Claim processor jobs in Delhi, MI

Who are we? Michigan Millers Mutual Insurance Company, an affiliate of Western National Mutual Insurance, is a mutual insurance company, rated A (Excellent) by A.M. Best, with over 140 years of experience serving policyholders' property-and-casualty insurance needs across multiple regions in the United States. We believe in striving for growth without sacrifice and know that our culture creates and cultivates happy and dedicated employees, which we believe gives us the ability to deliver the highest level of customer service. The core values for Michigan Millers and Western National Insurance, Connectiveness - Accountability - Empowerment are incorporated into all that we do. Our workplace culture encourages employees to seek out learning opportunities and to strive for growth and development in the insurance industry. We understand the importance of a positive work community and a healthy workplace environment when striving for organizational success. Our emphasis on internal growth and maintaining healthy team relationships translates into external growth and building sustainable customer relationships. Does this opportunity interest you? Michigan Millers Mutual Insurance Company is seeking an Auto Claims Representative to join our team! The individual in this role will have the opportunity to investigate, evaluate, negotiate, and resolve auto insurance claims. What are the responsibilities and opportunities of this role? * Handles high volume, low-to-moderate complexity claims within settlement authority. * Ensures customer service excellence. * Investigates and reviews policy forms, facts, and documents that are related to claims to make appropriate decisions on claims resolutions. * Establishes and reviews proper reserves for each claim based upon thorough investigation, evaluation, and experience while maintaining appropriate reports to ensure the current statuses of claims is clearly documented at all times. * Provides direction to outside resources. * Performs duties and activities covered by specific instructions, standard practices, and established procedures that generally require some interpretation. * Gathers input and makes recommendations to solve problems of moderate complexity. * Deals with moderately complex problems that must be broken down into manageable pieces. * Sees relationships between problem components and prioritizes them. * Utilizes knowledge, experience, and available resources to find solutions. * Participates in development of improvements and helps implement changes. * Maintains regular contact with customers (e.g., policyholders, claimants, agents) as well as regular contact with employees across the organization and outside vendors. * Travels for field work as required. * Performs special projects and other duties as assigned. Requirements What are the must-have qualifications for a candidate? * Understanding of industry practices, standards, and claims concepts. * Prior claims experience. * Ability to multitask and solve problems. * Proficient oral and written communication skills. * Bachelor's degree or equivalent related experience. What will our ideal candidate have? * Negotiation and relationship-building skills. * Analytical with ability to exercise sound business judgment. * Strong time management skills. * Proficient use of various core systems, office and computer equipment, and software packages. * Bachelor's degree or equivalent related experience. * Working toward AIC or AINS certification is preferred. Compensation overview The targeted hiring range for this role is $56,240 - $77,330, annually. However, the base pay offered may vary depending on the job-related knowledge, skills, credentials, and experience of each candidate, as well as other factors such as the scope and location of the role. Candidates looking for compensation outside of the posted range are encouraged to apply and will be considered based on their individual qualifications and / or may be considered for other positions. Culture and Total Rewards We offer full-time employees a significant Total Rewards Package, including: * Medical insurance options and other standard employee benefits, including dental insurance, vision benefits, life insurance, and more! * Health Savings Accounts (HSA) and Flexible Spending Accounts (FSA) * 401(k) Plan (plus company match) * Time Off - including vacation, volunteer, and holiday pay * Paid Parental Leave * Bonus opportunities * Tuition assistance * Wellness Program - including an onsite fitness studio Michigan Millers and Western National Insurance believe in supporting the balance between work and life by providing a flexible work environment, which includes a variety of hybrid work arrangements designed to balance individual, job, department, and company needs. Applicants must be authorized to work for any employer in the U.S. We are unable to sponsor or take over sponsorship of an employment Visa at this time. Michigan Millers provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state, or local laws.

This job is a non-clinical resource that coordinates, analyzes, and interprets the benefits and claims processes for clinical teams and serves as a liaison between various departments across the enterprise, including but not limited to, Clinical Strategy, Sales/Client Management, Customer Service, Claims, and Medical Policy. The person in this position must fully understand all product offerings available to Organization members and be versed in claims payment methodologies, benefits administration, and business process requirements. **ESSENTIAL RESPONSIBILITIES** + Coordinate, analyze, and interpret the benefits and claims processes for the department. + Serve as the liaison between the department and the claims processing departments to facilitate care/case management activities and special handling claims. Communicate benefit explanations clearly and concisely to all pertinent parties. + Investigate benefit/claim information and provide technical guidance to clinical and claims staff regarding the final adjudication of complex claims. Research and investigate conflicting benefit structures in multi-payor situations. + Provide prompt, thorough and courteous replies to written, electronic and telephonic inquiries from internal/external customers (e.g., clinical, sales/marketing, providers, vendors, etc.) Follow-up on all inquiries in accordance with corporate and regulatory standards and timeframes. + Must have the ability to apply knowledge about the business operations of the area within the defined scope of the job. Assess benefit limitations in accordance with Medical Policy Guidelines. + Monitor and identify claim processing inaccuracies. Bring trends to the attention of management. + Assist with handling inbound calls and strive to resolve customer concerns received via telephone or written communication. + Work independently of support, frequently utilizing resources to resolve customer inquiries. + Collaborate with Clinical Strategy, Sales/Client Management and other areas across the enterprise to respond to client questions and concerns about care/case management and high-cost claimants. + Gather information and develop presentation/training materials for support and education. + Other duties as assigned or requested. **EDUCATION** **Required** + High School or GED **Substitutions** + None **Preferred** + Associate's degree in or equivalent training in Business or a related field **EXPERIENCE** **Required** + 3 years of customer service, health insurance benefits and claims experience. + Working knowledge of Highmark products, systems (e.g., customer service and clinical platforms, knowledge resources, etc.), operations and medical policies + PC Proficiency including Microsoft Office Products + Ability to communicate effectively in both verbal and written form with all levels of employees **Preferred** + Working knowledge of medical procedures and terminology. + Complex claim workflow analysis and adjudication. + ICD9, CPT, HPCPS coding knowledge/experience. + Knowledge of Medicare and Medicaid policies **LICENSES or CERTIFICATIONS** **Required** + None **Preferred** + None **SKILLS** + Knowledge of principles and processes for providing customer service. This includes customer needs assessment, meeting quality standards for services + Knowledge of administrative and clerical procedures and systems such as managing files and records, designing forms and other office procedures + The ability to take direction, to navigate through multiple systems simultaneously + The ability to interact well with peers, supervisors and customers + Understanding the implications of new information for both current and future problem-solving and decision-making + Giving full attention to what other people are saying, taking time to understand the points being made, asking questions as appropriate and not interrupting at inappropriate times + Using logic and reasoning to identify the strengths and weaknesses of alternative solutions, conclusions or approaches to problems + Ability to solve complex issues on multiple levels. + Ability to solve problems independently and creatively. + Ability to handle many tasks simultaneously and respond to customers and their issues promptly. **Language (Other than English):** None **Travel Requirement:** 0% - 25% **PHYSICAL, MENTAL DEMANDS and WORKING CONDITIONS** **Position Type** Office-based Teaches / trains others regularly Occasionally Travel regularly from the office to various work sites or from site-to-site Rarely Works primarily out-of-the office selling products/services (sales employees) Never Physical work site required Yes Lifting: up to 10 pounds Constantly Lifting: 10 to 25 pounds Occasionally Lifting: 25 to 50 pounds Rarely **_Disclaimer:_** _The job description has been designed to indicate the general nature and essential duties and responsibilities of work performed by employees within this job title. It may not contain a comprehensive inventory of all duties, responsibilities, and qualifications required of employees to do this job._ **_Compliance Requirement_** _: This job adheres to the ethical and legal standards and behavioral expectations as set forth in the code of business conduct and company policies._ _As a component of job responsibilities, employees may have access to covered information, cardholder data, or other confidential customer information that must be protected at all times. In connection with this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as described in the Notice of Privacy Practices and Privacy Policies and Procedures as well as all data security guidelines established within the Company's Handbook of Privacy Policies and Practices and Information Security Policy._ _Furthermore, it is every employee's responsibility to comply with the company's Code of Business Conduct. This includes but is not limited to adherence to applicable federal and state laws, rules, and regulations as well as company policies and training requirements._ **Pay Range Minimum:** $21.53 **Pay Range Maximum:** $32.30 _Base pay is determined by a variety of factors including a candidate's qualifications, experience, and expected contributions, as well as internal peer equity, market, and business considerations. The displayed salary range does not reflect any geographic differential Highmark may apply for certain locations based upon comparative markets._ Highmark Health and its affiliates prohibit discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities and prohibit discrimination against all individuals based on any category protected by applicable federal, state, or local law. We endeavor to make this site accessible to any and all users. If you would like to contact us regarding the accessibility of our website or need assistance completing the application process, please contact the email below. For accommodation requests, please contact HR Services Online at ***************************** California Consumer Privacy Act Employees, Contractors, and Applicants Notice Req ID: J273827

Provides analyst support for claims research activities including reviewing and researching claims to ensure regulatory requirements are appropriately applied, identifying root-cause of processing errors through research and analysis, coordinating and engaging with appropriate departments, developing and tracking remediation plans, and monitoring claims reprocessing through resolution. Essential Job Duties * Serves as claims subject matter expert - using analytical skills to conduct research and analysis to address issues, requests, and support high-priority claims inquiries and projects. * Interprets and presents in-depth analysis of claims research findings and results to leadership and respective operations teams. * Manages and leads major claims projects of considerable complexity and volume that may be initiated internally, or through provider inquiries/complaints, or legal requests. * Assists with reducing rework by identifying and remediating claims processing issues. * Locates and interprets claims-related regulatory and contractual requirements. * Tailors existing reports and/or available data to meet the needs of claims projects. * Evaluates claims using standard principles and applicable state-specific regulations to identify claims processing errors. * Applies claims processing and technical knowledge to appropriately define a path for short/long-term systematic or operational fixes. * Seeks to improve overall claims performance, and ensure claims are processed accurately and timely. * Identifies claims requiring reprocessing or readjudication in a timely manner to ensure compliance. * Works collaboratively with internal/external stakeholders to define claims requirements. * Recommends updates to claims standard operating procedures (SOPs) and job aids to increase the quality and efficiency of claims processing. * Fields claims questions from the operations team. * Interprets, communicates, and presents, clear in-depth analysis of claims research results, root-cause analysis, remediation plans and fixes, overall progress, and status of impacted claims. * Appropriately conveys claims-related information and tailors communication based on targeted audiences. * Provides sufficient claims information to internal operations teams that communicate externally with providers and/or members. * Collaborates with other functional teams on claims-related projects, and completes tasks within designated/accelerated timelines to minimize provider/member impacts and maintain compliance. * Supports claims department initiatives to improve overall claims function efficiency. Required Qualifications * At least 3 years of medical claims processing experience, or equivalent combination of relevant education and experience. * Medical claims processing experience across multiple states, markets, and claim types. * Knowledge of claims processing related to inpatient/outpatient facilities contracted with Medicare, Medicaid, and Marketplace government-sponsored programs. * Data research and analysis skills. * Organizational skills and attention to detail. * Time-management skills, and ability to manage simultaneous projects and tasks to meet internal deadlines. * Ability to work cross-collaboratively in a highly matrixed organization. * Customer service skills. * Effective verbal and written communication skills. * Microsoft Office suite (including Excel), and applicable software programs proficiency. Preferred Qualifications * Health care claims analysis experience. * Project management experience. To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V Pay Range: $21.16 - $46.42 / HOURLY * Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level. About Us Molina Healthcare is a nationwide fortune 500 organization with a mission to provide quality healthcare to people receiving government assistance. If you are seeking a meaningful opportunity in a team-oriented environment, come be a part of a highly engaged workforce dedicated to our mission. Bring your passion and talents and together we can make a difference in the lives of others. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.

Eligible candidates for this role should reside within a commutable distance of Lansing, Michigan. Territory coverage includes Lansing, Jackson, Howell, and Flint Michigan areas. Job Title- Field Property Claim Specialist Reports to: Claim Manager as appropriate What you will do: Work under minimal supervision with a high-level approval authority to handle complex technical issues and complex claims. Review assigned claims, Contacting the insured and other affected parties, set expectations for the remainder of the claim process, and initiate documentation in the claim handling system. Complete complex coverage analysis. Ensure all possible policyholder benefits are identified. Create additional sub-claims if needed. Complete an investigation of the facts regarding the claim to further and in more detail determine if the claim should be paid, the applicable limits or exclusions and possible recovery potential. Conduct thorough reviews of damages and determine the applicability of state law and other factors related to the claim. Evaluate the financial value of the loss. Approve payments for the appropriate parties accordingly. Refer claims to other company units when necessary (e.g., Underwriting, Recovery Units or Claims Special Investigation Unit). Thoroughly document and/or code the claim file and complete all claim closure and related activities in the assigned claims management system. Utilize strong negotiating skills. Employees will be assigned to the Michigan Homeowner claim unit and will handle claims generally valued between $10,000 and $75,000 and occasionally over $100,000 for field role. Investigate claims requiring coverage analysis. When handling claims in the field, must prepare damage estimates using Xactimate estimating software. Review estimates for accuracy. May monitor contractor repair status and updates. Supervisory Responsibilities: None How you will benefit: A competitive annual salary between $65,700 - $90,000 ACG offers excellent and comprehensive benefits packages, including: Medical, dental and vision benefits 401k Match Paid parental leave and adoption assistance Paid Time Off (PTO), company paid holidays, CEO days, and floating holidays Paid volunteer day annually Tuition assistance program, professional certification reimbursement program and other professional development opportunities AAA Membership Discounts, perks, and rewards and much more We're looking for candidates who: Required Qualifications (these are the minimum requirements to qualify) Education: Associate degree in Business Administration, Insurance or a related field or the equivalent in related work experience Completion of the Insurance Institute of America's: General Insurance Program, Associate in Claims, associate in management or equivalent CPCU coursework or designation Xactware Training Complete ACG Claim Representative Training Program or demonstrate equivalent knowledge or experience. In states where an Adjuster's license is required, the candidate must be eligible to acquire a State Adjuster's license within 90 days of hire and maintain as specified for appropriate states. Must have a valid State Driver's License Ability to: Lift up to 25 pounds Climb ladders. Walk on roofs. Experience: Three years of experience or equivalent training in the following: Negotiation of claim settlements Securing and evaluating evidence Preparing manual and electronic estimates Subrogation claims Resolving coverage questions Taking statements Establishing clear evaluation and resolution plans for claims Knowledge and Skills: Advanced knowledge of: Fair Trade Practices Act as it relates to claims Subrogation procedures and processes Intercompany arbitration Handling simple litigation Advanced knowledge of building construction and repair techniques Ability to: Handle claims to the line Claim Handling Standards Follow and apply ACG Claim policies, procedures and guidelines Work within assigned ACG Claim systems including basic PC software Perform basic claim file review and investigations Demonstrate effective communication skills (verbal and written) Demonstrate customer service skills by building and maintaining relationships with insureds/claimants while exhibiting understanding of their problems and responding to questions and concerns Analyze and solve problems while demonstrating sound decision-making skills Prioritize claim related functions Process time sensitive data and information from multiple sources Manage time, organize and plan workload and responsibilities Safely operate a motor vehicle in order to visit repair facilities, homes (for inspections), patients, etc. Research analyze and interpret subrogation laws in various states May travel outside of assigned territory which may involve overnight stay Preferred Qualifications:Education: Associate degree in Business Administration, Insurance or a related field or the equivalent in related work experience Completion of the Insurance Institute of America's: General Insurance Program, Associate in Claims, Associate in Management or equivalent CPCU coursework or designation Xactware/Xactimate Training or equivalent Work EnvironmentThis position is currently able to work remotely from a home office location for day-to-day operations, with traveling to field locations as necessary to complete job responsibilities, unless occasional team building activities is specified by leadership. This is subject to change based on amendments and/or modifications to the ACG Flex Work policy. Who We Are Become a part of something bigger. The Auto Club Group (ACG) provides membership, travel, insurance, and financial service offerings to approximately 14+ million members and customers across 14 states and 2 U.S. territories through AAA, Meemic, and Fremont brands. ACG belongs to the national AAA federation and is the second largest AAA club in North America. By continuing to invest in more advanced technology, pursuing innovative products, and hiring a highly skilled workforce, AAA continues to build upon its heritage of providing quality service and helping our members enjoy life's journey through insurance, travel, financial services, and roadside assistance. And when you join our team, one of the first things you'll notice is that same, whole-hearted, enthusiastic advocacy for each other. We have positions available for every walk of life! AAA prides itself on creating an inclusive and welcoming environment of diverse backgrounds, experiences, and viewpoints, realizing our differences make us stronger. To learn more about AAA The Auto Club Group visit *********** Important Note: ACG's Compensation philosophy is to provide a market-competitive structure of fair, equitable and performance-based pay to attract and retain excellent talent that will enable ACG to meet its short and long-term goals. ACG utilizes a geographic pay differential as part of the base salary compensation program. Pay ranges outlined in this posting are based on the various ranges within the geographic areas which ACG operates. Salary at time of offer is determined based on these and other factors as associated with the job and job level. The above statements describe the principal and essential functions, but not all functions that may be inherent in the job. 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 accommodations will be made for otherwise qualified applicants, as needed, to enable them to fulfill these requirements. The Auto Club Group, and all its affiliated companies, is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, gender identity, sexual orientation, national origin, disability or protected veteran status. Regular and reliable attendance is essential for the function of this job. AAA The Auto Club Group is committed to providing a safe workplace. Every applicant offered employment within The Auto Club Group will be required to consent to a background and drug screen based on the requirements of the position.

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

Eligible candidates for this role should reside within a commutable distance of Lansing, Michigan. Territory coverage includes Lansing, Jackson, Howell, and Flint Michigan areas. Job Title- Field Property Claim Specialist Reports to: Claim Manager as appropriate What you will do: Work under minimal supervision with a high-level approval authority to handle complex technical issues and complex claims. * Review assigned claims, * Contacting the insured and other affected parties, set expectations for the remainder of the claim process, and initiate documentation in the claim handling system. * Complete complex coverage analysis. * Ensure all possible policyholder benefits are identified. * Create additional sub-claims if needed. * Complete an investigation of the facts regarding the claim to further and in more detail determine if the claim should be paid, the applicable limits or exclusions and possible recovery potential. * Conduct thorough reviews of damages and determine the applicability of state law and other factors related to the claim. * Evaluate the financial value of the loss. * Approve payments for the appropriate parties accordingly. * Refer claims to other company units when necessary (e.g., Underwriting, Recovery Units or Claims Special Investigation Unit). * Thoroughly document and/or code the claim file and complete all claim closure and related activities in the assigned claims management system. * Utilize strong negotiating skills. Employees will be assigned to the Michigan Homeowner claim unit and will handle claims generally valued between $10,000 and $75,000 and occasionally over $100,000 for field role. Investigate claims requiring coverage analysis. When handling claims in the field, must prepare damage estimates using Xactimate estimating software. Review estimates for accuracy. May monitor contractor repair status and updates. Supervisory Responsibilities: None How you will benefit: * A competitive annual salary between $65,700 - $90,000 * ACG offers excellent and comprehensive benefits packages, including: * Medical, dental and vision benefits * 401k Match * Paid parental leave and adoption assistance * Paid Time Off (PTO), company paid holidays, CEO days, and floating holidays * Paid volunteer day annually * Tuition assistance program, professional certification reimbursement program and other professional development opportunities * AAA Membership * Discounts, perks, and rewards and much more We're looking for candidates who: Required Qualifications (these are the minimum requirements to qualify) Education: * Associate degree in Business Administration, Insurance or a related field or the equivalent in related work experience * Completion of the Insurance Institute of America's: General Insurance Program, Associate in Claims, associate in management or equivalent * CPCU coursework or designation * Xactware Training * Complete ACG Claim Representative Training Program or demonstrate equivalent knowledge or experience. * In states where an Adjuster's license is required, the candidate must be eligible to acquire a State Adjuster's license within 90 days of hire and maintain as specified for appropriate states. * Must have a valid State Driver's License Ability to: * Lift up to 25 pounds * Climb ladders. * Walk on roofs. Experience: * Three years of experience or equivalent training in the following: * Negotiation of claim settlements * Securing and evaluating evidence * Preparing manual and electronic estimates * Subrogation claims * Resolving coverage questions * Taking statements * Establishing clear evaluation and resolution plans for claims Knowledge and Skills: Advanced knowledge of: * Fair Trade Practices Act as it relates to claims * Subrogation procedures and processes * Intercompany arbitration * Handling simple litigation * Advanced knowledge of building construction and repair techniques Ability to: * Handle claims to the line Claim Handling Standards * Follow and apply ACG Claim policies, procedures and guidelines * Work within assigned ACG Claim systems including basic PC software * Perform basic claim file review and investigations * Demonstrate effective communication skills (verbal and written) * Demonstrate customer service skills by building and maintaining relationships with insureds/claimants while exhibiting understanding of their problems and responding to questions and concerns * Analyze and solve problems while demonstrating sound decision-making skills * Prioritize claim related functions * Process time sensitive data and information from multiple sources * Manage time, organize and plan workload and responsibilities * Safely operate a motor vehicle in order to visit repair facilities, homes (for inspections), patients, etc. * Research analyze and interpret subrogation laws in various states * May travel outside of assigned territory which may involve overnight stay Preferred Qualifications: Education: * Associate degree in Business Administration, Insurance or a related field or the equivalent in related work experience * Completion of the Insurance Institute of America's: General Insurance Program, Associate in Claims, Associate in Management or equivalent * CPCU coursework or designation * Xactware/Xactimate Training or equivalent Work Environment This position is currently able to work remotely from a home office location for day-to-day operations, with traveling to field locations as necessary to complete job responsibilities, unless occasional team building activities is specified by leadership. This is subject to change based on amendments and/or modifications to the ACG Flex Work policy. Who We Are Become a part of something bigger. The Auto Club Group (ACG) provides membership, travel, insurance, and financial service offerings to approximately 14+ million members and customers across 14 states and 2 U.S. territories through AAA, Meemic, and Fremont brands. ACG belongs to the national AAA federation and is the second largest AAA club in North America. By continuing to invest in more advanced technology, pursuing innovative products, and hiring a highly skilled workforce, AAA continues to build upon its heritage of providing quality service and helping our members enjoy life's journey through insurance, travel, financial services, and roadside assistance. And when you join our team, one of the first things you'll notice is that same, whole-hearted, enthusiastic advocacy for each other. We have positions available for every walk of life! AAA prides itself on creating an inclusive and welcoming environment of diverse backgrounds, experiences, and viewpoints, realizing our differences make us stronger. To learn more about AAA The Auto Club Group visit *********** Important Note: ACG's Compensation philosophy is to provide a market-competitive structure of fair, equitable and performance-based pay to attract and retain excellent talent that will enable ACG to meet its short and long-term goals. ACG utilizes a geographic pay differential as part of the base salary compensation program. Pay ranges outlined in this posting are based on the various ranges within the geographic areas which ACG operates. Salary at time of offer is determined based on these and other factors as associated with the job and job level. The above statements describe the principal and essential functions, but not all functions that may be inherent in the job. 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 accommodations will be made for otherwise qualified applicants, as needed, to enable them to fulfill these requirements. The Auto Club Group, and all its affiliated companies, is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, gender identity, sexual orientation, national origin, disability or protected veteran status. Regular and reliable attendance is essential for the function of this job. AAA The Auto Club Group is committed to providing a safe workplace. Every applicant offered employment within The Auto Club Group will be required to consent to a background and drug screen based on the requirements of the position.

By joining Sedgwick, you'll be part of something truly meaningful. It's what our 33,000 colleagues do every day for people around the world who are facing the unexpected. We invite you to grow your career with us, experience our caring culture, and enjoy work-life balance. Here, there's no limit to what you can achieve. Newsweek Recognizes Sedgwick as America's Greatest Workplaces National Top Companies Certified as a Great Place to Work Fortune Best Workplaces in Financial Services & Insurance Claims Representative (IAP) - Workers Compensation Training Program Are you looking for an impactful job requiring no prior experience that offers an opportunity to develop a professional career? + A stable and consistent work environment in an office setting. + A training program to learn how to help employees and customers from some of the world's most reputable brands. + An assigned mentor and manager who will guide you on your career journey. + Career development and promotional growth opportunities through increasing responsibilities. + A diverse and comprehensive benefits package to take care of your mental, physical, financial and professional needs. **PRIMARY PURPOSE OF THE ROLE:** To be oriented and trained as new industry professional with the ability to analyze workers compensation claims and determine benefits due. **ARE YOU AN IDEAL CANDIDATE?** We are seeking enthusiastic individuals for an entry-level trainee position. This role begins with a comprehensive 6-week classroom-based professional training program designed to equip you with the foundational skills needed for a successful career in claims adjusting. Over the course of a few years, you'll have the opportunity to grow and advance within the field. **ESSENTIAL RESPONSIBLITIES MAY INCLUDE** + Attendance and completion of designated classroom claims professional training program. + Performs on-the-job training activities including: + Adjusting lost-time workers compensation claims under close supervision. May be assigned medical only claims. + Adjusting low and mid-level liability and/or physical damage claims under close supervision. + Processing disability claims of minimal disability duration under close supervision. + Documenting claims files and properly coding claim activity. + Communicating claim action/processing with claimant and client. + Supporting other claims examiners and claims supervisors with larger or more complex claims as assigned. + Participates in rotational assignments to provide temporary support for office needs. **QUALIFICATIONS** Bachelor's or Associate's degree from an accredited college or university preferred. **EXPERIENCE** Prior education, experience, or knowledge of: - Customer Service - Data Entry - Medical Terminology (preferred) - Computer Recordkeeping programs (preferred) - Prior claims experience (preferred) Additional helpful experience: - State license if required (SIP, Property and Liability, Disability, etc.) - WCCA/WCCP or similar designations - For internal colleagues, completion of the Sedgwick Claims Progression Program **TAKING CARE OF YOU** + Entry-level colleagues are offered a world class training program with a comprehensive curriculum + An assigned mentor and manager that will support and guide you on your career journey + Career development and promotional growth opportunities + A diverse and comprehensive benefits offering including medical, dental vision, 401K, PTO and more _As required by law, Sedgwick provides a reasonable range of compensation for roles that may be hired in jurisdictions requiring pay transparency in job postings. Actual compensation is influenced by a wide range of factors including but not limited to skill set, level of experience, and cost of specific location. For the jurisdiction noted in this job posting only, the range of starting pay for this role is 25.65/hr. A comprehensive benefits package is offered including but not limited to, medical, dental, vision, 401k and matching, PTO, disability and life insurance, employee assistance, flexible spending or health savings account, and other additional voluntary benefits. #claims #claimsexaminer #entrylevel #remote #LI-Remote_ Sedgwick is an Equal Opportunity Employer and a Drug-Free Workplace. **If you're excited about this role but your experience doesn't align perfectly with every qualification in the job description, consider applying for it anyway! Sedgwick is building a diverse, equitable, and inclusive workplace and recognizes that each person possesses a unique combination of skills, knowledge, and experience. You may be just the right candidate for this or other roles.** **Sedgwick is the world's leading risk and claims administration partner, which helps clients thrive by navigating the unexpected. The company's expertise, combined with the most advanced AI-enabled technology available, sets the standard for solutions in claims administration, loss adjusting, benefits administration, and product recall. With over 33,000 colleagues and 10,000 clients across 80 countries, Sedgwick provides unmatched perspective, caring that counts, and solutions for the rapidly changing and complex risk landscape. For more, see** **sedgwick.com**

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 ************.

Title: Claims Clerk Reports to: Senior Client Success Manager FLSA Classification: Non-Exempt Full-Time or Part-Time: Full-Time Salary Range: $14 - $17 * Starting pay varies based on location and experience, in compliance with specific state wage regulations. Competitive rates tailored to your geography and expertise. Position Overview: The Claims Clerk is responsible for performing a variety of administrative and clerical tasks to support the claims process. This role focuses on managing documentation, processing insurance claims, and providing accurate and timely communication both internally and externally. The ideal candidate is detail-oriented, organized, and comfortable working in a fast-paced, production-driven environment. Key Responsibilities: Work accounts in the billing system Pull, sort, and mail/fax claims, and insurance documents as needed Respond promptly and professionally to internal and external inquiries Prepare and batch documents for the scanning department when necessary Schedule and document the next follow-up date in the system Transfer completed accounts to the appropriate work queues for follow-up Maintain accurate and timely documentation in accordance with client-specific guidelines Meet or exceed established production and quality assurance standards Communicate observed error trends or recurring issues to the team lead Call physician offices to obtain missing or additional information Process and document returned mail appropriately Coordinate with global partners as part of claims processing Other duties as assigned Qualifications: Proficiency with Microsoft Word and Excel Minimum typing speed of 40 words per minute Familiarity with 10-key calculators Experience using basic office equipment including printer, phone, fax, and copier Strong phone etiquette and professional communication skills High School Diploma or equivalent required Working knowledge of Adobe Acrobat Prior experience in healthcare, billing, or claim environment preferred Additional information: This description is intended to provide only basic guidelines for meeting job requirements. Responsibilities, knowledge, skills, abilities, and working conditions may change as needs evolve. Coronis Health is committed to creating a diverse and inclusive environment where all employees are treated fairly and with respect. We are an equal-opportunity employer, providing equal opportunities to all applicants and employees regardless of race, color, religion, sex, sexual orientation, gender identity, national origin, age, disability, or any other protected characteristic. We welcome and encourage applications from candidates of all backgrounds.

Are you looking for a career with a premier property management company? Do you want to be part of a team that was rated as one of the top 100 workplaces to be a part of by the Detroit Free Press, five years in a row? Are you searching for a company that celebrates the uniqueness that each individual brings to our team? Join KMG Prestige, where our motto to “Do the Right Thing” is not just words, it's who we are. We are seeking an Area Compliance Support Coordinator in the Ann Arbor, MI area who is detail oriented, enjoys new challenges, and thrives within a deadline driven schedule. The Area Certification Specialist is responsible for supporting Section 8 and Tax Credit communities in southeast Michigan with file audit prep, file audit response support, EIV oversight, MOR pre- inspections and prep, Special claims processing, internal file and compliance auditing, onsite compliance training and more. The ideal candidate is an organized problem solver with strong time management skills and a positive attitude. This position requires in-person work at assigned properties. You Have: Proficiency in Microsoft Word, Excel, and Outlook Excellent communication skills Ability to prioritize tasks and meet deadlines Exceptional organizational skills Experience in affordable housing Demonstrated ability to work independently We Have: Medical Dental Vision Telemedicine Flexible Spending Account 401k (with employer match) Paid Time Off Parental Leave Life & Disability Insurance Tuition Reimbursement Pet Insurance Employee Assistance Program Wellness Program If you are excited to join a team that is striving to become the best, most respected property management company in the industry , please submit your resume. KMG Prestige is an Equal Opportunity Employer who is passionate about being a diverse and inclusive organization. Please contact us should you require accommodations in the application process.

OBJECTIVE AMD Claims Representative Objective To provide an efficient settlement of automobile physical damage losses while providing a WOW! customer experience. RESPONSIBILITIES AMD Claims Representative Responsibilities Complete appraisals and evaluate damage on vehicles. Relate appraisals to appropriate repair costs so as to have a significant positive effect on the overall profit picture of the company and provide quality service to the customer and aid in the retention of business. Maintain general knowledge of automobile repairs, procedures and accepted repair practices. Stay informed of the latest changes and updates in automobile repairs and technology. Focus on customer service by maintaining timely contacts with customers to inform them of their claim status and their role in the settlement process. Work with customers to agree upon a fair and equitable settlement on total loss claims using market information, condition of the vehicle, mileage and equipment to determine the value. Obtain titles, discharge of liens and letters of guaranty to assist salvage technicians in the sale of salvage vehicles. Ensure timely disposal of salvage vehicles in order to control excess storage and auction fees. Review auto claims for accuracy, and authorize and issue payments accordingly. Coordinate car rental coverage and billing for Farm Bureau customers and claimants according to policy coverage. Review police reports to determine fault in auto accidents. Assess liability, subrogation potential and underwriting concerns in first and third party exposures. Negotiate liability on out-of-state automobile claims. Assign out-of-state claims to independent appraisal companies while giving direction on coverage, liability and subrogation. Resolve complaints/concerns regarding claim issues from insureds, claimants, agents, and attorneys via the phone and customer walk-ins. Assist AMD Team Leader with coordinating workflows, new procedures and training assistance. Maintain general knowledge of all physical damage contracts written by the companies, their various endorsements, exclusions, company procedures and accepted claim practices. Maintain general knowledge of insurance law as it relates to the physical damage contracts written by the companies. Remain up-to-date with trends and developments in the insurance industry. QUALIFICATIONS AMD Claims Representative Qualifications : High school diploma or equivalent required. One to three years' experience required. Must possess basic knowledge of computer word processing. Possess the capability to converse with customers regarding the settlement of automobile claims required. Preferred: Bachelor's degree preferred. Note: If a candidate is not identified, a Senior Claims Representative may be considered based on level of experience. Farm Bureau offers a full benefit package including medical, dental, vision, and 401K. PM19

Provides analyst support for claims research activities including reviewing and researching claims to ensure regulatory requirements are appropriately applied, identifying root-cause of processing errors through research and analysis, coordinating and engaging with appropriate departments, developing and tracking remediation plans, and monitoring claims reprocessing through resolution. **Essential Job Duties** - Serves as claims subject matter expert - using analytical skills to conduct research and analysis to address issues, requests, and support high-priority claims inquiries and projects. - Interprets and presents in-depth analysis of claims research findings and results to leadership and respective operations teams. - Manages and leads major claims projects of considerable complexity and volume that may be initiated internally, or through provider inquiries/complaints, or legal requests. - Assists with reducing rework by identifying and remediating claims processing issues. - Locates and interprets claims-related regulatory and contractual requirements. - Tailors existing reports and/or available data to meet the needs of claims projects. - Evaluates claims using standard principles and applicable state-specific regulations to identify claims processing errors. - Applies claims processing and technical knowledge to appropriately define a path for short/long-term systematic or operational fixes. - Seeks to improve overall claims performance, and ensure claims are processed accurately and timely. - Identifies claims requiring reprocessing or readjudication in a timely manner to ensure compliance. - Works collaboratively with internal/external stakeholders to define claims requirements. - Recommends updates to claims standard operating procedures (SOPs) and job aids to increase the quality and efficiency of claims processing. - Fields claims questions from the operations team. - Interprets, communicates, and presents, clear in-depth analysis of claims research results, root-cause analysis, remediation plans and fixes, overall progress, and status of impacted claims. - Appropriately conveys claims-related information and tailors communication based on targeted audiences. - Provides sufficient claims information to internal operations teams that communicate externally with providers and/or members. - Collaborates with other functional teams on claims-related projects, and completes tasks within designated/accelerated timelines to minimize provider/member impacts and maintain compliance. - Supports claims department initiatives to improve overall claims function efficiency. **Required Qualifications** - At least 3 years of medical claims processing experience, or equivalent combination of relevant education and experience. - Medical claims processing experience across multiple states, markets, and claim types. - Knowledge of claims processing related to inpatient/outpatient facilities contracted with Medicare, Medicaid, and Marketplace government-sponsored programs. - Data research and analysis skills. - Organizational skills and attention to detail. - Time-management skills, and ability to manage simultaneous projects and tasks to meet internal deadlines. - Ability to work cross-collaboratively in a highly matrixed organization. - Customer service skills. - Effective verbal and written communication skills. - Microsoft Office suite (including Excel), and applicable software programs proficiency. **Preferred Qualifications** - Health care claims analysis experience. - Project management experience. To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V Pay Range: $21.16 - $46.42 / HOURLY *Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

Eligible candidates for this role should reside within a commutable distance of Saginaw, Michigan. Job Title- Field Property Claim Specialist Reports to: Claim Manager II What you will do: Work under minimal supervision with a high-level approval authority to handle complex technical issues and complex claims. * Review assigned claims, * Contacting the insured and other affected parties, set expectations for the remainder of the claim process, and initiate documentation in the claim handling system. * Complete complex coverage analysis. * Ensure all possible policyholder benefits are identified. * Create additional sub-claims if needed. * Complete an investigation of the facts regarding the claim to further and in more detail determine if the claim should be paid, the applicable limits or exclusions and possible recovery potential. * Conduct thorough reviews of damages and determine the applicability of state law and other factors related to the claim. * Evaluate the financial value of the loss. * Approve payments for the appropriate parties accordingly. * Refer claims to other company units when necessary (e.g., Underwriting, Recovery Units or Claims Special Investigation Unit). * Thoroughly document and/or code the claim file and complete all claim closure and related activities in the assigned claims management system. * Utilize strong negotiating skills. Employees will be assigned to the Michigan Homeowner claim unit and will handle claims generally valued between $10,000 and $75,000 and occasionally over $100,000 for field role. Investigate claims requiring coverage analysis. When handling claims in the field, must prepare damage estimates using Xactimate estimating software. Review estimates for accuracy. May monitor contractor repair status and updates. Supervisory Responsibilities: None How you will benefit: * A competitive annual salary between $65,700 - $82,000 * ACG offers excellent and comprehensive benefits packages, including: * Medical, dental and vision benefits * 401k Match * Paid parental leave and adoption assistance * Paid Time Off (PTO), company paid holidays, CEO days, and floating holidays * Paid volunteer day annually * Tuition assistance program, professional certification reimbursement program and other professional development opportunities * AAA Membership * Discounts, perks, and rewards and much more We're looking for candidates who: Required Qualifications (these are the minimum requirements to qualify) Education: * Associate degree in Business Administration, Insurance or a related field or the equivalent in related work experience * Completion of the Insurance Institute of America's: General Insurance Program, Associate in Claims, associate in management or equivalent * CPCU coursework or designation * Xactware Training * Complete ACG Claim Representative Training Program or demonstrate equivalent knowledge or experience. * In states where an Adjuster's license is required, the candidate must be eligible to acquire a State Adjuster's license within 90 days of hire and maintain as specified for appropriate states. * Must have a valid State Driver's License Ability to: * Lift up to 25 pounds * Climb ladders. * Walk on roofs. Experience: * Three years of experience or equivalent training in the following: * Negotiation of claim settlements * Securing and evaluating evidence * Preparing manual and electronic estimates * Subrogation claims * Resolving coverage questions * Taking statements * Establishing clear evaluation and resolution plans for claims Knowledge and Skills: Advanced knowledge of: * Fair Trade Practices Act as it relates to claims * Subrogation procedures and processes * Intercompany arbitration * Handling simple litigation * Advanced knowledge of building construction and repair techniques Ability to: * Handle claims to the line Claim Handling Standards * Follow and apply ACG Claim policies, procedures and guidelines * Work within assigned ACG Claim systems including basic PC software * Perform basic claim file review and investigations * Demonstrate effective communication skills (verbal and written) * Demonstrate customer service skills by building and maintaining relationships with insureds/claimants while exhibiting understanding of their problems and responding to questions and concerns * Analyze and solve problems while demonstrating sound decision-making skills * Prioritize claim related functions * Process time sensitive data and information from multiple sources * Manage time, organize and plan workload and responsibilities * Safely operate a motor vehicle in order to visit repair facilities, homes (for inspections), patients, etc. * Research analyze and interpret subrogation laws in various states * May travel outside of assigned territory which may involve overnight stay Preferred Qualifications: Education: * Associate degree in Business Administration, Insurance or a related field or the equivalent in related work experience * Completion of the Insurance Institute of America's: General Insurance Program, Associate in Claims, Associate in Management or equivalent * CPCU coursework or designation * Xactware/Xactimate Training or equivalent Work Environment This position is currently able to work remotely from a home office location for day-to-day operations, with traveling to field locations as necessary to complete job responsibilities, unless occasional team building activities is specified by leadership. This is subject to change based on amendments and/or modifications to the ACG Flex Work policy. Who We Are Become a part of something bigger. The Auto Club Group (ACG) provides membership, travel, insurance, and financial service offerings to approximately 14+ million members and customers across 14 states and 2 U.S. territories through AAA, Meemic, and Fremont brands. ACG belongs to the national AAA federation and is the second largest AAA club in North America. By continuing to invest in more advanced technology, pursuing innovative products, and hiring a highly skilled workforce, AAA continues to build upon its heritage of providing quality service and helping our members enjoy life's journey through insurance, travel, financial services, and roadside assistance. And when you join our team, one of the first things you'll notice is that same, whole-hearted, enthusiastic advocacy for each other. We have positions available for every walk of life! AAA prides itself on creating an inclusive and welcoming environment of diverse backgrounds, experiences, and viewpoints, realizing our differences make us stronger. To learn more about AAA The Auto Club Group visit *********** Important Note: ACG's Compensation philosophy is to provide a market-competitive structure of fair, equitable and performance-based pay to attract and retain excellent talent that will enable ACG to meet its short and long-term goals. ACG utilizes a geographic pay differential as part of the base salary compensation program. Pay ranges outlined in this posting are based on the various ranges within the geographic areas which ACG operates. Salary at time of offer is determined based on these and other factors as associated with the job and job level. The above statements describe the principal and essential functions, but not all functions that may be inherent in the job. 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 accommodations will be made for otherwise qualified applicants, as needed, to enable them to fulfill these requirements. The Auto Club Group, and all its affiliated companies, is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, gender identity, sexual orientation, national origin, disability or protected veteran status. Regular and reliable attendance is essential for the function of this job. AAA The Auto Club Group is committed to providing a safe workplace. Every applicant offered employment within The Auto Club Group will be required to consent to a background and drug screen based on the requirements of the position.

*There are multiple positions open across the 26 states in which we operate. The current locations for which we are seeking CAT Claim Reps are located in the job posting.* Auto-Owners Insurance, a top-rated insurance carrier, is seeking an experienced and motivated claims professional to join our team. The position requires the following, but is not limited to: Frequent travel up to 21 days at a time and is required upon short notice to location of catastrophe, which would most likely be out of state. Can meet the physical demands required for the position including carrying and climbing a ladder. Investigate and assemble facts, determine policy coverage, evaluate the amount of loss, analyze legal liability and pay or deny losses. Familiar with insurance coverage by studying insurance policies, endorsements and forms. Work towards the resolution of claims, possibly attending arbitrations, mediations, depositions or trials as necessary. Ensure that claims payments are issued in a timely and accurate manner. Desired Skills & Experience Bachelor's degree or equivalent experience Minimum of 2 years claims handling experience or comparable experience Field claims experience with multi-line property and casualty claims and wind/hail Proficient with Xactimate software Above-average communication skills (written and verbal) Ability to resolve complex issues Organize and interpret data Ability to handle multiple assignments Possess a valid driver's license Military experience is considered Benefits Competitive salary, matching 401(k) retirement plans, fully funded pension plan, bonus programs, paid holidays, vacation days, personal days, paid sick leave and a comprehensive health care plan. 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-KC1 #LI-Hybrid

OBJECTIVE Associate Property Claims Representative Objective To assure the consistent application of company procedures and practices in commercial, residential, farm property and property damage liability claim handling, so as to have a significant and positive overall effect on the company. To provide quality service to insureds and aid in the retention of business. To ensure that claims are properly investigated, evaluated and resolved within the company's contractual and legal obligations. To ensure timely service, while providing appropriate and equitable resolution to insureds, claimants and the company. RESPONSIBILITIES Associate Property Claims Representative Responsibilities Investigate, evaluate and control property and casualty claims under close supervision. Acquire working knowledge of general procedures and good claim practices. Acquire basic working knowledge of various types of buildings, construction, and repair costs and methods, repair estimating system and scoping damages. QUALIFICATIONS Associate Property Claims Representative Qualifications Required: High school diploma or equivalent required. Minimum one year experience with direct public contact, such as sales or service representatives required. Must possess outstanding listening and superior customer service skills. Must have access to high speed Internet at home if position is field-based. Must be able to live within a defined territory. Must possess a valid driver license with an acceptable driving record. Preferred: Bachelor's degree with focus on construction trades, agriculture-related studies, business administration or insurance-related field preferred. Knowledge of company and divisional policies and procedures preferred. Designations in INS, AIC, CPCU and/or similar professional insurance designation preferred. Note: If a candidate is not identified, a Property Claims Representative may be considered based on level of experience. Farm Bureau offers a full benefit package including medical, dental, vision, and 401K. PM19

The Provider Claims Adjudicator is responsible for responding to providers regarding issues with claims, coordinating, investigates and confirms the appropriate resolution of claims issues. This role will require actively researching issues to adjudicate claims Requires knowledge of operational areas and systems. Knowledge/Skills/Abilities * Facilitates the resolution of claims issues, including incorrectly paid claims, by working with operational areas and provider billings and analyzing the systems. * This role is involved in member enrollment, provider information management, benefits configuration and/or claims processing. * Responds to incoming calls from providers regarding claims inquiries and provides excellent customer service; documents calls and interactions. * Assists in the reviews of state or federal complaints related to claims. * Supports the other team members with several internal departments to determine appropriate resolution of issues. * Researches tracers, adjustments, and re-submissions of claims. * Adjudicates or re-adjudicates high volume of claims in a timely manner to ensure compliance to departmental turn-around time and quality standards. * Manages defect reduction by supporting the identifying and communicating error issues and potential solutions to management. * Handles special projects as assigned. * Other duties as assigned. Knowledgeable in systems utilized: * QNXT * Pega * Verint * Kronos * Microsoft Teams * Video Conferencing * Others as required by line of business or state Job Function Provides customer support and stellar service to assist Molina providers with claims inquiries. Leads and resolves issues and addresses needs appropriately and effectively, while demonstrating Molina values in their actions. Responsible for effectively managing and documenting calls and responding to providers regarding issues with claims and inquiries. Handles escalated inquiries, complex provider claims payments, records, and provides counsel to providers. Helps to mentor and coach Provider Claims Adjudicators. Job Qualifications REQUIRED EDUCATION: Associate's Degree or equivalent combination of education and experience; REQUIRED EXPERIENCE: 2-3 years customer service, claims, provider and investigation/research experience. Outcome focused and knowledge of multiple systems. 1+ years of claims research and/or issue resolution or analysis of reimbursement methodologies within the managed care health care industry PREFERRED EDUCATION: Bachelor's Degree or equivalent combination of education and experience PREFERRED EXPERIENCE: 4 years PHYSICAL DEMANDS: Working environment is generally favorable and lighting and temperature are adequate. Work is generally performed in a home or office environment in which there is only minimal exposure to unpleasant and/or hazardous working conditions. Must have the ability to sit for long periods. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential function. To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V. Pay Range: $21.16 - $38.37 / HOURLY * Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level. About Us Molina Healthcare is a nationwide fortune 500 organization with a mission to provide quality healthcare to people receiving government assistance. If you are seeking a meaningful opportunity in a team-oriented environment, come be a part of a highly engaged workforce dedicated to our mission. Bring your passion and talents and together we can make a difference in the lives of others. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.

Eligible candidates for this role should reside within a commutable distance of Saginaw, Michigan. Job Title- Field Property Claim Specialist Reports to: Claim Manager II What you will do: Work under minimal supervision with a high-level approval authority to handle complex technical issues and complex claims. * Review assigned claims, * Contacting the insured and other affected parties, set expectations for the remainder of the claim process, and initiate documentation in the claim handling system. * Complete complex coverage analysis. * Ensure all possible policyholder benefits are identified. * Create additional sub-claims if needed. * Complete an investigation of the facts regarding the claim to further and in more detail determine if the claim should be paid, the applicable limits or exclusions and possible recovery potential. * Conduct thorough reviews of damages and determine the applicability of state law and other factors related to the claim. * Evaluate the financial value of the loss. * Approve payments for the appropriate parties accordingly. * Refer claims to other company units when necessary (e.g., Underwriting, Recovery Units or Claims Special Investigation Unit). * Thoroughly document and/or code the claim file and complete all claim closure and related activities in the assigned claims management system. * Utilize strong negotiating skills. Employees will be assigned to the Michigan Homeowner claim unit and will handle claims generally valued between $10,000 and $75,000 and occasionally over $100,000 for field role. Investigate claims requiring coverage analysis. When handling claims in the field, must prepare damage estimates using Xactimate estimating software. Review estimates for accuracy. May monitor contractor repair status and updates. Supervisory Responsibilities: None How you will benefit: * A competitive annual salary between $65,700 - $82,000 * ACG offers excellent and comprehensive benefits packages, including: * Medical, dental and vision benefits * 401k Match * Paid parental leave and adoption assistance * Paid Time Off (PTO), company paid holidays, CEO days, and floating holidays * Paid volunteer day annually * Tuition assistance program, professional certification reimbursement program and other professional development opportunities * AAA Membership * Discounts, perks, and rewards and much more We're looking for candidates who: Required Qualifications (these are the minimum requirements to qualify) Education: * Associate degree in Business Administration, Insurance or a related field or the equivalent in related work experience * Completion of the Insurance Institute of America's: General Insurance Program, Associate in Claims, associate in management or equivalent * CPCU coursework or designation * Xactware Training * Complete ACG Claim Representative Training Program or demonstrate equivalent knowledge or experience. * In states where an Adjuster's license is required, the candidate must be eligible to acquire a State Adjuster's license within 90 days of hire and maintain as specified for appropriate states. * Must have a valid State Driver's License Ability to: * Lift up to 25 pounds * Climb ladders. * Walk on roofs. Experience: * Three years of experience or equivalent training in the following: * Negotiation of claim settlements * Securing and evaluating evidence * Preparing manual and electronic estimates * Subrogation claims * Resolving coverage questions * Taking statements * Establishing clear evaluation and resolution plans for claims Knowledge and Skills: Advanced knowledge of: * Fair Trade Practices Act as it relates to claims * Subrogation procedures and processes * Intercompany arbitration * Handling simple litigation * Advanced knowledge of building construction and repair techniques Ability to: * Handle claims to the line Claim Handling Standards * Follow and apply ACG Claim policies, procedures and guidelines * Work within assigned ACG Claim systems including basic PC software * Perform basic claim file review and investigations * Demonstrate effective communication skills (verbal and written) * Demonstrate customer service skills by building and maintaining relationships with insureds/claimants while exhibiting understanding of their problems and responding to questions and concerns * Analyze and solve problems while demonstrating sound decision-making skills * Prioritize claim related functions * Process time sensitive data and information from multiple sources * Manage time, organize and plan workload and responsibilities * Safely operate a motor vehicle in order to visit repair facilities, homes (for inspections), patients, etc. * Research analyze and interpret subrogation laws in various states * May travel outside of assigned territory which may involve overnight stay Preferred Qualifications: Education: * Associate degree in Business Administration, Insurance or a related field or the equivalent in related work experience * Completion of the Insurance Institute of America's: General Insurance Program, Associate in Claims, Associate in Management or equivalent * CPCU coursework or designation * Xactware/Xactimate Training or equivalent Work Environment This position is currently able to work remotely from a home office location for day-to-day operations, with traveling to field locations as necessary to complete job responsibilities, unless occasional team building activities is specified by leadership. This is subject to change based on amendments and/or modifications to the ACG Flex Work policy. Who We Are Become a part of something bigger. The Auto Club Group (ACG) provides membership, travel, insurance, and financial service offerings to approximately 14+ million members and customers across 14 states and 2 U.S. territories through AAA, Meemic, and Fremont brands. ACG belongs to the national AAA federation and is the second largest AAA club in North America. By continuing to invest in more advanced technology, pursuing innovative products, and hiring a highly skilled workforce, AAA continues to build upon its heritage of providing quality service and helping our members enjoy life's journey through insurance, travel, financial services, and roadside assistance. And when you join our team, one of the first things you'll notice is that same, whole-hearted, enthusiastic advocacy for each other. We have positions available for every walk of life! AAA prides itself on creating an inclusive and welcoming environment of diverse backgrounds, experiences, and viewpoints, realizing our differences make us stronger. To learn more about AAA The Auto Club Group visit *********** Important Note: ACG's Compensation philosophy is to provide a market-competitive structure of fair, equitable and performance-based pay to attract and retain excellent talent that will enable ACG to meet its short and long-term goals. ACG utilizes a geographic pay differential as part of the base salary compensation program. Pay ranges outlined in this posting are based on the various ranges within the geographic areas which ACG operates. Salary at time of offer is determined based on these and other factors as associated with the job and job level. The above statements describe the principal and essential functions, but not all functions that may be inherent in the job. 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 accommodations will be made for otherwise qualified applicants, as needed, to enable them to fulfill these requirements. The Auto Club Group, and all its affiliated companies, is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, gender identity, sexual orientation, national origin, disability or protected veteran status. Regular and reliable attendance is essential for the function of this job. AAA The Auto Club Group is committed to providing a safe workplace. Every applicant offered employment within The Auto Club Group will be required to consent to a background and drug screen based on the requirements of the position.

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 claims trainee to join our team. This job handles entry-level insurance claims under close supervision through the life-cycle of a claim including but not limited to: investigation, evaluation, and claim resolution. This job provides service to agents, insureds, and others to ensure claims resolve accurately and timely. This job includes training and development completion of the Company's claims training program for the assigned line of insurance and requires the person to: Investigate, evaluate, and settle entry-level insurance claims Study insurance policies, endorsements, and forms to develop foundational knowledge on Company insurance products Learn and comply with Company claim handling procedures Develop entry-level claim negotiation and settlement skills Build skills to effectively serve the needs of agents, insureds, and others Meet and communicate with claimants, legal counsel, and third-parties Develop specialized skills including but not limited to, estimating and use of designated computer-based programs for loss adjustment Study, obtain, and maintain an adjuster's license(s), if required by statute within the timeline established by the Company or legal requirements Desired Skills & Experience Bachelor's degree or direct equivalent experience with property/casualty claims handling Ability to organize data, multi-task and make decisions independently Above average communication skills (written and verbal) Ability to write reports and compose correspondence Ability to resolve complex issues Ability to maintain confidentially and data security Ability to effectively deal with a diverse group individuals Ability to accurately deal with mathematical problems, including, geometry (area and volume) and financial areas (such as accuracy in sums, unit costs, and the capacity to read and develop understanding of personal and business finance documents) Ability to drive an automobile, possess a valid driver license, and maintain a driving record consistent with the Company's underwriting guidelines for coverage Continually develop product knowledge through participation in approved educational programs 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-KC1 #LI-Hybrid

OBJECTIVE MACP Subrogation Claims Representative Objective To maximize the recovery of Farm Bureau Insurance paid claims by handling Michigan Assigned Claims Plan (MACP) subrogation efforts for recovery cases, as well as provide technical support for the Assigned Claims Unit. RESPONSIBILITIES MACP Subrogation Claims Representative Responsibilities Review and evaluate each subrogation file as directed to determine if all pertinent investigative information has been provided. Follow up with adjusters as necessary to obtain additional information. Work with computer systems keying functions, including but not limited to, letter composition, log entry, time entry, diary entry, report of investigation composition, and draft production. Handle subrogation claims on behalf of the Michigan Assigned Claims Plan. Confirm file closings and subrogation assignments. Develop a working knowledge of the Michigan No-Fault Law and Statute of Limitations that apply and maintain timely payments. QUALIFICATIONS MACP Subrogation Claims Representative Qualifications Required · High school diploma or equivalent required. · Minimum two years of experience in auto, property, or liability claims handling required. Preferred · Bachelor's degree or professional insurance designation preferred. Note: Possible travel to court appearances. Farm Bureau offers a full benefit package including medical, dental, vision, and 401K. PM19