Claim processor jobs in Flint, 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.

SCCMHA JOB VACANCY ANNOUNCEMENT CLASSIFICATION: Claims Processor PAY GRADE: $21.85 - $25.69 Hourly Under the general supervision of the Chief of Network Business Operations, this position will have the primary responsibility of processing provider network and hospital claims for payment. This position requires claims coordination of benefits (COB) experience ensuring all third-party insurance carriers have been appropriately billed prior to Saginaw County Community Mental Health Authority (SCCMHA) claims payment. The tasks of this position have monthly claims batch payment deadlines, which are coordinated with the other staff within the accounting department. This position must maintain current knowledge of regulations pertaining to approved CPT/HCPCS and Revenue Codes, methods of billing, and procedures related to Medicaid/Medicare and various unique Commercial Insurance reimbursements rules. This position will be knowledgeable about and actively support culturally competent recovery based practices; person centered planning as a shared decision making process with the individual, who defines his/her life goals and is assisted in developing a unique path toward those goals; and a trauma informed culture of safety to aid consumer in the recovery process. ESSENTIAL DUTIES AND RESPONSIBLITIES: 1. Coordinate and adjudicate paper and electronic claims submitted by the provider network and hospitals for payment in accordance with policies and procedures. Approve clean claims for payment. Assist as applicable with denied claims. Submit overrides for approval when appropriate. 2. Verify authorizations as they pertain to proper coding, dating, and fund source. 3. Review coordination of benefits documents prior to claims payment. Verify the Explanation of Benefits submitted by the Provider matches the Coordination of Benefits information on file for the consumer. Ensure reason codes are reasonable. Follow-up with provider as necessary to resolve discrepancies. 4. Process Event Verification settlements following Network Service Auditing review. 5. Process retro payments when contracted rates are modified. 6. Verify all the backup for each provider check/EFT is an agreement prior to mailing the payment. 7. Research, compile and prepare claim(s) remittance reports and other statistical data. Reconcile provider explanation of benefits (EOB) back to the claims detail. Interpret provider contract rates and requirements as they pertain to claims payment and provider benefit packages. 8. Help to establish and implement ongoing improvements to procedures for claims processing. 9. Answer telephones/work with providers to obtain timely, accurate and complete claims data. Train providers or other staff when needed of proper SCCMHA claims processing requirements. 10. Enter daily CTN/CTS skill build SALs into Sentri based on daily attendance calendars submitted by the respective programs. Reconcile the SALs to the CTN/CTS attendance sheets. 11. Process consumer Ability to Pay (ATP) based upon CFIS documents. Enter consumer ATP's data into Sentri. Perform insurance verification as applicable. 12. Provide backup and other miscellaneous duties as assigned. 13. Adheres to the mission, vision, core values and operating principles of SCCMHA at all times. INCIDENTAL DUTIES AND RESPONSIBILITES: 1. Communicates well with consumers, co-workers, and supervisors and meets deadlines and follows through with others as promised in order to provide additional information and/or to answer questions. 2. Demonstrates the ability to provide exceptional customer service to all consumers, staff, and providers of service. 3. Obtains necessary computer training in order to stay current with system changes as needed to complete all tasks related to this position. Works independently to stay informed of changes made within the assigned service area. 4. Attends meetings, in-service training, etc, as required for the finance department, the assigned service area or the Authority. 5. Reacts productively and responsively to change and handles other essential tasks as assigned. 6. Insures that the front desk is covered at all times in order to provide necessary customer service. (The above statements are intended to describe the general nature and level of work being performed by people assigned to this classification. They are not intended to be construed as an exhaustive list of all duties and responsibilities required of personnel so classified.) REPORTING RELATIONSHIPS: Reports to: Chief of Network Business Operations Supervises: None WORKING CONDITIONS/ENVIRONMENT: Works in office environment with usual pressures of time constraints and stress of long periods of computer use. Performs daily data entry of confidential financial data for individuals suffering from mentally ill or developmentally disabled. QUALIFICATIONS: Education: Associate Degree with healthcare related courses required. Medical terminology and medical billing college level courses required. Experience: Three (3) years of healthcare claims processing (including coordination of benefits) experience required. Licenses and Certifications: Valid Michigan Driver's license with a good driving record. Knowledge, Skills, and Abilities: 1. Professional knowledge of and ability to use computerized accounting software such as Great Plains. 2. Proficiency in Microsoft Office including Word, Excel, Access, and Outlook. 3. Comprehensive knowledge of the billing processing working with an Electronic Medical Records Healthcare System. 4. Knowledge of medical terminology and medical procedures associated with clinical billing codes. 5. Ability to communicate well with others and occasionally deal with irate individuals. 6. High degree of attention to detail. 7. Ability to diplomatically associate and relate to individuals of all social, economical, and cultural backgrounds. 8. Must be skilled in normal office procedures such as written and verbal correspondence and use of calculator and other office machines. 9. Maintaining a current knowledge of regulatory policies, procedures, and reporting will be required. Physical/Mental Requirements: 1. Hearing acuity to converse in person and on telephone. 2. Visual Acuity to read and proofread documents and use CRT. 3. Ability to walk, stand or sit for extended periods of time. 4. Manual dexterity to write and to operate standard office equipment (PC, Keyboard, Copy Machine, Fax Machine, etc.) 5. Ability to lift and carry files and supplies at least 20 pounds. 6. Strong interpersonal skills to interact with leadership, employees, consumers and the general public. 7. Mental capacity to think independently, follow instruction and use judgment. 8. Analytical skills necessary to conduct research, analyze, and interpret complex data and identify and solve problems by proposing courses of action. 9. Ability to plan short and long range and to manage and schedule time. 10. Ability to handle stress in meeting deadlines and dealing with large numbers of employees and/or consumers. (Listed qualifications are for guidance in filling this position. Any combination of education and experience that provides the necessary knowledge, skills, and abilities will be considered; however, mandatory licensing or certification requirements cannot be waived. Physical/mental requirements cannot be waived unless specifically indicated.)

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.

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.

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

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.

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: ************

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: ************

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.

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).

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).

OBJECTIVE Medical Claims Representative Objective To provide efficient investigation, evaluation and negotiation of Michigan No-Fault and/or Michigan Assigned Claims Plan. RESPONSIBILITIES Medical Claims Representative Responsibilities Respond to and control the disposition of all assigned Michigan No Fault Michigan Assigned Claims Plan. Work with computer systems keying functions, including but not limited to letter composition, log entry, diary entry, report of investigation composition and draft production. Read and apply policy of Michigan No-Fault MACP acts as written. Mathematically calculate work loss benefits for Michigan No-Fault Michigan Assigned Claims Plan claimants. Conduct business via frequent use of telephone. Review, evaluate an adjust reserves within company guidelines. Develop professional relationships with attorneys, physicians, and claims related professionals both inside and outside of the company. Maintain a personal development program. Read and interpret medical reports. Gain a general understanding of Michigan No-Fault/Michigan Assigned Claims Plan and laws. Periodically attend trials and court appearances and give testimony as may be required. Actively participate in meetings, round table discussions, and other collaborative efforts. QUALIFICATIONS Medical Claims Representative Qualifications Required High school diploma or equivalent required. Minimum two to three years medical claims handling experience required, Must possess a valid drivers license with an acceptable driving record. Preferred Bachelor's degree in business administration preferred. Designation in claims insurance preferred. Note: Farm Bureau offers a full benefit package including medical, dental, vision, and 401K. PM19

SCCMHA JOB VACANCY ANNOUNCEMENT CLASSIFICATION: Claims Processor PAY GRADE: $21.85 - $25.69 Hourly Under the general supervision of the Chief of Network Business Operations, this position will have the primary responsibility of processing provider network and hospital claims for payment. This position requires claims coordination of benefits (COB) experience ensuring all third-party insurance carriers have been appropriately billed prior to Saginaw County Community Mental Health Authority (SCCMHA) claims payment. The tasks of this position have monthly claims batch payment deadlines, which are coordinated with the other staff within the accounting department. This position must maintain current knowledge of regulations pertaining to approved CPT/HCPCS and Revenue Codes, methods of billing, and procedures related to Medicaid/Medicare and various unique Commercial Insurance reimbursements rules. This position will be knowledgeable about and actively support culturally competent recovery based practices; person centered planning as a shared decision making process with the individual, who defines his/her life goals and is assisted in developing a unique path toward those goals; and a trauma informed culture of safety to aid consumer in the recovery process. ESSENTIAL DUTIES AND RESPONSIBLITIES: 1. Coordinate and adjudicate paper and electronic claims submitted by the provider network and hospitals for payment in accordance with policies and procedures. Approve clean claims for payment. Assist as applicable with denied claims. Submit overrides for approval when appropriate. 2. Verify authorizations as they pertain to proper coding, dating, and fund source. 3. Review coordination of benefits documents prior to claims payment. Verify the Explanation of Benefits submitted by the Provider matches the Coordination of Benefits information on file for the consumer. Ensure reason codes are reasonable. Follow-up with provider as necessary to resolve discrepancies. 4. Process Event Verification settlements following Network Service Auditing review. 5. Process retro payments when contracted rates are modified. 6. Verify all the backup for each provider check/EFT is an agreement prior to mailing the payment. 7. Research, compile and prepare claim(s) remittance reports and other statistical data. Reconcile provider explanation of benefits (EOB) back to the claims detail. Interpret provider contract rates and requirements as they pertain to claims payment and provider benefit packages. 8. Help to establish and implement ongoing improvements to procedures for claims processing. 9. Answer telephones/work with providers to obtain timely, accurate and complete claims data. Train providers or other staff when needed of proper SCCMHA claims processing requirements. 10. Enter daily CTN/CTS skill build SALs into Sentri based on daily attendance calendars submitted by the respective programs. Reconcile the SALs to the CTN/CTS attendance sheets. 11. Process consumer Ability to Pay (ATP) based upon CFIS documents. Enter consumer ATP's data into Sentri. Perform insurance verification as applicable. 12. Provide backup and other miscellaneous duties as assigned. 13. Adheres to the mission, vision, core values and operating principles of SCCMHA at all times. INCIDENTAL DUTIES AND RESPONSIBILITES: 1. Communicates well with consumers, co-workers, and supervisors and meets deadlines and follows through with others as promised in order to provide additional information and/or to answer questions. 2. Demonstrates the ability to provide exceptional customer service to all consumers, staff, and providers of service. 3. Obtains necessary computer training in order to stay current with system changes as needed to complete all tasks related to this position. Works independently to stay informed of changes made within the assigned service area. 4. Attends meetings, in-service training, etc, as required for the finance department, the assigned service area or the Authority. 5. Reacts productively and responsively to change and handles other essential tasks as assigned. 6. Insures that the front desk is covered at all times in order to provide necessary customer service. (The above statements are intended to describe the general nature and level of work being performed by people assigned to this classification. They are not intended to be construed as an exhaustive list of all duties and responsibilities required of personnel so classified.) REPORTING RELATIONSHIPS: Reports to: Chief of Network Business Operations Supervises: None WORKING CONDITIONS/ENVIRONMENT: Works in office environment with usual pressures of time constraints and stress of long periods of computer use. Performs daily data entry of confidential financial data for individuals suffering from mentally ill or developmentally disabled. QUALIFICATIONS: Education: Associate Degree with healthcare related courses required. Medical terminology and medical billing college level courses required. Experience: Three (3) years of healthcare claims processing (including coordination of benefits) experience required. Licenses and Certifications: Valid Michigan Driver's license with a good driving record. Knowledge, Skills, and Abilities: 1. Professional knowledge of and ability to use computerized accounting software such as Great Plains. 2. Proficiency in Microsoft Office including Word, Excel, Access, and Outlook. 3. Comprehensive knowledge of the billing processing working with an Electronic Medical Records Healthcare System. 4. Knowledge of medical terminology and medical procedures associated with clinical billing codes. 5. Ability to communicate well with others and occasionally deal with irate individuals. 6. High degree of attention to detail. 7. Ability to diplomatically associate and relate to individuals of all social, economical, and cultural backgrounds. 8. Must be skilled in normal office procedures such as written and verbal correspondence and use of calculator and other office machines. 9. Maintaining a current knowledge of regulatory policies, procedures, and reporting will be required. Physical/Mental Requirements: 1. Hearing acuity to converse in person and on telephone. 2. Visual Acuity to read and proofread documents and use CRT. 3. Ability to walk, stand or sit for extended periods of time. 4. Manual dexterity to write and to operate standard office equipment (PC, Keyboard, Copy Machine, Fax Machine, etc.) 5. Ability to lift and carry files and supplies at least 20 pounds. 6. Strong interpersonal skills to interact with leadership, employees, consumers and the general public. 7. Mental capacity to think independently, follow instruction and use judgment. 8. Analytical skills necessary to conduct research, analyze, and interpret complex data and identify and solve problems by proposing courses of action. 9. Ability to plan short and long range and to manage and schedule time. 10. Ability to handle stress in meeting deadlines and dealing with large numbers of employees and/or consumers. (Listed qualifications are for guidance in filling this position. Any combination of education and experience that provides the necessary knowledge, skills, and abilities will be considered; however, mandatory licensing or certification requirements cannot be waived. Physical/mental requirements cannot be waived unless specifically indicated.)

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-DNI #IN-DNI

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 (***************************************************************************************** .

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: ************

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.

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.

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