Claim specialist jobs in Rochester Hills, MI - 75 jobs
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Claim Specialist
Claims Adjuster
Claim Processor
Claims Analyst
Claims Representative
Senior Claims Analyst
Claims Analyst
Cherokee Insurance Company
Claim specialist 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
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Bodily Injury Claims Specialist
Auto-Owners Insurance 4.3
Claim specialist job in Village of Clarkston, 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
$60k-81k yearly est. Auto-Apply 44d ago
Senior Claims Support Analyst
AAA Life Insurance Company 4.5
Claim specialist 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 44d ago
Mortgage Claims Default Specialist
The Emac Group
Claim specialist 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 ClaimsSpecialist 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 ClaimsSpecialist 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. 1d ago
Mortgage Claims Default Specialist
The EMAC Group
Claim specialist 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 ClaimsSpecialist 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 ClaimsSpecialist 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
Warranty Claims Specialist
Brightwing
Claim specialist job in Auburn Hills, MI
Job Title: Warranty ClaimsSpecialist
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. 7d ago
Claims Representative
The Strickland Group 3.7
Claim specialist 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
Bilingual Claims Examiner
Healthcare Support Staffing
Claim specialist 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. 1d ago
Claims Examiner, Commercial Insurance
Arch Capital Group Ltd. 4.7
Claim specialist 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
EHIM 3.8
Claim specialist 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.
$28k-45k yearly est. 21d ago
Claims Processor
Procare Rx 4.0
Claim specialist 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. 20d ago
Claims Adjuster Associate - WC
Amerisure Mutual Insurance Co 4.8
Claim specialist job in Farmington Hills, MI
Amerisure creates exceptional value for its partners, policyholders, and employees. As a property and casualty insurance company, Amerisure's promise to our partner agencies and policyholders begins with a comprehensive line of insurance products designed to protect businesses, as well as the health and safety of every employee. With an A.M. Best "A" (Excellent) rating, Amerisure serves mid-sized commercial enterprises focused in construction, manufacturing and healthcare. Ranked as one of the top 100 Property & Casualty companies in the United States, we proudly manage nearly $1 Billion of Direct Written Premium and maintain $1.21 billion in surplus.
Amerisure is hiring for a Claims Adjuster Associate to help support the claims department. This role will assist adjusters with all phases of the claim lifecycle. This role will specifically align to support two of our Workers' Compensation teams. This is a hybrid role with 2 days being onsite. The ideal candidate will also possess the following skill set.
Summary Statement
The Claims Associate provides quality assistance to adjusters at all phases of the claim lifecycle to drive the claim to timely conclusion. Supports the success of the organization through interactions with agencies, policyholders, and employees. This individual will handle incoming calls and mail for the claims department and facilitate tasks and processes to aid the adjuster to process claims accurately and efficiently.
Essential Tasks/Major Duties
* Respond to inquiries from policyholders, claimants, injured workers, and other stakeholders regarding claim status, receipt of payment or bills, and other claim-related questions.
* Obtain and verify information by gathering missing or incomplete details from relevant parties, including policyholders, claimants, witnesses, and external vendors, to support accurate claim processing.
* Assist with claim documentation by preparing and submitting require state filings, closing documents, and other administrative support requests on behalf of adjusters.
* Draft and distribute correspondence to policyholders, claimants, injured workers, or agents in accordance with company standards and regulatory requirements.
* Maintain accurate claim records by entering data into the claims management system and ensuring all documentation is complete and up to date.
* Coordinate external vendors by engaging appraisers, attorneys, and contractors, to support the claims process.
* Process payments and invoices by reviewing and issuing payments in accordance with company policies and adjuster direction.
Knowledge, Skills & Abilities
* Associate's degree or equivalent combination of education and experience.
* 1 year of experience in insurance, claims, or customer service is preferred.
* Ability to obtain appropriate state licensing as required.
* Proficiency in Microsoft Office Suite.
* Familiarity with claims management software preferred.
* Demonstrated successful ability to build positive relationships and partnerships within department, across the organization and with external customers.
* Excellent verbal and written communication skills with the ability to interact with internal and external customers.
* Demonstrated ability to organize and prioritize work to ensure timely deadlines.
* Demonstrated ability to input data with a high accuracy rating, and strong attention to detail.
Just as we are committed to creating exceptional value for our Partners For Success agencies and policyholders, Amerisure also remains committed to being an employer of choice. We reinforce this commitment by adhering to an Employee Value Proposition that, in part, is provided through a competitive total rewards package. This package includes competitive base pay, performance-based incentive pay, comprehensive health and welfare benefits, a 401(k) savings plan with profit sharing, and generous paid time off programs. We also offer flexible work arrangements to promote work-life balance. Recognized as one of the Best and Brightest Companies to Work For in the Nation and one of Business Insurance magazine's Best Places to Work in Insurance, we provide a workplace that fosters excellence and professional growth. If you are looking for a collaborative and rewarding career, Amerisure is looking for you.
Amerisure Insurance provides equal employment opportunities (EEO) to all employees and applicants for employment without regard to race, color, religion, sex, national origin, age, disability or genetics. In addition to federal law requirements, Amerisure Insurance complies with applicable state and local laws governing nondiscrimination in employment in every location in which the company has facilities. This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation and training. Amerisure Insurance expressly prohibits any form of workplace harassment based on race, color, religion, gender, sexual orientation, gender identity or expression, national origin, age, genetic information, disability, or veteran status. Improper interference with the ability of Amerisure's employees to perform their job duties may result in discipline up to and including discharge.
$49k-59k yearly est. Auto-Apply 13d ago
Independent Insurance Claims Adjuster in Clinton Township, Michigan
Milehigh Adjusters Houston
Claim specialist job in Clinton, MI
IS IT TIME FOR A CAREER CHANGE? INDEPENDENT INSURANCE CLAIMS ADJUSTERS NEEDED NOW! Are you ready to embark on a dynamic and in-demand career as an Independent Insurance Claims Adjuster? This is your chance to join a thriving industry with endless opportunities for growth and advancement.
Why This Opportunity Matters:
With the current surge in storm-related events sweeping across the nation, there's an urgent need for new adjusters to meet the escalating demand.
As a Licensed Claims Adjuster, you'll play a crucial role in helping individuals and businesses recover from unforeseen disasters and rebuild their lives.
This is not just a job-it's a rewarding career path where you can make a real difference in people's lives while enjoying flexibility, autonomy, and competitive compensation.
Join Our Team:
Are you actively working as a Licensed Claims Adjuster with 100 claims or more under your belt?
If so, that's great! If not, no problem! Let us help you on your career path as a Licensed Claims Adjuster.
You're welcome to sign up on our jobs roster if you meet our guidelines.
How We Can Help You Succeed:
At MileHigh Adjusters Houston, we offer comprehensive training programs tailored to equip you with the essential skills and knowledge needed to excel in the field of claims adjusting.
Our expert instructor, with years of industry experience, will provide you with hands-on training, insider tips, and practical insights to prepare you for real-world challenges.
Whether you're a seasoned professional or a newcomer to the field, our training programs are designed to meet you where you are and help you reach your full potential as a claims adjuster.
Don't miss out on this opportunity-let us assist you in advancing your career in claims adjusting and achieving your professional goals. With our guidance and support, you'll have the opportunity to thrive in a dynamic and rewarding industry, making a positive impact on the lives of others while achieving your professional goals.
Seize the Opportunity Today!
Contact us now at ************ or [email protected] to learn more about our training programs and take the first step towards a fulfilling career as a Licensed Claims Adjuster. Visit our website at ******************************** to explore our offerings and view our 375+ Five-Star Google Reviews.
You can also find us on YouTube at: (*********************************************************
and Facebook at: (************************************************** for additional resources and updates.
APPLY HERE
#AdjustersNeeded #CareerOpportunity #ClaimsAdjusterTraining #MileHighAdjustersHouston
By applying to this position, you consent to receive informational and promotional messages from MileHigh Adjusters Houston about training opportunities and related career programs. You may opt out at any time.
$47k-59k yearly est. Auto-Apply 60d+ ago
Field Claims Adjuster
EAC Claims Solutions 4.6
Claim specialist job in Detroit, MI
At EAC Claims Solutions, we are dedicated to resolving claims with integrity and efficiency. Join us in delivering exceptional service while upholding the highest standards of professionalism and compliance. Explore more about our commitment to innovation and community impact at **********************
Overview:
Join EAC Claims Solutions as a Property Field Adjuster, where you will be managing insurance claims from inception to resolution.
Key Responsibilities:
- Planning and organizing daily workload to process claims and conduct inspections
- Investigating insurance claims, including interviewing claimants and witnesses
- Handling property claims involving damage to buildings, structures, contents and/or property damage
- Conducting thorough property damage assessments and verifying coverage
- Evaluating damages to determine appropriate settlement
- Negotiating settlements
- Uploading completed reports, photos, and documents using our specialized software systems
Requirements:
- Ability to perform physical tasks including standing for extended periods, climbing ladders, and navigating tight spaces
- Strong interpersonal communication, organizational, and analytical skills
- Proficiency in computer software programs such as Microsoft Office and claims management systems
- Self-motivated with the ability to work independently and prioritize tasks effectively
- High school diploma or equivalent required
- Previous experience in insurance claims or related field is a plus but not required
Next Steps:
If you're passionate about making a difference, thrive on challenges, and deeply value your work, we invite you to apply. Should your application progress, a recruiter will reach out to discuss the next steps.
Join us at EAC Claims Solutions, where your passion meets purpose, and where your contributions truly matter.
$48k-59k yearly est. Auto-Apply 41d ago
Mortgage Claims Specialist
The EMAC Group
Claim specialist job in Detroit, 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 ClaimsSpecialist 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 ClaimsSpecialist 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 Specialist
The Emac Group
Claim specialist job in Detroit, 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 ClaimsSpecialist 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 ClaimsSpecialist 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. 1d ago
Bilingual Claims Examiner
Healthcare Support Staffing
Claim specialist 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 InformationInterested in hearing more about this great opportunity?
If you are interested in applying to this position, please click Apply Now and email your resume to Michael Grifon.
$27k-45k yearly est. 60d+ ago
Claims Processor
Employee Health Insurance Management Inc. 3.8
Claim specialist 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. 21d ago
Independent Insurance Claims Adjuster in Ann Arbor, Michigan
Milehigh Adjusters Houston
Claim specialist job in Ann Arbor, MI
IS IT TIME FOR A CAREER CHANGE? INDEPENDENT INSURANCE CLAIMS ADJUSTERS NEEDED NOW! Are you ready to embark on a dynamic and in-demand career as an Independent Insurance Claims Adjuster? This is your chance to join a thriving industry with endless opportunities for growth and advancement.
Why This Opportunity Matters:
With the current surge in storm-related events sweeping across the nation, there's an urgent need for new adjusters to meet the escalating demand.
As a Licensed Claims Adjuster, you'll play a crucial role in helping individuals and businesses recover from unforeseen disasters and rebuild their lives.
This is not just a job-it's a rewarding career path where you can make a real difference in people's lives while enjoying flexibility, autonomy, and competitive compensation.
Join Our Team:
Are you actively working as a Licensed Claims Adjuster with 100 claims or more under your belt?
If so, that's great! If not, no problem! Let us help you on your career path as a Licensed Claims Adjuster.
You're welcome to sign up on our jobs roster if you meet our guidelines.
How We Can Help You Succeed:
At MileHigh Adjusters Houston, we offer comprehensive training programs tailored to equip you with the essential skills and knowledge needed to excel in the field of claims adjusting.
Our expert instructor, with years of industry experience, will provide you with hands-on training, insider tips, and practical insights to prepare you for real-world challenges.
Whether you're a seasoned professional or a newcomer to the field, our training programs are designed to meet you where you are and help you reach your full potential as a claims adjuster.
Don't miss out on this opportunity-let us assist you in advancing your career in claims adjusting and achieving your professional goals. With our guidance and support, you'll have the opportunity to thrive in a dynamic and rewarding industry, making a positive impact on the lives of others while achieving your professional goals.
Seize the Opportunity Today!
Contact us now at ************ or [email protected] to learn more about our training programs and take the first step towards a fulfilling career as a Licensed Claims Adjuster. Visit our website at ******************************** to explore our offerings and view our 375+ Five-Star Google Reviews.
You can also find us on YouTube at: (*********************************************************
and Facebook at: (************************************************** for additional resources and updates.
APPLY HERE
#AdjustersNeeded #CareerOpportunity #ClaimsAdjusterTraining #MileHighAdjustersHouston
By applying to this position, you consent to receive informational and promotional messages from MileHigh Adjusters Houston about training opportunities and related career programs. You may opt out at any time.
$47k-59k yearly est. Auto-Apply 60d+ ago
Mortgage Claims Default Specialist
The EMAC Group
Claim specialist job in Detroit, 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 ClaimsSpecialist 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 ClaimsSpecialist 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.
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: ************
How much does a claim specialist earn in Rochester Hills, MI?
The average claim specialist in Rochester Hills, MI earns between $32,000 and $88,000 annually. This compares to the national average claim specialist range of $27,000 to $67,000.
Average claim specialist salary in Rochester Hills, MI
$53,000
What are the biggest employers of Claim Specialists in Rochester Hills, MI?
The biggest employers of Claim Specialists in Rochester Hills, MI are: