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Claim processor jobs in Grand Rapids, MI - 220 jobs

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Claim Processor
Claim Specialist
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Claims Analyst
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Senior Claims Examiner
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Liability Claims Representative
Processor
Senior Claims Analyst
Claim Auditor
  • Processor

    United Mortgage Lending LLC 3.5company rating

    Claim processor job in Troy, MI

    Full job description United Mortgage Lending LLC is looking for a detail-oriented and motivated Mortgage Loan Processor to join our team. In this role you will process mortgage applications, ensure and analyze all loan documentation, and ensuring that all loan documents are accurate and compliant with applicable regulations. Key Responsibilities: Review loan approvals and gather necessary documentation while maintaining strong communication with the borrowers Ensure compliance with Federal lending regulations Clear loan conditions and communicate effectively with the sales team Provide excellent customer service throughout the loan process Job Requirements: Minimum 2 years of experience in Wholesale Mortgage processing Manage a pipeline of 30-50 loans. Experience with Salesforce, Lending Pad and UWM portal Knowledge of Conventional, Jumbo, FHA, and VA processing Strong verbal and written communication skills Education: High school diploma or GED Languages: English required; Spanish a plus Benefits: Health, dental, and vision insurance 401(k) Job Type: Full-time Pay: $60,000.00 - $80,000.00 per year Benefits: 401(k) 401(k) matching Dental insurance Health insurance Paid time off Vision insurance Experience: Loan processing: 2 years (Preferred) wholesale mortgage: 1 year (Preferred) Ability to Commute: Troy, MI (Required) Work Location: In person
    $28k-34k yearly est. 2d ago
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  • Claims Analyst

    Cherokee Insurance Company

    Claim processor job in Sterling Heights, MI

    Cherokee Insurance Company, a leading casualty insurance provider to the transportation industry is seeking an entry level liability adjuster for our Sterling Heights, MI office. Cherokee Insurance is rated ‘A' (Excellent) by A.M. Best Company. Now is your chance to join a team of trained professionals and enhance your skills. We are seeking detail-oriented individuals with superior customer service and negotiation skills to investigate and process both first- and third-party claims. Liability Adjusters are trained on site and are not required to travel. Based at our Corporate Office, this is an exceptional chance for learning, exposure, and career advancement. Job Responsibilities: Gather accident information and assist the insured to begin the claim process Take and organize detailed notes/information from all involved parties Ensure that all claims information is accurately input to claims system Prepare claim information Meet deadlines while making priority adjustments as needed Confidently and professionally work well with internal and external customers Handle matters according to various state regulatory requirements and respond to issues in a timely, appropriate fashion Stay abreast of and utilize claim handling best practices as directed by management and regulatory/professional organizations Maintain file communications and associated details to ensure that a complete file is available to the company at all times After appropriate training and foundational understanding (3 - 6 months), Liability Adjusters will be responsible for: Determining responsibility, coverages and coverage limits Consulting with all involved vendors and out of state contracted adjusters Reviewing and approving price quotes Settlement negotiation The ideal candidate will possess the following: Exceptional communication skills: listening, reading, writing, speaking Solid organizational, multi-tasking and time-management skills Strong analytical and problem-solving skills Ability to work both independently and in a team-oriented environment Intermediate knowledge of Microsoft Office Suite Strong sense of urgency Willingness to learn and desire for promotion/advancement Bachelor's Degree in business, economics, finance or related field Salary and Benefits: Competitive Salary Medical/dental benefits 401(k) Paid vacation Life Insurance Collaborative environment Opportunity for advancement
    $44k-76k yearly est. 3d ago
  • Casualty Claims Representative

    Michigan Farm Bureau 4.1company rating

    Claim processor job in Lansing, MI

    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
    $49k-57k yearly est. Auto-Apply 13d ago
  • Claims Examiner, Commercial Insurance

    Arch Capital Group Ltd. 4.7company rating

    Claim processor job in Garden City, MI

    With a company culture rooted in collaboration, expertise and innovation, we aim to promote progress and inspire our clients, employees, investors and communities to achieve their greatest potential. Our work is the catalyst that helps others achieve their goals. In short, We Enable Possibility℠. Position Summary Arch Insurance Group Inc., AIGI, has an opening with the Claims Division as a Claims Examiner, Casualty. In this role, the responsibilities include actively managing medium-high severity commercial liability claims in jurisdictions throughout the United States. Responsibilities * Identify and assess coverage issues, draft coverage position letters, and retain coverage counsel, when necessary, as well as review coverage counsel's opinion letters and analysis * Develop and implement strategy relative to coverage issues which correlate with the overall strategy of matters entrusted to the handler's care * Develop and implement timely and accurate resolution strategies to ensure mitigation of indemnity and expense exposures * Maintain contact with any/all associated claims carrier(s)' claims staff, business line leader, underwriter, defense counsel, program manager, and broker to communicate developments and outcomes as necessary * Investigate claims and review the insureds' materials, pleadings, and other relevant documents * Identify and review each jurisdiction's applicable statutes, rules, and case law * Review litigation materials including depositions and expert's reports * Analyze and direct risk transfer, additional insured issues, and contractual indemnity issues * Retain counsel when necessary and direct counsel in accordance with resolution strategy * Analyze coverage, liability and damages for purposes of assessing and recommending reserves * Prepare and present written/oral reports to senior management setting forth all issues influencing evaluations and recommending reserves * Travel to and from locations within the United States to attend mediations, trials, and other proceedings relevant to the resolution of the matter * Negotiate resolution of claims * Select and utilize structure brokers * Maintain a diary of all claims, post reserves in a timely fashion, and expeditiously respond to inquiries from the insured, counsel, underwriters, brokers, and senior management regarding claims Experience & Required Skills * Exceptional communication (written and verbal), evaluating, influencing, negotiating, listening, and interpersonal skills to effectively develop productive working relationships with internal/external peers and other professionals across organizational lines * Strong time management and organizational skills * Demonstrated ability to take part in active strategic discussions * Demonstrated ability to work well independently and in a team environment * Hands-on experience and strong aptitude with Microsoft Excel, PowerPoint and Word * Willing and able to travel 10% * Hybrid schedule, 3 days a week in office Education * Bachelor's degree required. * Minimum of 3 years of working experience with a primary and or excess carrier supporting commercial accounts for Casualty claims * Proper & active adjuster licensing in all applicable states #LI-SW1 #LI-HYBRID For individuals assigned or hired to work in the location(s) indicated below, the base salary range is provided. Range is as of the time of posting. Position is incentive eligible. $95,000 - $150,000/year based on experience level * Total individual compensation (base salary, short & long-term incentives) offered will take into account a number of factors including but not limited to geographic location, scope & responsibilities of the role, qualifications, talent availability & specialization as well as business needs. The above pay range may be modified in the future. * Arch is committed to helping employees succeed through our comprehensive benefits package that includes multiple medical plans plus dental, vision and prescription drug coverage; a competitive 401k with generous matching; PTO beginning at 20 days per year; up to 12 paid company holidays per year plus 2 paid days of Volunteer Time Offer; basic Life and AD&D Insurance as well as Short and Long-Term Disability; Paid Parental Leave of up to 10 weeks; Student Loan Assistance and Tuition Reimbursement, Backup Child and Elder Care; and more. Click here to learn more on available benefits. Do you like solving complex business problems, working with talented colleagues and have an innovative mindset? Arch may be a great fit for you. If this job isn't the right fit but you're interested in working for Arch, create a job alert! Simply create an account and opt in to receive emails when we have job openings that meet your criteria. Join our talent community to share your preferences directly with Arch's Talent Acquisition team.
    $39k-52k yearly est. Auto-Apply 3d ago
  • Claims Processor

    Employee Health Insurance Management Inc. 3.8company rating

    Claim processor job in Southfield, MI

    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.
    $28k-45k yearly est. 20d ago
  • Claims Examiner

    Harriscomputer

    Claim processor job in Michigan

    Responsibilities & Duties:Claims Processing and Assessment: Evaluate incoming claims to determine eligibility, coverage, and validity. Conduct thorough investigations, including reviewing medical records and other relevant documentation. Analyze policy provisions and contractual agreements to assess claim validity. Utilize claims management systems to document findings and process claims efficiently. Communication and Customer Service: Communicate effectively with policyholders, beneficiaries, and healthcare providers regarding claim status and requirements. Provide timely responses to inquiries and maintain professional and empathetic communication throughout the claims process. Address customer concerns and escalate complex issues to senior claims personnel or management as needed. Compliance and Documentation: Ensure compliance with company policies, procedures, and regulatory requirements. Maintain accurate records and documentation related to claims activities. Follow established guidelines for claims adjudication and payment authorization. Quality Assurance and Improvement: Identify opportunities for process improvement and efficiency within the claims department. Participate in quality assurance initiatives to uphold service standards and improve claim handling practices. Collaborate with team members and management to implement best practices and enhance overall departmental performance. Reporting and Analysis: Generate reports and provide data analysis on claims trends, processing times, and outcomes. Contribute to the development of management reports and presentations regarding claims operations.
    $27k-45k yearly est. Auto-Apply 33d ago
  • Claims Processor

    Procare Rx 4.0company rating

    Claim processor job in Southfield, MI

    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.
    $26k-41k yearly est. 19d ago
  • Bilingual Claims Examiner

    Healthcare Support Staffing

    Claim processor job in Troy, MI

    HealthCare Support Staffing, Inc. (HSS), is a proven industry-leading national healthcare recruiting and staffing firm. HSS has a proven history of placing talented healthcare professionals in clinical and non-clinical positions with some of the largest and most prestigious healthcare facilities including: Fortune 100 Health Plans, Mail Order Pharmacies, Medical Billing Centers, Hospitals, Laboratories, Surgery Centers, Private Practices, and many other healthcare facilities throughout the United States. HealthCare Support Staffing maintains strong relationships with top providers in healthcare and can assure healthcare professionals they will receive fast access to great career opportunities that best fit their expertise. Connect with one of our Professional Recruiting Consultants today to see how a conversation can turn into a long-lasting and rewarding career! Job Description: Are you an experienced Claims Representative looking for a new opportunity with a prestigious healthcare company? Do you want the chance to advance your career by joining a rapidly growing company? If you answered “yes" to any of these questions - this is the position for you! Daily Responsibilities: • Resolves Provider Reconsideration Requests (PRR) from providers relating to claims payment and requests for claim adjustments • Researches claims processing guidelines, provider contracts, fee schedules and system configurations to determine root cause of payment error • Identifies potential Provider problems through a proactive approach in which data is mined and trended to identify and prevent provider problem areas Qualifications Hours for this Position: • Mon-Fri 8am-4:30pm Advantages of this Opportunity: • Competitive salary, negotiable based on relevant experience • Acquire new skills and learn new knowledge • Fun and positive work environment Qualifications/ Requirements: • Must be bilingual in Spanish • Claims, Appeals, Denials experience for an insurance company or hospital or medical office or financial company • HS Diploma/GED Additional Information Interested in hearing more about this great opportunity? If you are interested in applying to this position, please click Apply Now and email your resume to Michael Grifon.
    $27k-45k yearly est. 23h ago
  • Senior Claims Support Analyst

    AAA Life Insurance Company 4.5company rating

    Claim processor job in Livonia, MI

    Why AAA Life AAA Life is a respected and trusted American brand that has been focusing on Life Insurance and Annuity Products since 1969. At AAA Life we have over 1.8 million policies where we take pride in earning the trust of our policyholders who understand our promise to be there for them - and their families - when we're needed most. By joining the AAA Life team, you are joining a company that genuinely cares about helping each other, with a devotion to protect the lives of those around us. We embrace a diverse, equitable, inclusive culture where all associates can feel a sense of belonging and use their unique talents and perspective to influence, innovate, motivate, and thrive. The Senior Claims Support Analyst supports both the Claims and Treasury functions by ensuring the efficient flow of funds, accuracy of claims payments, and continuous improvement of claims financial processes. This role combines analytical and operational expertise to maintain regulatory compliance, improve claims payment accuracy, and optimize cash management procedures. The analyst develops, monitors, and reports on key performance metrics, reconciles payment and claims data, supports quality reviews, and collaborates cross-functionally with Finance, Treasury, and Claims Leadership to streamline processes and improve financial integrity in claims operations. Responsibilities 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.
    $86k-125k yearly est. Auto-Apply 43d ago
  • Bodily Injury Claims Specialist

    Auto-Owners Insurance Co 4.3company rating

    Claim processor job in Grand Rapids, MI

    We offer a merit-based work-from-home program based on job responsibilities. After initial training in-person, you could have the flexibility of work-from-home time as defined by the leadership team. Auto-Owners Insurance, a top-rated insurance carrier, is seeking a motivated individual to join our Claims department as a Bodily Injury Claims Representative. The position requires the person to: * Assemble facts, determine coverage, evaluate the amount of loss, analyze legal liability, make payments in accordance with coverage, damage and liability determination, and perform other functions or duties to properly adjust the loss. * Study insurance policies, endorsements, and forms to develop an understanding of insurance coverage. * Follow claims handling procedures and participate in claim negotiations and settlements. * Deliver a high level of customer service to our agents, insureds, and others. * Devise alternative approaches to provide appropriate service, dependent upon the circumstances. * Meet with people involved with claims, sometimes outside of our office environment. * Handle investigations by telephone, email, mail, and on-site investigations. * Maintain appropriate adjuster's license(s), if required by statute in the jurisdiction employed, within the time frame prescribed by the Company or statute. * Handle complex and unusual exposure claims effectively through on-site investigations and through participation in mediations, settlement conferences, and trials. * Handle confidential information according to Company standards and in accordance with any applicable law, regulation, or rule. * Assist in the evaluation and selection of outside counsel. * Maintain punctual attendance according to an assigned work schedule at a Company approved work location. Desired Skills & Experience * A minimum of three years of insurance claims related experience. * The ability to organize and conduct an investigation involving complex issues and assimilate the information to reach a logical and timely decision. * The ability to effectively understand, interpret and communicate policy language. * The dissemination of appropriate claim handling techniques so that others involved in the claim process are understanding of issues. Benefits Auto-Owners offers a wide range of career opportunities, and we are seeking talent that will help us continue our long tradition of success. We offer a friendly work environment, structured training program, employee mentoring and an excellent compensation/benefits package. Along with a competitive base salary, matched 401(k), fully-funded pension plan (once vested), and bonus programs, Auto-Owners also provides generous paid time off including holidays, vacation days, personal time, and sick leave. If you're looking to do rewarding work alongside great people, Auto-Owners is the place for you! Equal Employment Opportunity Auto-Owners Insurance is an equal opportunity employer. The Company hires, transfers, and promotes on the basis of ability, without consideration of disability, age, sex, race, color, religion, height, weight, marital status, sexual orientation, gender identity or national origin, or any factor contrary to federal, state or local law. * Please note that the ability to work in the U.S. without current or future sponsorship is a requirement. #LI-DNI #IN-DNI
    $57k-76k yearly est. Auto-Apply 60d+ ago
  • Automotive Claims Specialist

    Loss Prevention Services, LLC 3.6company rating

    Claim processor job in Grandville, MI

    Job DescriptionSalary: The Claims Specialist is responsible for handling damage claims and property loss claims, to help resolve them efficiently and fairly. Successful Candidates MUST prior experience with automotive insurance claims or experience working with insurance in a body shop or similar vehicle repair facility to be considered for this position. Job Type: Full Time On-Site or Hybrid at our office in Grandville, MI - This is not a fully remote position. Duties and Responsibilities: Investigating and analyzing details of damage claims and property loss claims to determine the level of liability. Reviewing and evaluating damage claims and property loss claims for accuracy and completeness. Interacting with service providers, clients, and claimants to gather more information about damage claims and property loss claims. Documenting all claim related activities and maintaining claim files for review and auditing purposes. Following all company policies and procedures and complying with all legal requirements Maintaining a high level of customer service by answering questions and providing information to all parties involved in the claims process. Requirements: Experience in the Collateral Recovery industry required, preferably in a Claims related role. Excellent written and verbal communications skills. Excellent listening, negotiation and problem-solving skills. Attention to detail and high level of accuracy. Must be proficient in Microsoft Office or Google Suite. Benefits: Medical, Dental and Vision Insurance Paid Time Off Paid Holidays
    $51k-89k yearly est. 6d ago
  • Fremont Property Desk Claims Specialist

    Acg 4.2company rating

    Claim processor job in Fremont, MI

    Fremont Property Desk Claims Specialist- AAA The Auto Club Group 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. Claim handling responsibilities will include the following: reviewing assigned claims, contacting the insured and other affected parties, setting expectations for the remainder of the claim process, and initiating 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. Claim Specialists assigned to Homeowner/CAT claim unit handle claims valued over $25,000 (for the inside desk role) and over $100,000 (for field role). Investigate claims requiring in-depth coverage analysis. When handling claims in the field, must prepare damage estimates using claims software. Review estimates for accuracy. May monitor contractor repair status. May assist Claim Manager with file reviews and training. Supervisory Responsibilities: None How you will benefit: A competitive annual salary between $74,900.00 - $90,000.00 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 are looking for candidates who: II. Required Qualifications (these are the minimum requirements to qualify) Education: 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. A valid driver's license is required if the primary responsibilities of the role involve conducting in-person inspections or frequent in-person meetings with members. 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: Essential Insurance Act (Michigan) 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 work load 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 travel outside of assigned territory which may involve overnight stay relocate, work evenings or weekends 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 Training Work Environment This position is currently able to work remotely from a home office location for day-to-day operations unless occasional travel for meetings, collaborative activities, or 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.
    $74.9k-90k yearly Auto-Apply 44d ago
  • Pharmacy 340B Claims Specialist

    Family Health Care 4.3company rating

    Claim processor job in White Cloud, MI

    Family Health Care is currently seeking applications for the position of Pharmacy 340B Claims Specialist! General Function: This position functions at the highest level (III) in the series of Pharmacy Technician roles within Family Health Care. The individual in this role is a “work-leader” serving as the expert on prescription claims reimbursement and performing self-auditing for the pharmacy department. This individual will ensure prescription claim integrity by having advanced knowledge of claim requirements for the various pharmacy benefit managers (PBM) and shall use that information to identify areas of improvement by performing targeted claim audits and will provide education to the pharmacy staff on billing requirements, when needed. Responsibilities: Acts as pharmacy claims auditor and will audit claims daily into order to track claims accuracy, trends, anomalies and other critical information to help BFHC ensuring appropriate reimbursement while mitigating organizational risk for claims remediations resulting from claim processing errors. Acts as pharmacy 340B claims auditor and audits claims on a scheduled basis into order to track 340B claims accuracy, trends, anomalies, and other critical information to help BFHC maintain 340B claim integrity while ensuring adherence to 340B policies, procedures, rules and regulations. Ensures timely and accurate billing/collections of all pharmacy charges and reimbursement activities through the use of reporting and reconciliation. Ensures integrity if financial reports and provides necessary reports to the finance department upon request. Assists the Chief Pharmacist and pharmacy staff in the research, development and implementation of new and existing pharmacy services. Location(s): White Cloud, MI Employment Type: Full Time Exempt/Non-Exempt: Non-Exempt Benefits: Competitive wage and excellent benefits package. FHC is an eligible organization for State and Federal Loan Repayment Programs. Family Health Care is an Equal Opportunity Employer.
    $52k-73k yearly est. 39d ago
  • Mortgage Claims Default Specialist

    The EMAC Group

    Claim processor job in Troy, MI

    The EMAC Group is a provider of mortgage recruiting services, we offer an extensive network of mortgage professionals and proven expertise developed over 20 years of experience identifying, attracting and recruiting mortgage talent for our clients. Job Description POSITION SUMMARY The Claims Specialist is responsible for processing required claims to Fannie Mae, Mortgage Insurance Companies, FHA, VA or other investors to recover advances incurred throughout the default process. The Claims Specialist will file required claims; meet investor time frames, and complete audits of claims processes for validation. Responsibilities as well will entail tracking of claim payments received for proper application, and filing of any required supplemental claims as necessary, and respond regarding any contested claim information as required. ESSENTIAL POSITION FUNCTIONS • Review, analyze, and ensure timely settlement of investor and mortgage insurance claims and manage aging claims to determine status and bring to closure and request extensions as needed. • Document and maintain all systems necessary for proper claim handling and follow-up. • Research issues and obtain proper supporting documentation in a timely manner as requested by investor or mortgage insurance company. • Manage application of all claim funds received and provide additional information as necessary in order to validate all available funds received prior to claim being closed. • Monitor claim process reports to ensure all required responses are timely filed. • Complete timely audits of all assigned claims to ensure all requirements have been met, and claim process can be validated. Qualifications EDUCATION / EXPERIENCE REQUIREMENTS • Graduation from a 4-year college or university with major course work in a discipline related to the requirements of the position is preferred. Will consider the equivalent combination of job experience & education that demonstrates the ability to perform the essential functions of this job. • Knowledge of Microsoft Office a must; knowledge of YARDI, LoanSphere, VALERI, USDA LINC and Workout Prospector a plus. • Previous work with mortgage claim filing is a requirement. Additional Information Please contact Tabitha Wolf at: ************
    $41k-69k yearly est. 60d+ ago
  • Mortgage Claims Default Specialist

    The Emac Group

    Claim processor job in Troy, MI

    The EMAC Group is a provider of mortgage recruiting services, we offer an extensive network of mortgage professionals and proven expertise developed over 20 years of experience identifying, attracting and recruiting mortgage talent for our clients. Job Description POSITION SUMMARY The Claims Specialist is responsible for processing required claims to Fannie Mae, Mortgage Insurance Companies, FHA, VA or other investors to recover advances incurred throughout the default process. The Claims Specialist will file required claims; meet investor time frames, and complete audits of claims processes for validation. Responsibilities as well will entail tracking of claim payments received for proper application, and filing of any required supplemental claims as necessary, and respond regarding any contested claim information as required. ESSENTIAL POSITION FUNCTIONS • Review, analyze, and ensure timely settlement of investor and mortgage insurance claims and manage aging claims to determine status and bring to closure and request extensions as needed. • Document and maintain all systems necessary for proper claim handling and follow-up. • Research issues and obtain proper supporting documentation in a timely manner as requested by investor or mortgage insurance company. • Manage application of all claim funds received and provide additional information as necessary in order to validate all available funds received prior to claim being closed. • Monitor claim process reports to ensure all required responses are timely filed. • Complete timely audits of all assigned claims to ensure all requirements have been met, and claim process can be validated. Qualifications EDUCATION / EXPERIENCE REQUIREMENTS • Knowledge of Microsoft Office a must; knowledge of YARDI, LoanSphere, VALERI, USDA LINC and Workout Prospector a plus. • Previous work with mortgage claim filing is a requirement. Additional Information Please contact Tabitha Wolf at: ************
    $41k-69k yearly est. 23h ago
  • Warranty Claims Specialist

    Brightwing

    Claim processor job in Auburn Hills, MI

    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
    $40k-69k yearly est. 6d ago
  • Loss Claims Specialist M-F 8am-5pm

    Fifth Third Bank, N.A 4.6company rating

    Claim processor job in Grand Rapids, MI

    Make banking a Fifth Third better We connect great people to great opportunities. Are you ready to take the next step? Discover a career in banking at Fifth Third Bank. GENERAL FUNCTION: Under moderate supervision, collects and documents accounts involved in total or repairable loss claims involving a primary insurance carrier and/or GAP company in accordance with departmental, investor, and legal guidelines. Coordinate with insurance carrier through phone/email contact to ensure claim proceeds are received and accurate. Conduct research through account/contract reviews, receive and process aftermarket product cancellation payments, and track results for accuracy. Responsible and accountable for risk by openly exchanging ideas and opinions, elevating concerns, and personally following policies and procedures as defined. Accountable for always doing the right thing for customers and colleagues and ensures that actions and behaviors drive a positive customer experience. While operating within the Bank's risk appetite, achieves results by consistently identifying, assessing, managing, monitoring, and reporting risks of all types. ESSENTIAL DUTIES AND RESPONSIBILITIES: + Coordinate with insurance companies and customers through inbound/outbound calls and emails to assist in the handling of total loss and/or repair claims + Review accounts and work with dealers and/or providers to cancel aftermarket products + Accurately and efficiently process refunds and update trackers to reflect payment information received + Follow up with dealers and/or providers regarding discrepancies in refunds + Procure and supply documentation necessary to garner claim proceeds + Conduct research including statements, customer files, and payment copies to verify accuracy of claim proceeds + Record all efforts via the department systems insuring that all accounts are called and noted accurately + Perform any other duties as assigned SUPERVISORY RESPONSIBILITIES: None MINIMUM KNOWLEDGE, SKILLS AND ABILITIES REQUIRED: + High school diploma or equivalent required. + Minimum 2 years of collections, insurance claims, or equivalent work experience. + Excellent verbal and written communication skills. + Strong experience with Microsoft office products, such as Word, Excel, PowerPoint, and Outlook. + Proficient with computer systems and keyboarding / data entry skills with moderate speed and accuracy. + Ability to work in a team environment, presenting a professional image and commanding the respect of peers and leadership. + General knowledge of collection laws, regulations, principles of credit lending, and risk management. + Utilizes a fair degree of independence and problem solving. + Ability to multi-task and be flexible while managing change. #LI-EG1 Loss Claims Specialist M-F 8am-5pm At Fifth Third, we understand the importance of recognizing our employees for the role they play in improving the lives of our customers, communities and each other. Our Total Rewards include comprehensive benefits and differentiated compensation offerings to give each employee the opportunity to be their best every day. The base salary for this position is reflective of the range of salary levels for all roles within this pay grade across the U.S. Individual salaries within this range will vary based on factors such as role, relevant skillset, relevant experience, education and geographic location. Our extensive benefits programs are designed to support the individual needs of our employees and their families, encompassing physical, financial, emotional and social well-being. You can learn more about those programs on our 53.com Careers page at: *************************************************************** or by consulting with your talent acquisition partner. LOCATION -- Grand Rapids, Michigan 49546 Attention search firms and staffing agencies: do not submit unsolicited resumes for this posting. Fifth Third does not accept resumes from any agency that does not have an active agreement with Fifth Third. Any unsolicited resumes - no matter how they are submitted - will be considered the property of Fifth Third and Fifth Third will not be responsible for any associated fee. Fifth Third Bank, National Association is proud to have an engaged and inclusive culture and to promote and ensure equal employment opportunity in all employment decisions regardless of race, color, gender, national origin, religion, age, disability, sexual orientation, gender identity, military status, veteran status or any other legally protected status.
    $107k-128k yearly est. 4d ago
  • Claims Representative

    The Strickland Group 3.7company rating

    Claim processor job in Detroit, MI

    Join Our Dynamic Insurance Team - Unlock Your Potential! Are you ready to take control of your future and build a career in one of the most stable and lucrative industries? We are seeking driven individuals to join our thriving insurance team, where you'll receive top-tier training, support, and unlimited income potential. NOW HIRING: ✅ Licensed Life & Health Agents ✅ Unlicensed Individuals (We'll guide you through the licensing process!) We're looking for our next leaders-those who want to build a career or an impactful part-time income stream. Is This You? ✔ Willing to work hard and commit for long-term success? ✔ Ready to invest in yourself and your business? ✔ Self-motivated and disciplined, even when no one is watching? ✔ Coachable and eager to learn? ✔ Interested in a business that is both recession- and pandemic-proof? If you answered YES to any of these, keep reading! Why Choose Us? 💼 Work from anywhere - full-time or part-time, set your own schedule. 💰 Uncapped earning potential - Part-time: $40,000 - $60,000 /month | Full-time: $70,000 - $150,000+++/month. 📈 No cold calling - You'll only assist individuals who have already requested help. ❌ No sales quotas, no pressure, no pushy tactics. 🧑 🏫 World-class training & mentorship - Learn directly from top agents. 🎯 Daily pay from the insurance carriers you work with. 🎁 Bonuses & incentives - Earn commissions starting at 80% (most carriers) + salary 🏆 Ownership opportunities - Build your own agency (if desired). 🏥 Health insurance available for qualified agents. 🚀 This is your chance to take back control, build a rewarding career, and create real financial freedom. 👉 Apply today and start your journey in financial services! ( Results may vary. Your success depends on effort, skill, and commitment to training and sales systems. )
    $41k-54k yearly est. Auto-Apply 60d+ ago
  • Casualty Claim Specialist

    Hybrid or Remote

    Claim processor job in Hastings, MI

    Deliver fair, strategic resolutions for complex commercial casualty claims. Schedule: Monday-Friday, 8:00 a.m.-4:30 p.m. About the Role: The Casualty Claim Specialist investigates, evaluates, and resolves moderate to complex commercial casualty claims in accordance with company policies, contractual obligations, and legal requirements. This role is responsible for timely, accurate claim handling, effective communication with stakeholders, appropriate reserving, and equitable claim resolution. The position also serves as a technical resource and may support training, projects, or mentoring within the casualty claims organization. What You'll Do: Review, investigate, evaluate, and resolve assigned open and closed commercial casualty claims to achieve equitable resolutions within contractual and legal liability. Facilitate the casualty claim process through timely, professional communication with policyholders, agents, attorneys, vendors, and internal partners. Utilize Hastings' claims and estimating systems, including Guidewire ClaimCenter, and other approved technologies to perform job duties. Review and apply coverage appropriately and provide guidance to others regarding coverage, exposure, reserves, settlement values, and claim strategy when appropriate. Establish, maintain, and adjust case reserves in a timely manner to accurately reflect claim exposure through settlement, litigation, or arbitration. Identify, pursue, and coordinate salvage and subrogation opportunities to minimize claim losses. Utilize approved loss and expense savings programs and direct outside vendors to ensure cost-effective claim handling. Identify potential fraud and refer matters to appropriate internal or external investigative resources. Coordinate claim information with Loss Control, Underwriting, Marketing, and other departments to support current claim handling and future loss prevention. Investigate construction accidents and other serious losses, including those involving significant injuries or litigation. Document claim files accurately, thoroughly, and consistently to support claim disposition and minimize errors or improper payments. Participate in special projects, committees, or assignments as directed and serve as a technical resource or trainer for other adjusters when needed. Additional Role Highlights: Handles moderate to complex commercial casualty claims, including litigated files. Frequent interaction with attorneys, independent adjusters, investigators, and external vendors. Works independently with a high degree of accountability while collaborating within a team environment. Opportunity to contribute to departmental training, mentoring, and process improvement efforts. Flexible work arrangement options based on location and business needs. What You'll Bring: Bachelor's degree preferred. Formal insurance education or equivalent claim experience may be considered. Minimum of ten years of progressive claims experience, with at least five years handling complex casualty or commercial claims. At least three years of experience managing litigated claim files. Professional designations such as Senior Claim Law Associate (SCLA) or Chartered Property Casualty Underwriter (CPCU), or active pursuit of a designation. Strong verbal and written communication skills, including experience presenting or facilitating training. Demonstrated ability to manage multiple priorities in a results-focused environment. Proven commitment to delivering excellent customer service to agents, policyholders, and internal and external partners. High level of self-motivation with the ability to work independently and exercise sound judgment. Ability to exemplify Hastings' behavior standards and comply with ethical and professional guidelines. About Us: At Hastings Insurance, we're more than an insurance provider- we're a trusted partner to our agents, policyholders, and the communities we serve. For over 135 years, we've been helping individuals, families, and businesses protect what matters most and rebuild after loss. We're proud to be rated A (Excellent) by A.M. Best Company, recognizing our enduring financial strength and stability. While our heritage runs deep, we're always looking ahead. We embrace emerging technologies, cultivate strong partnerships with independent agents, and continuously evolve our products to meet the needs of today's customers. Our strategy is focused on responsible growth, expanding our reach while staying innovative, agile, and committed to personalized service. Our people are the heart of everything we do. Our talented team members, many recognized as industry experts, are passionate about delivering exceptional service, driving progress, and making a real impact. At Hastings Insurance, we foster a culture of collaboration, continuous learning, and appreciation for the diverse skills and ideas our employees bring. Our Commitment as an Employer: We believe that diverse perspectives and inclusive teams drive innovation and strengthen our organization. We're committed to fostering a workplace where every employee feels valued, respected, and empowered to contribute their best. We are proud to be an equal opportunity employer, and we make employment decisions based on business needs, role requirements, and individual qualifications, without regard to race, color, religion, gender, sexual orientation, gender identity, national origin, age, appearance, disability, veteran status, family status, marital status, or any other legally protected characteristic. We also understand the importance of providing a welcoming and accessible experience for all candidates. If you require accommodation during the application or interview process, please reach out to our Talent Acquisition Specialist or contact us at ************.
    $40k-67k yearly est. 6d ago
  • Supplier Claims Auditor

    Stellantis Nv

    Claim processor job in Auburn Hills, MI

    The Supplier Claims Auditor will be responsible for assisting with the performance of supplier cancellation claim audits. This individual will interact with suppliers, purchasing, and engineering to resolve disputed claims. The Supplier Claims Auditor will perform substantive testing of supplier claims, obtaining sufficient evidence to support the claim recommendation, document the results and findings and communicate the results to appropriate staff. The selected candidate will perform on-site verification of inventories, production tooling and other assets that may be included in a cancellation claim. This individual will also coordinate audit efforts with dealer field auditors, Chrysler Leadership Development program participants, and other groups within Chrysler. Prepare appropriate management reports as needed. Travel requirements up to 30% (focused primarily in the mid-west). Basic Qualifications: * Bachelor's degree with emphasis in Finance. * Minimum of five years' experience in related field (Finance, Purchasing, Tool Valuation, Engineering, Supply, System Cost Engineering). Preferred Qualifications: * Strong project management skills. * Excellent verbal and written communication skills. * Experience on managing multiple projects simultaneously.
    $39k-56k yearly est. 60d+ ago

Learn more about claim processor jobs

How much does a claim processor earn in Grand Rapids, MI?

The average claim processor in Grand Rapids, MI earns between $21,000 and $56,000 annually. This compares to the national average claim processor range of $26,000 to $62,000.

Average claim processor salary in Grand Rapids, MI

$35,000
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