Claim processor jobs in Waverly, MI

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

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

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

Why AAA Life AAA Life is a respected and trusted American brand that has been focusing on Life Insurance and Annuity Products since 1969. At AAA Life we have over 1.8 million policies where we take pride in earning the trust of our policyholders who understand our promise to be there for them - and their families - when we're needed most. By joining the AAA Life team, you are joining a company that genuinely cares about helping each other, with a devotion to protect the lives of those around us. We embrace a diverse, equitable, inclusive culture where all associates can feel a sense of belonging and use their unique talents and perspective to influence, innovate, motivate, and thrive. The Senior Claims Support Analyst supports both the Claims and Treasury functions by ensuring the efficient flow of funds, accuracy of claims payments, and continuous improvement of claims financial processes. This role combines analytical and operational expertise to maintain regulatory compliance, improve claims payment accuracy, and optimize cash management procedures. The analyst develops, monitors, and reports on key performance metrics, reconciles payment and claims data, supports quality reviews, and collaborates cross-functionally with Finance, Treasury, and Claims Leadership to streamline processes and improve financial integrity in claims operations. Responsibilities What You'll Do Perform analytical reviews of claims payment and financial transactions to ensure accuracy, compliance, and adherence to internal controls and resolve related issues. Compile and interpret data for claims-related financial and operational reports, including accuracy trends, payment reconciliation, and reserve management. Maintain and analyze spreadsheets and databases used for claims funding, payment tracking, and financial reconciliations. Partner with Treasury to forecast cash needs related to claims payouts and ensure adequate liquidity for daily claim obligations. Develop and maintain process documentation and financial models to improve claims funding and payment accuracy. Conduct quality audits for all claim types (Life, Annuity, A&H) to verify regulatory compliance and identify opportunities for improvement. Support service recovery and resolution for escalated claim issues; provide data and analysis for Department of Insurance or external audit responses. Collaborate with Finance to analyze trends, variances, and reconciliation discrepancies; recommend corrective actions. Identify and implement process improvements to reduce manual handling, improve automation, and enhance data accuracy. Prepare and present claims financial metrics and insights to management, highlighting process efficiencies and control improvements. Serve as liaison for audit-related requests (internal, reinsurer, or regulatory) and provide supporting documentation. Provide training, guidance, and feedback to claims staff on financial procedures and quality standards. Ensure compliance with MAR, internal audit requirements, and fair claims practices regulations. Qualifications What You Offer: Bachelor's Degree in Business, Finance, Accounting, or related field (or equivalent work experience). Minimum 5 years of experience in Claims Operations, Treasury Support, or related insurance field. Strong understanding of claims processing systems, payment workflows, and audit requirements. Proficiency in Microsoft Excel, Access, and financial modeling; familiarity with COGNOS or similar reporting tools preferred. Demonstrated experience in data analysis, reconciliation, and process improvement. Excellent communication and collaboration skills, with the ability to work effectively across departments. Strong organizational and time-management skills with attention to detail. Ability to manage multiple priorities in a fast-paced, deadline-driven environment. What We offer: A collaborative, energetic work environment where you can put your passion for people to work Medical, Dental, Vision, Life and Disability coverage available day one Pension Plan Performance-based incentive plan 401k available with a Company match Holidays and Paid Time Off AAA Basic Membership #LI-Hybrid While performing the duties of this job, the employee is frequently required to stand, walk, sit, use hands to finger, handle, or feel, talk, hear and concentrate. Specific vision abilities required by this job include close vision, distance vision, depth perception, and ability to adjust focus. This job requires the ability to perform duties contained in the job description for this position, including, but not limited to, the above requirements. Reasonable accommodation will be made for otherwise qualified applicants as needed to enable them to fulfill these requirements. We are committed to ensuring equal employment opportunities for all job applicants and employees. Employment decisions are based upon job-related reasons regardless of an applicant's race, color, religion, sex, sexual orientation, gender identity, age, national origin, disability, marital status, genetic information, protected veteran status, or any other status protected by law.

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℠. Arch Insurance Group Inc., AIGI, has an opening in the Claims Division is seeking a Senior Claims Examiner to join the Casualty Team. In this role, the responsibilities include actively managing commercial accounts claims caseload throughout the United States. Primary Responsibilities Specific duties include but not limited to the below: * 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 strategy to resolve matters of liability and damages of a particular case * Maintain contact with the business line leader, underwriter, defense counsel, program manager, and broker * Investigate claim and review the insureds' materials, pleadings, and other relevant documents * Identify and review of 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 evaluation 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 Qualifications * Proper adjuster licensing in all applicable states * 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 * Ability to take part in active strategic discussions * 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 20% * This role is hybrid with 2 days in office Education and Experience * Bachelor's degree; Juris Doctorate degree preferred * Five (5) years of working experience with a primary and / or excess carrier supporting commercial accounts for Casualty claims; Professional Liability claims #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. For Jersey City, Morristown, NYC: $123,400 - $166,633/year For Hartford, Chicago, Long Island: $111,100 - $149,970/year * 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. For Colorado Applicants - The deadline to submit your application is: December 08, 2025 14400 Arch Insurance Group Inc.

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

We offer a merit-based work-from-home program based on job responsibilities. After initial training in-person, you could have the flexibility of work-from-home time as defined by the leadership team. Auto-Owners Insurance, a top-rated insurance carrier, is seeking a motivated individual to join our Claims department as a Bodily Injury Claims Representative. The position requires the person to: * Assemble facts, determine coverage, evaluate the amount of loss, analyze legal liability, make payments in accordance with coverage, damage and liability determination, and perform other functions or duties to properly adjust the loss. * Study insurance policies, endorsements, and forms to develop an understanding of insurance coverage. * Follow claims handling procedures and participate in claim negotiations and settlements. * Deliver a high level of customer service to our agents, insureds, and others. * Devise alternative approaches to provide appropriate service, dependent upon the circumstances. * Meet with people involved with claims, sometimes outside of our office environment. * Handle investigations by telephone, email, mail, and on-site investigations. * Maintain appropriate adjuster's license(s), if required by statute in the jurisdiction employed, within the time frame prescribed by the Company or statute. * Handle complex and unusual exposure claims effectively through on-site investigations and through participation in mediations, settlement conferences, and trials. * Handle confidential information according to Company standards and in accordance with any applicable law, regulation, or rule. * Assist in the evaluation and selection of outside counsel. * Maintain punctual attendance according to an assigned work schedule at a Company approved work location. Desired Skills & Experience * A minimum of three years of insurance claims related experience. * The ability to organize and conduct an investigation involving complex issues and assimilate the information to reach a logical and timely decision. * The ability to effectively understand, interpret and communicate policy language. * The dissemination of appropriate claim handling techniques so that others involved in the claim process are understanding of issues. Benefits Auto-Owners offers a wide range of career opportunities, and we are seeking talent that will help us continue our long tradition of success. We offer a friendly work environment, structured training program, employee mentoring and an excellent compensation/benefits package. Along with a competitive base salary, matched 401(k), fully-funded pension plan (once vested), and bonus programs, Auto-Owners also provides generous paid time off including holidays, vacation days, personal time, and sick leave. If you're looking to do rewarding work alongside great people, Auto-Owners is the place for you! Equal Employment Opportunity Auto-Owners Insurance is an equal opportunity employer. The Company hires, transfers, and promotes on the basis of ability, without consideration of disability, age, sex, race, color, religion, height, weight, marital status, sexual orientation, gender identity or national origin, or any factor contrary to federal, state or local law. * Please note that the ability to work in the U.S. without current or future sponsorship is a requirement. #LI-CH1 #LI-Hybrid

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

The Claims Specialist is responsible for handling damage claims and property loss claims, to help resolve them efficiently and fairly. Successful Candidates need to have prior automotive insurance claims experience or experience working with insurance in a body shop or similar vehicle repair facility. 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

Through our dedicated associates, Conduent delivers mission-critical services and solutions on behalf of Fortune 100 companies and over 500 governments - creating exceptional outcomes for our clients and the millions of people who count on them. You have an opportunity to personally thrive, make a difference and be part of a culture where individuality is noticed and valued every day. **Supplier Claims Auditor** **Hybrid | Warren, MI** **Part-Time | Hours Assigned as Needed** **Hours of Operation: Monday- Friday, 7:00 AM - 4:00 PM EST** **About the Role:** As a Supplier Claims Auditor, you'll play a vital role in the Supplier Claim Activity (SCA) group by reviewing and auditing supplier obsolescence and cancellation claims. You'll validate costs, ensure compliance with contract terms and conditions, and prepare detailed audit reports for internal and external stakeholders. This position requires strong analytical, financial, and organizational skills, along with a proactive approach to problem-solving and collaboration. A typical day includes reviewing assigned supplier claims, auditing supporting documentation, preparing audit files and recommendations, collaborating with internal stakeholders to determine settlements, and tracking open claims to ensure timely resolution. This position is ideal for someone who enjoys detail-oriented, analytical work and thrives in a collaborative yet independent environment. **Requirements:** We're looking for professionals who are analytical, organized, and comfortable managing multiple priorities. To be successful in this role, you should have: + Experience in auditing, finance, purchasing, tax, or cost analysis + Proficiency in Microsoft Excel, including PivotTables, VLOOKUP, and Conditional Formatting + Strong written, verbal, and interpersonal communication skills + Ability to manage multiple claim reviews and meet deadlines independently + Familiarity with automotive manufacturing processes and cost factors such as labor, materials, and profit + Successful completion of background check _Pay Transparency Laws in some locations require disclosure of compensation and/or benefits-related information. For this position, actual salaries will vary and may be above or below the range based on various factors including but not limited to location, experience, and performance. In addition to base pay, this position, based on business need, may be eligible for a bonus or incentive. In addition, Conduent provides a variety of benefits to employees including health insurance coverage, voluntary dental and vision programs, life and disability insurance, a retirement savings plan, paid holidays, and paid time off (PTO) or vacation and/or sick time. The estimated salary range for this role is $_ _45,360 - $_ _56,700._ Conduent is an Equal Opportunity Employer and considers applicants for all positions without regard to race, color, creed, religion, ancestry, national origin, age, gender identity, gender expression, sex/gender, marital status, sexual orientation, physical or mental disability, medical condition, use of a guide dog or service animal, military/veteran status, citizenship status, basis of genetic information, or any other group protected by law. For US applicants: People with disabilities who need a reasonable accommodation to apply for or compete for employment with Conduent may request such accommodation(s) by submitting their request through this form that must be downloaded: click here to access or download the form (********************************************************************************************** . Complete the form and then email it as an attachment to ******************** . You may also click here to access Conduent's ADAAA Accommodation Policy (***************************************************************************************** .

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.

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 • 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: ************

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. )

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

Medicaid Specialist at Cambridge Dental Group - Dearborn Heights, MI* Cambridge Dental Group is seeking a detail-oriented and experienced CBO Team Member to join our centralized business office team. This role is essential in ensuring accurate and timely submission and follow-up of Medicaid pre-authorizations and claims. The ideal candidate will bring a strong background in Medicaid billing and revenue cycle management (RCM), with a commitment to accuracy and efficiency. Responsibilities: Submit all Medicaid pre-authorizations and claims in a timely manner. Follow up consistently on pre-authorizations and claims to ensure proper resolution. Review and manage daily work logs to resolve outstanding claims. Appropriately document all account activities within the practice management system. Process EOB and R/A payments/denials accurately and promptly. Communicate effectively with leadership, co-workers, and dental offices regarding claim status. Maintain a high level of accuracy and attention to detail in all job functions. Provide backup support to other CBO team members as needed. Required Qualifications: 5+ years of Medicaid billing and RCM experience (preferred) Proven ability to manage pre-authorizations and claims efficiently High attention to detail and task-focused work style Strong organizational and follow-up skills Preferred Qualifications: Some dental clinical experience (helpful but not required) Why Join Us: Full-time position with comprehensive benefits including health insurance, life insurance, PTO, paid holidays, disability options, 401k with match Be part of a supportive and collaborative CBO team Play a key role in ensuring smooth financial operations for our office Competitive compensation and growth opportunities within a trusted dental group #indeedwavedp Requirements Education and Training High school diploma or equivalent required. Three years healthcare cash posting, billing, third party follow-up and collections experience required; OR a combination of education and/or experience in business or related field totaling three years. Knowledge of automated business applications, including word-processing, spreadsheet and data base management applications required. Data entry experience and knowledge of Medicare, Medicaid, and third-party insurance preferred. FLSA Status: Hourly, Non-Exempt Reports to: VP of Finance

Benefits: 401(k) Dental insurance Health insurance Paid time off Parental leave Vision insurance Who We AreIncingo is a medical cost containment company that helps manage everything from short-term post-op to catastrophic care for worker's compensation claims. We use our nationwide network of proven, credentialed vendors and create customized programs for efficient authorizing and shipping of medical supplies. We also coordinate medical transportation, home health care and in-home modifications. We are located in the heart of downtown Ann Arbor and we are looking for a full-time Claims Specialist. Hybrid work is available, prefer candidates in Michigan. We offer a best-in-class benefits package with a flexible work environment. Our culture is one of caring and collaboration, and we enjoy a team-oriented environment. Visit our website or LinkedIn to learn more. What You'll Do Serve as primary contact for inbound and outbound customer support by phone, email, or instant message Facilitate resolution of open receivables by review of coding, product, contract, payment agreement, fee schedule and/or authorization terms. Work independently and as part of a team on invoice renegotiations, vendor management, and provider and patient relations Review EOB's and address denial and partial payment of invoices in a timely and accurate manner Maintain accurate documentation of workers compensation claim files in multiple databases Ensure quality components of service delivery and patient/payor satisfaction with services provided Establish and maintain strong vendor relationships Participate in process for continuous credentialing and quality monitoring of assigned accounts Work with team to conduct cost analysis and identify margin opportunities Demonstrate performance aligned with WRS guiding principles, including caring, collaboration, trustparency, and innovation What You'll Bring High School Diploma (or equivalent); college degree preferred 1+ year experience in a medical setting preferred A customer focused approach to tasks and responsibilities Must be analytical and solution-oriented with excellent problem-solving abilities, superior follow-up skills, and the ability to shift gears frequently throughout the day Intermediate MS Suite, typing and email skills Excellent verbal and written communication skills Familiarity of workers compensation state fee schedules preferred Flexible work from home options available. Compensation: $45,000.00 - $50,000.00 per year We are an equal opportunity employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability status, protected veteran status, or any other characteristic protected by law. Physician Dispensing providers are proliferating. But WRS is one of the few that's trusted over time, with 12+ years in orthopedic healing. We know what works. And we understand that even the simplest change is tough in a busy practice. So our local support is there 24/7, to help integrate your dispensing program into your day-to-day workflow, seamlessly. Immediate dispensing can make all the difference. Our non-opioid formulary and multidisciplinary approach to healing can help manage patient's pain through non-narcotic alternatives. Ready access to treatment helps to save you time and saves patients added pain, as post-op treatment regimens begin faster. So patients may return to work faster, too. Along with our on-call pharmacist support for any questions that arise, together, we can fight today's opioid epidemic.

Since 2002, Quantix ProTech has successfully delivered IT resources and solutions to companies while building a solid reputation for integrity and consistent quality. Quantix ProTech continues to partner with the commercial sector for specialized IT placement and staffing services. Quantix ProTech was recently featured in US News and World Report and Forbes. Job Title: Healthcare Claims Auditor Location: Ann Arbor, MI Type: Contract Length: Through 12/22/2016 Job Description: Our client in the Ann Arbor, Michigan area is looking for Healthcare Claims Auditors to join their team on a short term contract basis. This candidates will translate client's healthcare Summary Plan Descriptions into plan builds in the the audit rules engine. Successful candidates will have a solid understanding of healthcare claims processing having gained experience working for a health plan or a TPA. Required Skills: 1) Healthcare Claims Auditing. 2) Helathcare Coding methods. Qualifications Required Skills: 1) Healthcare Claims Auditing. 2) Helathcare Coding methods. Additional Information All your information will be kept confidential according to EEO guidelines. If your interested, send a copy of your resume at henriquez@quantixinc. com or reach me at ************.

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