordance with any applicable law, regulation, or rule.
* Assist in the evaluation and selection of outside counsel.
* Maintain punctual attendance according to an assigned work schedule at a Company approved work location.
Desired Skills & Experience
* A minimum of three years of insurance claims related experience.
* The ability to organize and conduct an investigation involving complex issues and assimilate the information to reach a logical and timely decision.
* The ability to effectively understand, interpret and communicate policy language.
* The dissemination of appropriate claim handling techniques so that others involved in the claim process are understanding of issues.
Benefits
Auto-Owners offers a wide range of career opportunities, and we are seeking talent that will help us continue our long tradition of success. We offer a friendly work environment, structured training program, employee mentoring and an excellent compensation/benefits package. Along with a competitive base salary, matched 401(k), fully-funded pension plan (once vested), and bonus programs, Auto-Owners also provides generous paid time off including holidays, vacation days, personal time, and sick leave. If you're looking to do rewarding work alongside great people, Auto-Owners is the place for you!
Equal Employment Opportunity
Auto-Owners Insurance is an equal opportunity employer. The Company hires, transfers, and promotes on the basis of ability, without consideration of disability, age, sex, race, color, religion, height, weight, marital status, sexual orientation, gender identity or national origin, or any factor contrary to federal, state or local law.
* Please note that the ability to work in the U.S. without current or future sponsorship is a requirement.
#LI-CH1 #LI-Hybrid
Auto-ApplySupplier Claims Auditor
Claim processor job in Warren, MI
Through our dedicated associates, Conduent delivers mission-critical services and solutions on behalf of Fortune 100 companies and over 500 governments - creating exceptional outcomes for our clients and the millions of people who count on them. You have an opportunity to personally thrive, make a difference and be part of a culture where individuality is noticed and valued every day.
Supplier Claims Auditor
Hybrid | Warren, MI
Part-Time | Hours Assigned as Needed
Hours of Operation: Monday- Friday, 7:00 AM - 4:00 PM EST
About the Role:
As a Supplier Claims Auditor, you'll play a vital role in the Supplier Claim Activity (SCA) group by reviewing and auditing supplier obsolescence and cancellation claims. You'll validate costs, ensure compliance with contract terms and conditions, and prepare detailed audit reports for internal and external stakeholders. This position requires strong analytical, financial, and organizational skills, along with a proactive approach to problem-solving and collaboration.
A typical day includes reviewing assigned supplier claims, auditing supporting documentation, preparing audit files and recommendations, collaborating with internal stakeholders to determine settlements, and tracking open claims to ensure timely resolution. This position is ideal for someone who enjoys detail-oriented, analytical work and thrives in a collaborative yet independent environment.
Requirements:
We're looking for professionals who are analytical, organized, and comfortable managing multiple priorities. To be successful in this role, you should have:
* Experience in auditing, finance, purchasing, tax, or cost analysis
* Proficiency in Microsoft Excel, including PivotTables, VLOOKUP, and Conditional Formatting
* Strong written, verbal, and interpersonal communication skills
* Ability to manage multiple claim reviews and meet deadlines independently
* Familiarity with automotive manufacturing processes and cost factors such as labor, materials, and profit
* Successful completion of background check
Pay Transparency Laws in some locations require disclosure of compensation and/or benefits-related information. For this position, actual salaries will vary and may be above or below the range based on various factors including but not limited to location, experience, and performance. In addition to base pay, this position, based on business need, may be eligible for a bonus or incentive. In addition, Conduent provides a variety of benefits to employees including health insurance coverage, voluntary dental and vision programs, life and disability insurance, a retirement savings plan, paid holidays, and paid time off (PTO) or vacation and/or sick time. The estimated salary range for this role is $ 45,360 - $ 56,700.
Conduent is an Equal Opportunity Employer and considers applicants for all positions without regard to race, color, creed, religion, ancestry, national origin, age, gender identity, gender expression, sex/gender, marital status, sexual orientation, physical or mental disability, medical condition, use of a guide dog or service animal, military/veteran status, citizenship status, basis of genetic information, or any other group protected by law.
For US applicants: People with disabilities who need a reasonable accommodation to apply for or compete for employment with Conduent may request such accommodation(s) by submitting their request through this form that must be downloaded: click here to access or download the form. Complete the form and then email it as an attachment to ********************. You may also click here to access Conduent's ADAAA Accommodation Policy.
Claims Specialist
Claim processor job in Novi, MI
Job DescriptionBenefits:
401(k)
Dental insurance
Health insurance
Paid time off
Parental leave
Vision insurance
Who We Are Incingo is a medical cost containment company that helps manage everything from short-term post-op to catastrophic care for workers compensation claims. We use our nationwide network of proven, credentialed vendors and create customized programs for efficient authorizing and shipping of medical supplies. We also coordinate medical transportation, home health care and in-home modifications. We are located in the heart of downtown Ann Arbor and we are looking for a full-time Claims Specialist. Hybrid work is available, prefer candidates in Michigan.
We offer a best-in-class benefits package with a flexible work environment. Our culture is one of caring and collaboration, and we enjoy a team-oriented environment.
Visit our website or LinkedIn to learn more.
What Youll Do
Serve as primary contact for inbound and outbound customer support by phone, email, or instant message
Facilitate resolution of open receivables by review of coding, product, contract, payment agreement, fee schedule and/or authorization terms.
Work independently and as part of a team on invoice renegotiations, vendor management, and provider and patient relations
Review EOBs and address denial and partial payment of invoices in a timely and accurate manner
Maintain accurate documentation of workers compensation claim files in multiple databases
Ensure quality components of service delivery and patient/payor satisfaction with services provided
Establish and maintain strong vendor relationships
Participate in process for continuous credentialing and quality monitoring of assigned accounts
Work with team to conduct cost analysis and identify margin opportunities
Demonstrate performance aligned with WRS guiding principles, including caring, collaboration, trustparency, and innovation
What Youll Bring
High School Diploma (or equivalent); college degree preferred
1+ year experience in a medical setting preferred
A customer focused approach to tasks and responsibilities
Must be analytical and solution-oriented with excellent problem-solving abilities, superior follow-up skills, and the ability to shift gears frequently throughout the day
Intermediate MS Suite, typing and email skills
Excellent verbal and written communication skills
Familiarity of workers compensation state fee schedules preferred
Flexible work from home options available.
Healthcare Claims Auditor
Claim processor job in Ann Arbor, MI
Since 2002, Quantix ProTech has successfully delivered IT resources and solutions to companies while building a solid reputation for integrity and consistent quality. Quantix ProTech continues to partner with the commercial sector for specialized IT placement and staffing services. Quantix ProTech was recently featured in US News and World Report and Forbes.
Job Title: Healthcare Claims Auditor
Location: Ann Arbor, MI
Type: Contract
Length: Through 12/22/2016
Job Description: Our client in the Ann Arbor, Michigan area is looking for Healthcare Claims Auditors to join their team on a short term contract basis. This candidates will translate client's healthcare Summary Plan Descriptions into plan builds in the the audit rules engine. Successful candidates will have a solid understanding of healthcare claims processing having gained experience working for a health plan or a TPA.
Required Skills:
1) Healthcare Claims Auditing.
2) Helathcare Coding methods.
Qualifications
Required Skills:
1) Healthcare Claims Auditing.
2) Helathcare Coding methods.
Additional Information
All your information will be kept confidential according to EEO guidelines. If your interested, send a copy of your resume at
henriquez@quantixinc. com
or reach me at
************.
Dental Claims Specialist
Claim processor job in Dearborn Heights, MI
Medicaid Specialist at
Cambridge Dental Group - Dearborn Heights, MI*
Cambridge Dental Group is seeking a detail-oriented and experienced CBO Team Member to join our centralized business office team. This role is essential in ensuring accurate and timely submission and follow-up of Medicaid pre-authorizations and claims. The ideal candidate will bring a strong background in Medicaid billing and revenue cycle management (RCM), with a commitment to accuracy and efficiency.
Responsibilities:
Submit all Medicaid pre-authorizations and claims in a timely manner.
Follow up consistently on pre-authorizations and claims to ensure proper resolution.
Review and manage daily work logs to resolve outstanding claims.
Appropriately document all account activities within the practice management system.
Process EOB and R/A payments/denials accurately and promptly.
Communicate effectively with leadership, co-workers, and dental offices regarding claim status.
Maintain a high level of accuracy and attention to detail in all job functions.
Provide backup support to other CBO team members as needed.
Required Qualifications:
5+ years of Medicaid billing and RCM experience (preferred)
Proven ability to manage pre-authorizations and claims efficiently
High attention to detail and task-focused work style
Strong organizational and follow-up skills
Preferred Qualifications:
Some dental clinical experience (helpful but not required)
Why Join Us:
Full-time position with comprehensive benefits including health insurance, life insurance, PTO, paid holidays, disability options, 401k with match
Be part of a supportive and collaborative CBO team
Play a key role in ensuring smooth financial operations for our office
Competitive compensation and growth opportunities within a trusted dental group
#indeedwavedp
Requirements
Education and Training
High school diploma or equivalent required.
Three years healthcare cash posting, billing, third party follow-up and collections experience required; OR a combination of education and/or experience in business or related field totaling three years.
Knowledge of automated business applications, including word-processing, spreadsheet and data base management applications required.
Data entry experience and knowledge of Medicare, Medicaid, and third-party insurance preferred.
FLSA Status: Hourly, Non-Exempt
Reports to: VP of Finance
Mortgage Claims Default Specialist
Claim processor job in Troy, MI
The EMAC Group is a provider of mortgage recruiting services, we offer an extensive network of mortgage professionals and proven expertise developed over 20 years of experience identifying, attracting and recruiting mortgage talent for our clients.
Job Description
POSITION SUMMARY
The Claims Specialist is responsible for processing required claims to Fannie Mae, Mortgage Insurance Companies, FHA, VA or other investors to recover advances incurred throughout the default process. The Claims Specialist will file required claims; meet investor time frames, and complete audits of claims processes for validation. Responsibilities as well will entail tracking of claim payments received for proper application, and filing of any required supplemental claims as necessary, and respond regarding any contested claim information as required.
ESSENTIAL POSITION FUNCTIONS
• Review, analyze, and ensure timely settlement of investor and mortgage insurance claims and manage aging claims to determine status and bring to closure and request extensions as needed.
• Document and maintain all systems necessary for proper claim handling and follow-up.
• Research issues and obtain proper supporting documentation in a timely manner as requested by investor or mortgage insurance company.
• Manage application of all claim funds received and provide additional information as necessary in order to validate all available funds received prior to claim being closed.
• Monitor claim process reports to ensure all required responses are timely filed.
• Complete timely audits of all assigned claims to ensure all requirements have been met, and claim process can be validated.
Qualifications
EDUCATION / EXPERIENCE REQUIREMENTS
• Graduation from a 4-year college or university with major course work in a discipline related to the requirements of the position is preferred. Will consider the equivalent combination of job experience & education that demonstrates the ability to perform the essential functions of this job.
• Knowledge of Microsoft Office a must; knowledge of YARDI, LoanSphere, VALERI, USDA LINC and Workout Prospector a plus.
• Previous work with mortgage claim filing is a requirement.
Additional Information
Please contact Tabitha Wolf at: ************
Mortgage Claims Default Specialist
Claim processor job in Troy, MI
The EMAC Group is a provider of mortgage recruiting services, we offer an extensive network of mortgage professionals and proven expertise developed over 20 years of experience identifying, attracting and recruiting mortgage talent for our clients.
Job Description
POSITION SUMMARY
The Claims Specialist is responsible for processing required claims to Fannie Mae, Mortgage Insurance Companies, FHA, VA or other investors to recover advances incurred throughout the default process. The Claims Specialist will file required claims; meet investor time frames, and complete audits of claims processes for validation. Responsibilities as well will entail tracking of claim payments received for proper application, and filing of any required supplemental claims as necessary, and respond regarding any contested claim information as required.
ESSENTIAL POSITION FUNCTIONS
• Review, analyze, and ensure timely settlement of investor and mortgage insurance claims and manage aging claims to determine status and bring to closure and request extensions as needed.
• Document and maintain all systems necessary for proper claim handling and follow-up.
• Research issues and obtain proper supporting documentation in a timely manner as requested by investor or mortgage insurance company.
• Manage application of all claim funds received and provide additional information as necessary in order to validate all available funds received prior to claim being closed.
• Monitor claim process reports to ensure all required responses are timely filed.
• Complete timely audits of all assigned claims to ensure all requirements have been met, and claim process can be validated.
Qualifications
EDUCATION / EXPERIENCE REQUIREMENTS
• Knowledge of Microsoft Office a must; knowledge of YARDI, LoanSphere, VALERI, USDA LINC and Workout Prospector a plus.
• Previous work with mortgage claim filing is a requirement.
Additional Information
Please contact Tabitha Wolf at: ************
Claims Representative
Claim processor job in Detroit, MI
Join Our Dynamic Insurance Team - Unlock Your Potential!
Are you ready to take control of your future and build a career in one of the most stable and lucrative industries? We are seeking driven individuals to join our thriving insurance team, where you'll receive top-tier training, support, and unlimited income potential.
NOW HIRING:
✅ Licensed Life & Health Agents
✅ Unlicensed Individuals (We'll guide you through the licensing process!)
We're looking for our next leaders-those who want to build a career or an impactful part-time income stream.
Is This You?
✔ Willing to work hard and commit for long-term success?
✔ Ready to invest in yourself and your business?
✔ Self-motivated and disciplined, even when no one is watching?
✔ Coachable and eager to learn?
✔ Interested in a business that is both recession- and pandemic-proof?
If you answered YES to any of these, keep reading!
Why Choose Us?
💼 Work from anywhere - full-time or part-time, set your own schedule.
💰 Uncapped earning potential - Part-time: $40,000 - $60,000 /month | Full-time: $70,000 - $150,000+++/month.
📈 No cold calling - You'll only assist individuals who have already requested help.
❌ No sales quotas, no pressure, no pushy tactics.
🧑 🏫 World-class training & mentorship - Learn directly from top agents.
🎯 Daily pay from the insurance carriers you work with.
🎁 Bonuses & incentives - Earn commissions starting at 80% (most carriers) + salary
🏆 Ownership opportunities - Build your own agency (if desired).
🏥 Health insurance available for qualified agents.
🚀 This is your chance to take back control, build a rewarding career, and create real financial freedom.
👉 Apply today and start your journey in financial services!
(
Results may vary. Your success depends on effort, skill, and commitment to training and sales systems.
)
Auto-ApplySupplier Claims Auditor
Claim processor job in Auburn Hills, MI
The Supplier Claims Auditor will be responsible for assisting with the performance of supplier cancellation claim audits. This individual will interact with suppliers, purchasing, and engineering to resolve disputed claims. The Supplier Claims Auditor will perform substantive testing of supplier claims, obtaining sufficient evidence to support the claim recommendation, document the results and findings and communicate the results to appropriate staff. The selected candidate will perform on-site verification of inventories, production tooling and other assets that may be included in a cancellation claim. This individual will also coordinate audit efforts with dealer field auditors, Chrysler Leadership Development program participants, and other groups within Chrysler. Prepare appropriate management reports as needed. Travel requirements up to 30% (focused primarily in the mid-west).
Claims Specialist - Corporate
Claim processor job in Southfield, MI
Job Description
About Us PACE Southeast Michigan is a unique health plan and comprehensive care provider, committed to keeping chronically ill aging adults in their home, by caring for their medical, psychosocial and spiritual needs. Join a mission-driven team that's changing lives every day - helping seniors age with dignity, purpose, and joy.
About the Role
Under the supervision of the Finance Manager, the PACE Southeast Michigan (PACE SEMI) Claims Specialist is responsible for performing a variety of functions related to processing and analyzing medical claims.
Primary Functions:
• Process all medical claims according to vendor contracts, Medicare/Medicaid guidelines, and internal authorizations.
• Manage the collection and submission of risk adjustment and encounter data to Medicare.
• Analyze, maintain, and update computer programs to provide accurate financial data to various departments.
• Keep abreast of governmental regulations pertaining to Medicare/Medicaid reimbursement.
• Perform other duties as assigned.
Knowledge, Skills, and Abilities:
• Bachelor's degree in healthcare administration.
• In lieu of degree, 3-5 years of medical claims processing experience will be considered.
• Basic knowledge of computer programming to learn PACE SEMI's financial system and understand complex governmental regulations.
• Visual ability required for analyzing reports, contracts, and other documents.
• Manual dexterity requires preparing and tabulating data and drafting reports
• Must meet or exceed core customer service responsibilities, standards, and behaviors, including:
o Communication
o Ownership
o Confidentiality
o Understanding
o Motivation
o Sensitivity
o Excellence
o Teamwork
o Respect
• Self-directed, flexible, and committed to the team concept.
• Demonstrated teamwork, initiative, and willingness to learn.
• Maintains customer service skills as provided through ongoing training and in-services.
• Completes all annual mandatory in-service trainings and screenings, including but not limited to infection control, TB testing, flu shot, emergency preparedness, HIPAA, ergonomics, and participant rights.
• Possesses the ability to establish and maintain effective interpersonal relationships.
Working Conditions:
• Office setting with possible local travel to other PACE centers.
• Normal office environment with minimal exposure to noise, dust, or extreme temperatures.
Supplier Claims Auditor
Claim processor job in Auburn Hills, MI
The Supplier Claims Auditor will be responsible for assisting with the performance of supplier cancellation claim audits. This individual will interact with suppliers, purchasing, and engineering to resolve disputed claims. The Supplier Claims Auditor will perform substantive testing of supplier claims, obtaining sufficient evidence to support the claim recommendation, document the results and findings and communicate the results to appropriate staff. The selected candidate will perform on-site verification of inventories, production tooling and other assets that may be included in a cancellation claim. This individual will also coordinate audit efforts with dealer field auditors, Chrysler Leadership Development program participants, and other groups within Chrysler. Prepare appropriate management reports as needed. Travel requirements up to 30% (focused primarily in the mid-west).
MEDICAL CHART PREP PROCESSOR - ONCOLOGY
Claim processor job in Toledo, OH
Responsible for portaling and scanning paper documents into electronic medical records for upcoming patient appointments. Responsible for reviewing patient records to add comorbid conditions to patient problem list. Responsible for electronically processing patient health information. Clinical knowledge and understanding of medical terminology to correctly identify health information in medical charts.
Principal Duties & Responsibilities:
Example of Essential Duties:
1) Portal patient records from outside health systems
2) Review patient records for comorbid conditions to add to patient problem list
3) Accurately scan medical records into EHR system
4) Fax records to physician offices or Hospitals
5) Answer phones
6) Ability to identify patient medical record documents by name.
Other Essential Duties May Include (but are not limited to):
* Handle requests for release of patient medical information according to HIPAA rules and copy service contract.
* Other duties as assigned.
Knowledge, Skills & Abilities Required:
Required:
* Knowledge of comorbid conditions
* Clinical knowledge and ability to read and understand medical charts
* Ability to accurately identify medical record documentation by name for electronic filing.
* Excellent customer relations and phone protocol
* Excellent organizational skills required.
* Consistently arrives at work, in professional attire, on time and completes all tasks within established time frame.
* Seeks appropriate tasks when primary tasks are completed and assists co-workers as needed.
* Demonstrates adaptability to expanded roles.
* Adheres to all clinic policies and procedures.
Education:
* HS diploma or GED
Preferred:
* Previous experience in a medical office, in medical coding, or in medical records.
Mortgage Claims Default Specialist
Claim processor job in Troy, MI
The EMAC Group is a provider of mortgage recruiting services, we offer an extensive network of mortgage professionals and proven expertise developed over 20 years of experience identifying, attracting and recruiting mortgage talent for our clients.
Job Description
POSITION SUMMARY
The Claims Specialist is responsible for processing required claims to Fannie Mae, Mortgage Insurance Companies, FHA, VA or other investors to recover advances incurred throughout the default process. The Claims Specialist will file required claims; meet investor time frames, and complete audits of claims processes for validation. Responsibilities as well will entail tracking of claim payments received for proper application, and filing of any required supplemental claims as necessary, and respond regarding any contested claim information as required.
ESSENTIAL POSITION FUNCTIONS
• Review, analyze, and ensure timely settlement of investor and mortgage insurance claims and manage aging claims to determine status and bring to closure and request extensions as needed.
• Document and maintain all systems necessary for proper claim handling and follow-up.
• Research issues and obtain proper supporting documentation in a timely manner as requested by investor or mortgage insurance company.
• Manage application of all claim funds received and provide additional information as necessary in order to validate all available funds received prior to claim being closed.
• Monitor claim process reports to ensure all required responses are timely filed.
• Complete timely audits of all assigned claims to ensure all requirements have been met, and claim process can be validated.
Qualifications
EDUCATION / EXPERIENCE REQUIREMENTS
• Knowledge of Microsoft Office a must; knowledge of YARDI, LoanSphere, VALERI, USDA LINC and Workout Prospector a plus.
• Previous work with mortgage claim filing is a requirement.
Additional Information
Please contact Tabitha Wolf at: ************
Supplier Claims Auditor
Claim processor job in Warren, MI
Through our dedicated associates, Conduent delivers mission-critical services and solutions on behalf of Fortune 100 companies and over 500 governments - creating exceptional outcomes for our clients and the millions of people who count on them. You have an opportunity to personally thrive, make a difference and be part of a culture where individuality is noticed and valued every day.
**Supplier Claims Auditor**
**Hybrid | Warren, MI**
**Part-Time | Hours Assigned as Needed**
**Hours of Operation: Monday- Friday, 7:00 AM - 4:00 PM EST**
**About the Role:**
As a Supplier Claims Auditor, you'll play a vital role in the Supplier Claim Activity (SCA) group by reviewing and auditing supplier obsolescence and cancellation claims. You'll validate costs, ensure compliance with contract terms and conditions, and prepare detailed audit reports for internal and external stakeholders. This position requires strong analytical, financial, and organizational skills, along with a proactive approach to problem-solving and collaboration.
A typical day includes reviewing assigned supplier claims, auditing supporting documentation, preparing audit files and recommendations, collaborating with internal stakeholders to determine settlements, and tracking open claims to ensure timely resolution. This position is ideal for someone who enjoys detail-oriented, analytical work and thrives in a collaborative yet independent environment.
**Requirements:**
We're looking for professionals who are analytical, organized, and comfortable managing multiple priorities. To be successful in this role, you should have:
+ Experience in auditing, finance, purchasing, tax, or cost analysis
+ Proficiency in Microsoft Excel, including PivotTables, VLOOKUP, and Conditional Formatting
+ Strong written, verbal, and interpersonal communication skills
+ Ability to manage multiple claim reviews and meet deadlines independently
+ Familiarity with automotive manufacturing processes and cost factors such as labor, materials, and profit
+ Successful completion of background check
_Pay Transparency Laws in some locations require disclosure of compensation and/or benefits-related information. For this position, actual salaries will vary and may be above or below the range based on various factors including but not limited to location, experience, and performance. In addition to base pay, this position, based on business need, may be eligible for a bonus or incentive. In addition, Conduent provides a variety of benefits to employees including health insurance coverage, voluntary dental and vision programs, life and disability insurance, a retirement savings plan, paid holidays, and paid time off (PTO) or vacation and/or sick time. The estimated salary range for this role is $_ _45,360 - $_ _56,700._
Conduent is an Equal Opportunity Employer and considers applicants for all positions without regard to race, color, creed, religion, ancestry, national origin, age, gender identity, gender expression, sex/gender, marital status, sexual orientation, physical or mental disability, medical condition, use of a guide dog or service animal, military/veteran status, citizenship status, basis of genetic information, or any other group protected by law.
For US applicants: People with disabilities who need a reasonable accommodation to apply for or compete for employment with Conduent may request such accommodation(s) by submitting their request through this form that must be downloaded: click here to access or download the form (********************************************************************************************** . Complete the form and then email it as an attachment to ******************** . You may also click here to access Conduent's ADAAA Accommodation Policy (***************************************************************************************** .
Mortgage Claims Specialist
Claim processor job in Detroit, MI
The EMAC Group is a provider of mortgage recruiting services, we offer an extensive network of mortgage professionals and proven expertise developed over 20 years of experience identifying, attracting and recruiting mortgage talent for our clients.
Job Description
POSITION SUMMARY
The Claims Specialist is responsible for processing required claims to Fannie Mae, Mortgage Insurance Companies, FHA, VA or other investors to recover advances incurred throughout the default process. The Claims Specialist will file required claims; meet investor time frames, and complete audits of claims processes for validation. Responsibilities as well will entail tracking of claim payments received for proper application, and filing of any required supplemental claims as necessary, and respond regarding any contested claim information as required.
ESSENTIAL POSITION FUNCTIONS
• Review, analyze, and ensure timely settlement of investor and mortgage insurance claims and manage aging claims to determine status and bring to closure and request extensions as needed.
• Document and maintain all systems necessary for proper claim handling and follow-up.
• Research issues and obtain proper supporting documentation in a timely manner as requested by investor or mortgage insurance company.
• Manage application of all claim funds received and provide additional information as necessary in order to validate all available funds received prior to claim being closed.
• Monitor claim process reports to ensure all required responses are timely filed.
• Complete timely audits of all assigned claims to ensure all requirements have been met, and claim process can be validated.
Qualifications
EDUCATION / EXPERIENCE REQUIREMENTS
• Graduation from a 4-year college or university with major course work in a discipline related to the requirements of the position is preferred. Will consider the equivalent combination of job experience & education that demonstrates the ability to perform the essential functions of this job.
• Knowledge of Microsoft Office a must; knowledge of YARDI, LoanSphere, VALERI, USDA LINC and Workout Prospector a plus.
• Previous work with mortgage claim filing is a requirement.
Additional Information
Please contact Tabitha Wolf at: ************
Claims Specialist
Claim processor job in Novi, MI
Benefits:
401(k)
Dental insurance
Health insurance
Paid time off
Parental leave
Vision insurance
Who We AreIncingo is a medical cost containment company that helps manage everything from short-term post-op to catastrophic care for worker's compensation claims. We use our nationwide network of proven, credentialed vendors and create customized programs for efficient authorizing and shipping of medical supplies. We also coordinate medical transportation, home health care and in-home modifications. We are located in the heart of downtown Ann Arbor and we are looking for a full-time Claims Specialist. Hybrid work is available, prefer candidates in Michigan.
We offer a best-in-class benefits package with a flexible work environment. Our culture is one of caring and collaboration, and we enjoy a team-oriented environment. Visit our website or LinkedIn to learn more. What You'll Do
Serve as primary contact for inbound and outbound customer support by phone, email, or instant message
Facilitate resolution of open receivables by review of coding, product, contract, payment agreement, fee schedule and/or authorization terms.
Work independently and as part of a team on invoice renegotiations, vendor management, and provider and patient relations
Review EOB's and address denial and partial payment of invoices in a timely and accurate manner
Maintain accurate documentation of workers compensation claim files in multiple databases
Ensure quality components of service delivery and patient/payor satisfaction with services provided
Establish and maintain strong vendor relationships
Participate in process for continuous credentialing and quality monitoring of assigned accounts
Work with team to conduct cost analysis and identify margin opportunities
Demonstrate performance aligned with WRS guiding principles, including caring, collaboration, trustparency, and innovation
What You'll Bring
High School Diploma (or equivalent); college degree preferred
1+ year experience in a medical setting preferred
A customer focused approach to tasks and responsibilities
Must be analytical and solution-oriented with excellent problem-solving abilities, superior follow-up skills, and the ability to shift gears frequently throughout the day
Intermediate MS Suite, typing and email skills
Excellent verbal and written communication skills
Familiarity of workers compensation state fee schedules preferred
Flexible work from home options available.
Compensation: $45,000.00 - $50,000.00 per year
We are an equal opportunity employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability status, protected veteran status, or any other characteristic protected by law.
Physician Dispensing providers are proliferating. But WRS is one of the few that's trusted over time, with 12+ years in orthopedic healing. We know what works. And we understand that even the simplest change is tough in a busy practice. So our local support is there 24/7, to help integrate your dispensing program into your day-to-day workflow, seamlessly. Immediate dispensing can make all the difference. Our non-opioid formulary and multidisciplinary approach to healing can help manage patient's pain through non-narcotic alternatives. Ready access to treatment helps to save you time and saves patients added pain, as post-op treatment regimens begin faster. So patients may return to work faster, too. Along with our on-call pharmacist support for any questions that arise, together, we can fight today's opioid epidemic.
Auto-ApplySupplier Claims Auditor
Claim processor job in Auburn Hills, MI
The Supplier Claims Auditor will be responsible for assisting with the performance of supplier cancellation claim audits. This individual will interact with suppliers, purchasing, and engineering to resolve disputed claims. The Supplier Claims Auditor will perform substantive testing of supplier claims, obtaining sufficient evidence to support the claim recommendation, document the results and findings and communicate the results to appropriate staff. The selected candidate will perform on-site verification of inventories, production tooling and other assets that may be included in a cancellation claim. This individual will also coordinate audit efforts with dealer field auditors, Chrysler Leadership Development program participants, and other groups within Chrysler. Prepare appropriate management reports as needed. Travel requirements up to 30% (focused primarily in the mid-west).
Basic Qualifications:
* Bachelor's degree with emphasis in Finance.
* Minimum of five years' experience in related field (Finance, Purchasing, Tool Valuation, Engineering, Supply, System Cost Engineering).
Preferred Qualifications:
* Strong project management skills.
* Excellent verbal and written communication skills.
* Experience on managing multiple projects simultaneously.
Medical Chart Prep Processor - Oncology
Claim processor job in Toledo, OH
Responsible for portaling and scanning paper documents into electronic medical records for upcoming patient appointments. Responsible for reviewing patient records to add comorbid conditions to patient problem list. Responsible for electronically processing patient health information. Clinical knowledge and understanding of medical terminology to correctly identify health information in medical charts.
Principal Duties & Responsibilities:
Example of Essential Duties:
1) Portal patient records from outside health systems
2) Review patient records for comorbid conditions to add to patient problem list
3) Accurately scan medical records into EHR system
4) Fax records to physician offices or Hospitals
5) Answer phones
6) Ability to identify patient medical record documents by name.
Other Essential Duties May Include (but are not limited to):
Handle requests for release of patient medical information according to HIPAA rules and copy service contract.
Other duties as assigned.
Knowledge, Skills & Abilities Required:
Required:
- Knowledge of comorbid conditions
- Clinical knowledge and ability to read and understand medical charts
- Ability to accurately identify medical record documentation by name for electronic filing.
- Excellent customer relations and phone protocol
- Excellent organizational skills required.
- Consistently arrives at work, in professional attire, on time and completes all tasks within established time frame.
- Seeks appropriate tasks when primary tasks are completed and assists co-workers as needed.
- Demonstrates adaptability to expanded roles.
- Adheres to all clinic policies and procedures.
Education:
- HS diploma or GED
Preferred:
- Previous experience in a medical office, in medical coding, or in medical records.
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