Claim processor jobs in Flint, MI - 55 jobs

At Stout, we're dedicated to exceeding expectations in all we do - we call it Relentless Excellence . Both our client service and culture are second to none, stemming from our firmwide embrace of our core values: Positive and Team-Oriented, Accountable, Committed, Relationship-Focused, Super-Responsive, and being Great communicators. Sound like a place you can grow and succeed? Read on to learn more about an exciting opportunity to join our team. About Stout's Forensics and Compliance GroupStout's Forensics and Compliance group supports organizations in addressing complex compliance, investigative, and regulatory challenges. Our professionals bring strong technical capabilities and healthcare industry experience to identify fraud, waste, abuse, and operational inefficiencies, while promoting a culture of integrity and accountability. We work closely with clients, legal counsel, and internal stakeholders to support investigations, regulatory inquiries, litigation, and the implementation of sustainable compliance and revenue cycle improvements.What You'll DoAs an Analyst, you will play a hands-on role in client engagements, contributing independently while collaborating closely with senior team members. Responsibilities include: Support and execute client engagements related to healthcare billing, coding, reimbursement, and revenue cycle operations. Perform detailed forensic analyses and compliance reviews to identify potential fraud, waste, abuse, and process inefficiencies. Analyze and document EMR/EHR hospital billing workflows (e.g., Epic Resolute), including charge capture, claims processing, and reimbursement logic. Assist in audits, investigations, and litigation support engagements, including evidence gathering, issue identification, and corrective action planning. Collaborate with Stout engagement teams, client compliance functions, legal counsel, and leadership to support project objectives. Support EMR/EHR implementations and optimization initiatives, including system testing, data validation, workflow review, and post-go-live support. Prepare clear, well-structured analyses, reports, and client-ready presentations summarizing findings, risks, and recommendations. Communicate proactively with managers and project teams to ensure alignment, quality, and timely delivery. Continue developing technical, analytical, and consulting skills while building credibility with clients. Stay current on healthcare regulations, payer rules, EMR/EHR enhancements, and industry trends impacting compliance and reimbursement. Contribute to internal knowledge sharing, thought leadership, and practice development initiatives within Stout's Healthcare Consulting team. What You Bring Bachelor's degree in Healthcare Administration, Information Technology, Computer Science, Accounting, or a related field required; Master's degree preferred. Two (2)+ years of experience in healthcare revenue cycle operations, EMR/EHR implementations, compliance, or related healthcare consulting roles. Experience supporting consulting engagements, audits, or investigations related to billing, coding, reimbursement, or compliance. Epic Resolute or other hospital billing system experience preferred; Epic certification a plus. Nationally recognized coding credential (e.g., CCS, CPC, RHIA, RHIT) required. Additional certifications such as CHC, CFE, or AHFI preferred. Working knowledge of EMR/EHR system configuration, workflows, issue resolution, and optimization. Proficiency in Microsoft Office (Excel, PowerPoint, Word); experience with Visio, SharePoint, Tableau, or Power BI preferred. Understanding of key healthcare regulatory and compliance frameworks, including CMS regulations, HIPAA, and the False Claims Act. Willingness to travel up to 25%, based on client and project needs. How You'll Thrive Analytical and Detail-Oriented: You are comfortable working with complex data and systems, identifying risks, and drawing well-supported conclusions. Collaborative and Client-Focused: You communicate clearly, work well in team-based environments, and contribute to positive client relationships. Accountable and Proactive: You take ownership of your work, manage priorities effectively, and deliver high-quality results on time. Adaptable and Curious: You are eager to learn new systems, regulations, and methodologies in a fast-paced consulting environment. Growth-Oriented: You seek feedback, develop your technical and professional skills, and build toward increased responsibility. Aligned with Stout Values: You demonstrate integrity, professionalism, and a commitment to excellence in all client and team interactions. Why Stout? At Stout, we offer a comprehensive Total Rewards program with competitive compensation, benefits, and wellness options tailored to support employees at every stage of life. We foster a culture of inclusion and respect, embracing diverse perspectives and experiences to drive innovation and success. Our leadership is committed to inclusion and belonging across the organization and in the communities we serve. We invest in professional growth through ongoing training, mentorship, employee resource groups, and clear performance feedback, ensuring our employees are supported in achieving their career goals. Stout provides flexible work schedules and a discretionary time off policy to promote work-life balance and help employees lead fulfilling lives. Learn more about our benefits and commitment to your success. en/careers/benefits The specific statements shown in each section of this description are not intended to be all-inclusive. They represent typical elements and criteria necessary to successfully perform the job. Stout is an Equal Employment Opportunity. All qualified applicants will receive consideration for employment on the basis of valid job requirements, qualifications and merit without regard to race, color, religion, sex, national origin, disability, age, protected veteran status or any other characteristic protected by applicable local, state or federal law. Stout is required by applicable state and local laws to include a reasonable estimate of the compensation range for this role. The range for this role considers several factors including but not limited to prior work and industry experience, education level, and unique skills. The disclosed range estimate has not been adjusted for any applicable geographic differential associated with the location at which the position may be filled. It is not typical for an individual to be hired at or near the top of the range for their role and compensation decisions are dependent on the facts and circumstances of each case. A reasonable estimate of the current range is $60,000.00 - $130,000.00 Annual. This role is also anticipated to be eligible to participate in an annual bonus plan. Information about benefits can be found here - en/careers/benefits.

OBJECTIVE Casualty Claims Representative Objective To provide efficient adjustment, processing, and settlement of casualty claims consistent in accordance with established adjusting procedures while providing a WOW! customer experience and also controlling loss and loss adjustment expenses. RESPONSIBILITIES Casualty Claims Representative Responsibilities Investigate and interpret policy as it pertains to the loss, evaluate liability, negotiate settlement or declination, and defend Farm Bureau insureds according to Farm Bureau insurance contracts. Accomplish function under general supervision with emphasis on customer service and controlling loss and loss adjustment expenses. Evaluate insurance coverage based on loss notice, insurance policies, applicable statutes and case law to determine if insurance coverage is afforded. Obtain all documentation necessary to determine liability and damages of alleged bodily injury or property damage through a thorough investigation focusing on key issues. QUALIFICATIONS Casualty Claims Representative Qualifications : High school diploma or equivalent required. Minimum one to three years' experience required. Keyboarding skills of 40 wpm required. Must possess outstanding listening and customer service skills. Knowledge of computers and various software including Microsoft Office products required. Must possess a valid driver license with an acceptable driving record. Designation in AIC, INS, CPCU, SCLA or similar insurance designation preferred, or actively being pursued. Preferred: Bachelor's degree or equivalent experience preferred with focus on agricultural-related studies, business administration or insurance-related field. Note: Farm Bureau offers a full benefit package including medical, dental, vision, and 401K. PM19

SCCMHA JOB VACANCY ANNOUNCEMENT CLASSIFICATION: Claims Processor PAY GRADE: $22.73 - $26.71 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.)

Job Description Receive, analyze and process assigned claims by product (medical, dental, vision, FSA or HRA) and group. Ensure accurate processing based on benefit plan design and/or regulations. Evaluate underpayments, resolve non-payments and rejected claims. Follow through until the claim is completely resolved and check is issued. Create appropriate Explanation of Benefits or letter to provider for each claim. Identify and escalate claims for review or audit based on business rules. Ensure required documentation or reporting is completed timely and accurately. Answer incoming telephone calls related to claim processing, provider support and member benefit coverage options. Make outgoing calls to members and providers to obtain additional information as needed. Retrieve and sort mail, fax and email to ensure timely and accurate handling and response. Perform clerical functions including data entry, filing, and sorting, typing, organizing, and recording information. Train co-workers and new employees, as required. Perform various related duties as assigned. Position Requirements: High school diploma or equivalent required, post high school education preferred. Minimum two years of experience as a medical claims processor, medical biller or a similar service position in the health care industry. Must be flexible with scheduled work hours. Must have strong customer service orientation and excellent communication skills, and the ability to work effectively with clients, medical providers and plan members. Proficient PC skills in Windows-based applications. Ability to be flexible and quickly adapt to the changing needs in the department. Must be highly organized with strong attention to detail. Must be dependable and demonstrate responsible work patterns. Must have a high level of professionalism and courtesy.

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 How You'll Work Work Solution: Hybrid Relocation Eligibility: Available 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 Qualifications 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. Preferred Qualifications 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. #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.

Receive, analyze and process assigned claims by product (medical, dental, vision, FSA or HRA) and group. Ensure accurate processing based on benefit plan design and/or regulations. Evaluate underpayments, resolve non-payments and rejected claims. Follow through until the claim is completely resolved and check is issued. Create appropriate Explanation of Benefits or letter to provider for each claim. Identify and escalate claims for review or audit based on business rules. Ensure required documentation or reporting is completed timely and accurately. Answer incoming telephone calls related to claim processing, provider support and member benefit coverage options. Make outgoing calls to members and providers to obtain additional information as needed. Retrieve and sort mail, fax and email to ensure timely and accurate handling and response. Perform clerical functions including data entry, filing, and sorting, typing, organizing, and recording information. Train co-workers and new employees, as required. Perform various related duties as assigned. Position Requirements: High school diploma or equivalent required, post high school education preferred. Minimum two years of experience as a medical claims processor, medical biller or a similar service position in the health care industry. Must be flexible with scheduled work hours. Must have strong customer service orientation and excellent communication skills, and the ability to work effectively with clients, medical providers and plan members. Proficient PC skills in Windows-based applications. Ability to be flexible and quickly adapt to the changing needs in the department. Must be highly organized with strong attention to detail. Must be dependable and demonstrate responsible work patterns. Must have a high level of professionalism and courtesy.

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.

ESIS, Inc. (ESIS) provides sophisticated risk management services designed to reduce claims frequency and loss costs. ESIS, the Risk Management Services Company of ACE USA, provides claims, risk control & loss information systems to Fortune 1000 accounts. ESIS employs more than 1,500 professionals in nine regional centers and 15 major claims offices, as well as local representatives in select jurisdictions. We take our fiduciary responsibilities seriously and are proud to manage over $2.5 billion of customer losses and over 320,000 new claims annually. We specialize in large accounts which have multi-state operations. For information regarding ESIS please visit ************* Summary: ESIS is seeking an experienced workers' compensation Medical Claims Analyst for the Southfield MI. The person in this role will handle and maintain Medical Only Workers' Compensation claims and file reviews under the general supervision of a supervisor and as part of the ESIS team. Minimum Responsibilities: Receive new claim losses and verify accuracy of information submitted. Provide customer service to agents, insureds, clients and other customers. Process medical only claims that are clearly work related and do not require investigation. Process authorized payments. Input data entry correspondence into claim system, and review files at appropriate intervals determined by Best Practices. Complete required state forms. Typing, photocopying, indexing and filing. Maintain desk according to Best Practice Standards 1-2 years previous claims processing experience. Strong customer service background. Ability to operate and contribute positively in a team-based environment. Good written and oral communication skills including effective telephone skills. Ability to work independently under limited supervision. Superior organizational skills and the ability to effectively manage multiple priorities. Demonstrate initiative as evidenced by the ability to self-manage, organize and prioritize work. Strong working knowledge of computer systems and various Microsoft applications such as Word, Excel and Outlook Committed to high standards of behavior and performance. An applicable resident or designated home state adjuster's license is required for ESIS Field Claims Adjusters. Adjusters that do not fulfill the license requirements will not meet ESIS's employment requirements for handling claims. ESIS supports independent self-study time and will allow up to 4 months to pass the adjuster licensing exam.

The EDI Claims Analyst is responsible for analyzing and processing electronic data interchange (EDI) transactions, including claims and eligibility inquiries. This role involves reviewing and resolving claim rejections, ensuring accurate data submission, and supporting various EDI transactions. The analyst will work closely with provider relations, IT, and other internal teams to ensure smooth and efficient claims processing. Requirement: Strong understanding of EDI transactions and claims processing Proficiency in SQL and data analysis Knowledge of Edifecs Smart-Trading platform, Availity Essentials, Informatica, and Apigee Familiarity with CBH systems, including Connects and Flexicare Excellent problem-solving and analytical skills Ability to mentor and train team members Executive leadership client facing Interested candidates can send their updated resumes at ********************* Job Posted by ApplicantPro

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

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 Title: Warranty Claims Specialist This role is responsible for reviewing and processing warranty claims, including conducting technical analyses to ensure compliance with established Warranty Policies and Procedures in effect at the time of repair. The position provides support to dealers, field staff, and corporate employees through phone and email to ensure claims are accurately submitted, reviewed, and paid in a timely manner. Key Responsibilities: Review and evaluate warranty claims for accuracy, compliance, and eligibility. Provide guidance and support to dealers, field staff, and internal employees regarding claim submission and processing. Clarify warranty coverage, policies, and procedures, including proper claim coding and documentation requirements. Adjust and approve claims for payment and ensure all updates are properly recorded in the Warranty Audit Trail. Maintain accurate data within the SAGA system to ensure smooth claim processing and reduce unnecessary rejections. Review and resolve claims that fail SAGA system edits. Track and analyze warranty trends to identify opportunities for improvement. Train dealer staff, new corporate employees, and field employees on warranty procedures and claim adjusting processes. Skills & Competencies: Strong analytical and problem-solving skills Excellent communication and customer service abilities Attention to detail and accuracy Ability to interpret warranty policies and technical documentation Experience working with claims processing systems preferred

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 Commercial and Farm 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, 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 Commercial and Farm Property Claims Representative Responsibilities Investigate, evaluate, and control property and casualty claims under general supervision. Maintain moderate knowledge of various types of buildings, construction, repair cost and methods, repair-estimating system and scoping damages. Maintain moderate knowledge of farm machinery, livestock and home furnishings. Learn to explain moderate loss settlement figures and claim procedures to customers. Learn to explain moderate policy language, coverage and exclusions. Maintain a moderate understanding of subrogation and salvage processes. Adjust reserves to accurately reflect known exposures according to current information available. Revise reserves based on developments in the course of adjusting the claim. Serve as a resource and mentor for others. Participate in projects and assist to develop solutions/processes. Learn to handle medium-to-large size losses as directed, including managed repair claims, independent adjuster, personal property, liability, and property damage (PD) claims. Handle and/or estimate losses involving commercial structures and loss of business income. QUALIFICATIONS Commercial and Farm Property Claims Representative Qualifications Required Bachelor's degree required with focus on construction trades, agriculture-related studies, business administration or insurance related field preferred, or equivalent experience may be considered. Minimum one to three years commercial property, farm, and/or liability claims handling experience required. Knowledge of insurance contracts written by the companies required. Knowledge of company and divisional policies and procedures required. Must possess outstanding listening and superior customer service skills. Knowledge of estimating systems and construction requirements and methods required. Must have access to high-speed Internet at home. Must possess a valid driver license with an acceptable driving record. Preferred Designations in INS, AIC, CPCU and/or similar professional insurance designation preferred. Note: Farm Bureau offers a full benefit package including medical, dental, vision, and 401K. PM19

Receive, analyze and process assigned claims by product (medical, dental, vision, FSA or HRA) and group. Ensure accurate processing based on benefit plan design and/or regulations. Evaluate underpayments, resolve non-payments and rejected claims. Follow through until the claim is completely resolved and check is issued. Create appropriate Explanation of Benefits or letter to provider for each claim. Identify and escalate claims for review or audit based on business rules. Ensure required documentation or reporting is completed timely and accurately. Answer incoming telephone calls related to claim processing, provider support and member benefit coverage options. Make outgoing calls to members and providers to obtain additional information as needed. Retrieve and sort mail, fax and email to ensure timely and accurate handling and response. Perform clerical functions including data entry, filing, and sorting, typing, organizing, and recording information. Train co-workers and new employees, as required. Perform various related duties as assigned. Position Requirements: High school diploma or equivalent required, post high school education preferred. Minimum two years of experience as a medical claims processor, medical biller or a similar service position in the health care industry. Must be flexible with scheduled work hours. Must have strong customer service orientation and excellent communication skills, and the ability to work effectively with clients, medical providers and plan members. Proficient PC skills in Windows-based applications. Ability to be flexible and quickly adapt to the changing needs in the department. Must be highly organized with strong attention to detail. Must be dependable and demonstrate responsible work patterns. Must have a high level of professionalism and courtesy.

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 InformationInterested 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.