Adjuster, Property Insurance Claims
Claims adjuster job in Grand Rapids, MI
Elevate Claims Solutions is founded on the belief that human experience and claim quality are the essence of profitable growth and retention for our adjuster partners, our clients, and ourselves. Are you ready, willing, and able to Elevate?
Elevate Claims Solutions is seeking an Independent Adjuster in Western Michigan.
How will we Elevate you?
We want to know and understand your unique skillset and goals. We are committed to receiving your feedback on how we can best support your progression and advancement towards those goals.
Expand your career opportunities in a role where you can see that you are making a difference in people's lives.
Meaningful work in a culture of continuous improvement.
A diverse market of carriers
Clear communication of service and quality expectations; internal and external.
Guidelines that provide upfront understanding of each carrier's requirements.
Continuous feedback, including real -time Quality Assurance and formalized quarterly coaching sessions to identify areas of strength and opportunity. Training and development opportunities tailored to individual growth objectives.
A tenured foundation of industry experts with a wide knowledge base for you to consult.
How will you Elevate?
Prioritize policyholders during their time loss through demonstrated empathy and understanding.
Valuing our partnerships with our carrier clients; recognizing and maximizing the ways in which our Elevated Claims Handling can support them and their policyholders.
Outstanding work ethic. This is not a 9 -5 position and you will be called upon to maintain a flexible schedule to help meet the needs of insureds and carriers.
Clear, consistent, and timely communication. We, and our carriers, want and need strong lines of communication.
You must be open to receiving and providing feedback.
The ability to effectively and independently manage workload while exercising good judgement.
Strong written and verbal communication skills.
Strong technological skills with the ability to work within various claims management systems.
Minimum of three years of residential and commercial property adjusting experience.
Carrier experience is desired.
Liability experience is a plus.
Current, active Xactimate license and experience writing both residential and commercial damage estimates in Xactimate.
Ability to pass a background screen.
Current, active license where required.
Equipment and ability to access roofs.
If you are ready to Elevate claims with a firm that truly values and supports you, let us know - we may be a fit.
Field Claims Adjuster
Claims adjuster job in Grand Rapids, 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.
Independent Insurance Claims Adjuster in Grand Rapids, Michigan
Claims adjuster job in Grand Rapids, 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.
Auto-ApplySupervisor, Claims
Claims adjuster job in Grand Rapids, MI
As a family company, we serve people and communities. When you work at Meijer, you're provided with career and community opportunities centered around leadership, personal growth and development. Consider joining our family - take care of your career and your community!
Meijer Rewards
Weekly pay
Scheduling flexibility
Paid parental leave
Paid education assistance
Team member discount
Development programs for advancement and career growth
Please review the job profile below and apply today!
The Supervisor, Claims Examiners is responsible for overseeing a team of risk management examiners, ensuring efficient and effective handling of general liability claims. This role involves supervising and supporting claims examiners, providing guidance and training, and ensuring compliance with company policies and industry regulations. The supervisor will also handle complex claims, assist in the implementation of claims strategies and helping to identify efficiencies in the claims processes.
What You'll be Doing:
Supervise and mentor a team of risk management examiners
Review and approve claims settlements within authority limits, as decided by the company
Ensure timely and accurate processing of claims, while holding examiners to a high level of customer service
Handle complex and high-value claims
Provide training and development opportunities for risk management examiners
Monitor and ensure compliance with company policies, procedures, and industry regulations
Assist with implementation of claims handling strategies to improve efficiency and effectiveness
Conduct regular audits of risk management examiner claim files to ensure quality and accuracy
Collaborate with other departments, such as legal, asset protection and safety, to resolve claims issues
Prepare reports on claims activities and performance metrics for leadership as requested
This job profile is not meant to be all inclusive of the responsibilities of this position; may perform other duties as assigned or
What You Bring with You (Qualifications):
Associate's degree in business, insurance, or a related field
Minimum of two (2) years of experience in general liability claims handling
At least one (1) year of previous supervisory or leadership experience
Strong knowledge of general liability insurance policies and regulations
Excellent analytical and problem-solving skills
Effective communication and interpersonal skills
Ability to manage multiple priorities and meet deadlines
Proficiency in claims management software and Microsoft Office Suite
Auto-ApplyAuto Claims Representative
Claims adjuster job in Grand Rapids, MI
We offer a merit-based work-from-home program based on job responsibilities. After initial training in-person, you could have the flexibility of work-from-home time as defined by the leadership team. Auto-Owners Insurance, a top-rated insurance carrier, is seeking a motivated claims trainee to join our team. This job handles entry-level insurance claims under close supervision through the life-cycle of a claim including but not limited to: investigation, evaluation, and claim resolution. This job provides service to agents, insureds, and others to ensure claims resolve accurately and timely. This job includes training and development completion of the Company's claims training program for the assigned line of insurance and requires the person to:
* Investigate, evaluate, and settle entry-level insurance claims
* Study insurance policies, endorsements, and forms to develop foundational knowledge on Company insurance products
* Learn and comply with Company claim handling procedures
* Develop entry-level claim negotiation and settlement skills
* Build skills to effectively serve the needs of agents, insureds, and others
* Meet and communicate with claimants, legal counsel, and third-parties
* Develop specialized skills including but not limited to, estimating and use of designated computer-based programs for loss adjustment
* Study, obtain, and maintain an adjuster's license(s), if required by statute within the timeline established by the Company or legal requirements
Desired Skills & Experience
* Bachelor's degree or direct equivalent experience with property/casualty claims handling
* Ability to organize data, multi-task and make decisions independently
* Above average communication skills (written and verbal)
* Ability to write reports and compose correspondence
* Ability to resolve complex issues
* Ability to maintain confidentially and data security
* Ability to effectively deal with a diverse group individuals
* Ability to accurately deal with mathematical problems, including, geometry (area and volume) and financial areas (such as accuracy in sums, unit costs, and the capacity to read and develop understanding of personal and business finance documents)
* Ability to drive an automobile, possess a valid driver license, and maintain a driving record consistent with the Company's underwriting guidelines for coverage
* Continually develop product knowledge through participation in approved educational programs
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
Auto-ApplyContents Adjuster
Claims adjuster job in Grand Rapids, MI
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
Contents Adjuster
**PRIMARY PURPOSE** : To handle losses and claims for property and casualty insurers.
**ESSENTIAL FUNCTIONS and RESPONSIBILITIES**
+ Examines insurance policies and other records to determine insurance coverage.
+ Interviews, telephones, and/or corresponds with claimant and witnesses regarding claim.
+ Consults police and hospital records and inspects property damage to determine extent of company's liability and varying methods of investigation according to type of insurance.
+ Estimates cost of repair, replacement, or compensation.
+ Prepares report of findings and negotiates settlement with claimant.
+ Recommends litigation by legal department when settlement cannot be negotiated.
+ Attends litigation hearings.
+ Revises case reserves in assigned claims files to cover probable costs.
+ Assists in preparing loss experience report to help determine profitability and calculates adequate future rates.
**ADDITIONAL FUNCTIONS and RESPONSIBILITIES**
+ Performs other duties as assigned.
+ Supports the organization's quality program(s).
+ Travels as required.
**QUALIFICATIONS**
**Education & Licensing**
Bachelor's degree from an accredited college or university preferred. Obtain IIA-AIC designation within 12 to 18 months. Appropriate state adjuster license is required.
**Experience**
None.
**Skills & Knowledge**
+ Strong oral and written communication, including presentation skills
+ PC literate, including Microsoft Office products
+ Demonstrated commitment to timely reporting
+ Strong customer service skills
+ Strong interpersonal skills
+ Attention to detail and accuracy
+ Good time management and organizational skills
+ Ability to work independently or in a team environment
+ Ability to meet or exceed Performance Competencies
**WORK ENVIRONMENT**
When applicable and appropriate, consideration will be given to reasonable accommodations.
**Mental** : Clear and conceptual thinking ability; excellent judgment and discretion; ability to handle work-related stress; ability to handle multiple priorities simultaneously; and ability to meet deadlines
**Physical** :
+ Must be able to stand and/or walk for long periods of time.
+ Must be able to kneel, squat or bend.
+ Must be able to work outdoors in hot and/or cold weather conditions.
+ Have the ability to climb, crawl, stoop, kneel, reaching/working overhead
+ Be able to lift/carry up to 50 pounds
+ Be able to push/pull up to 100 pounds
+ Be able to drive up to 4 hours per day.
+ Must have continual use of manual dexterity.
**Auditory/Visual** : Hearing, vision and talking
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 ($45,000 - $60,000 USD annually). 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.
The statements contained in this document are intended to describe the general nature and level of work being performed by a colleague assigned to this description. They are not intended to constitute a comprehensive list of functions, duties, or local variances. Management retains the discretion to add or to change the duties of the position at any time.
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**
Outside Property Adjuster - Grand Rapids, MI
Claims adjuster job in Grand Rapids, MI
Our Claims department is currently seeking an Outside Property Adjuster for the Michigan territory of Grand Rapids. This is a remote full-time/exempt role with field investigations. Outside property adjusters handle property claims requiring field investigations and/or inspections. They must establish rapport with our insureds and maintain relationships with our agents, underwriters, contractors, restoration vendors, and experts. They are expected to know their territory, including the geography; regulations and the law as pertains to property claims; state and local public safety and regulatory agencies and officials; the insurance and legal climate; and public adjusters. Outside property adjusters may use a company claims office location as their base of operations, or they may work out of their homes.
IN THIS ROLE, YOU WILL:
Handle personal property claims requiring outside field investigations and/or inspections
May use a company claims office location as their base operations, or they may work out of their homes
Handle business interruption (BI) features in conjunction with BI specialists
Work within specific limits and authority on assignments of moderate technical complexity
Possess functional knowledge and skills reflective of fully competent practitioner
Identify possibly suspicious claims
Investigate, analyze, evaluate and negotiate personal claims of minimal to moderate complexity
May handle low complexity commercial claims
May be responsible for all aspects of each claim, including informal hearings, arbitrations, and claims litigation and maintaining a high level of productivity, confidentiality and customer service
Implement and coordinate the most effective management techniques to mitigate loss and expense payments
Settlement and reserving authority levels are moderate
Required to have and maintain sufficient home-based internet connection
WHAT YOU NEED TO APPLY:
2+ years of experience adjusting claims
Preferred experience with Xactimate estimating software
Must have or secure and maintain appropriate states adjuster license(s) and continuing education credits
Must have valid driver's license
Dedicated to meeting the expectations and requirements of internal and external customers
Makes decisions in an informed, confident and timely manner
Maintains constructive working relationships despite differing perspectives
Strong organizational and time management skills
Ability to negotiate skillfully in difficult situations with both internal and external groups
Demonstrates ability to win concessions without damaging relationships
Demonstrates strong written and verbal communication skills
Promotes and facilitates free and open communication
Understanding of applicable statutes, regulations and case law
Think critically and anticipate, recognize, identify and develop solutions to problems in a timely manner
Easily adapt to new or different changing situations, requirements or priorities
Cultivate an environment of teamwork and collaboration
Operate with latitude for un-reviewed action or decision
Computer experience (MS Office, excel, word, etc)
Proficient using Claims systems (i.e. CSS, PMS, etc.)
Ability to use a personal computer and other standard office equipment
Ability to travel as necessary
Ability to sit and/or stand for extended periods
Ability to operate a motor vehicle 4-5 hours per day and to get in and out of the vehicle numerous times during the day
Ability to load and unload equipment and supplies weighing up to 30 pounds from a motor vehicle as needed to perform field work
Ability to bend, walk, and climb for several consecutive hours while inspecting damaged buildings, often with utilities turned off or inoperable
Ability to use a ladder safely to get onto and off of roofs, and maintain balance while inspecting roofs
Ability to perform field work in adverse weather
This job posting provides cursory examples of some of the job duties associated with this position. The examples provided are not complete, and the position may entail other essential and job-related functions and responsibilities that employees will be required to perform.
Field Adjuster (Residential or Commercial) - Grand Rapids, MI
Claims adjuster job in Grand Rapids, MI
CCMS & Associates is looking for a 1099 Field Adjuster in Michigan, specifically the Grand Rapids area. We are looking to add to our existing roster. The time is now to get on board with our team! We are seeking a residential or commercial field adjuster with at least 1 year of field experience.
Requirements:
Minimum 1 year first-party commercial and/or residential property adjusting experience
Maintain own current estimating software - Xactimate preferred (Symbility experience a plus)
Working computer - internet access and Microsoft Word required
Must demonstrate strong time management and customer service skills
Experience in preparing Statement of Loss, Proof of Loss, and denial letters
Must have a valid drivers license
Responsibilities:
Complete residential and commercial field property inspections utilizing Xactimate software
Investigate claims by obtaining recorded statements from insureds, claimants, or witnesses and by interviewing fire, police, or other governmental officials as well as inspecting claimed damages
Recommend claim reserves based on investigation, through well-supported reserve report
Obtain and interpret official reports
Review applicable coverage forms and endorsements, provide a thorough analysis of coverage and any coverage issues in a well-documented initial captioned report to the client
Maintain acceptable product quality through compliance with established best practices
Knowledge and Skills:
In-depth knowledge of property and liability insurance coverage and industry standards
Ability to prepare full-captioned reports by collecting and summarizing required information
Strong verbal and written communications skills
Prompt, reliable, and friendly
Preferred but Not Required:
College degree
AIC, IICRC, HAAG or other professional designations
All candidates must pass a full background check (void in states where prohibited)
CCMS & Associates offers multi-line claim adjusting and third-party administration services dedicated to solving the challenges of the complex claim in the property and casualty insurance industry. We create programs that drive a successful claim life cycle while strategically managing all aspects of the complicated issues carriers and policyholders are facing. Servicing excess and surplus/domestic carriers in the United States.
Auto-ApplyAutomotive Claims Specialist
Claims adjuster job in Grandville, MI
The Claims Specialist is responsible for handling damage claims and property loss claims, to help resolve them efficiently and fairly. Successful Candidates must 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
Senior Complex Claim Specialist
Claims adjuster job in Hastings, MI
Champion fair, strategic resolutions for Hastings most complex and litigated claims.
Schedule: Monday - Friday, 8:00 AM - 4:30 PM
About the Role:
The Senior Claim Specialist manages a personal caseload of large, complex coverage and high-exposure claims, both litigated and non-litigated, while supporting the Complex Claims Unit with technical guidance. This position ensures compliance with best practices and legal obligations, serves as a resource on coverage and strategy, and collaborates with internal and external partners to resolve claims efficiently and equitably.
What You'll Do:
Manage a portfolio of large and complex coverage and litigated claims from investigation through resolution.
Evaluate liability, damages, and coverage issues to determine appropriate claim outcomes.
Exercise sound judgment on reserve and settlement decisions within authority levels.
Provide technical guidance and mentorship to Complex Claims Unit members.
Oversee assignments of new complex claims and assist with vetting and selection of outside counsel.
Review and approve vendor invoices and ensure cost-effective claim handling.
Lead field investigations and coordinate with agents, insureds, attorneys, and experts.
Support litigation strategy, reporting, and presentations to senior leadership.
Participate in departmental projects and initiatives that enhance claim operations.
Additional Role Highlights:
Frequent collaboration with agents, policyholders, attorneys, vendors, and reinsurers.
May serve as a witness or expert and attend depositions, hearings, and trials.
Occasional overnight travel may be required.
Role based at Hastings Insurance corporate offices, with hybrid or remote flexibility possible.
What You'll Bring:
Bachelor's degree or equivalent insurance education and experience required.
At least 12 years of progressive claim experience, with strong background in commercial and litigated claims.
Proven expertise in coverage evaluation, negotiation, and complex litigation management.
Exceptional written and verbal communication skills.
Strong analytical, decision-making, and conflict-resolution skills.
Ability to work independently while contributing to a collaborative team environment.
Proficiency with claim management systems and Microsoft Office.
Professional insurance designation (or active pursuit) preferred.
About Us:
At Hastings Insurance, we're more than an insurance provider- we're a trusted partner to our agents, policyholders, and the communities we serve. For over 135 years, we've been helping individuals, families, and businesses protect what matters most and rebuild after loss. We're proud to be rated A (Excellent) by A.M. Best Company, recognizing our enduring financial strength and stability.
While our heritage runs deep, we're always looking ahead. We embrace emerging technologies, cultivate strong partnerships with independent agents, and continuously evolve our products to meet the needs of today's customers. Our strategy is focused on responsible growth, expanding our reach while staying innovative, agile, and committed to personalized service.
Our people are the heart of everything we do. Our talented team members, many recognized as industry experts, are passionate about delivering exceptional service, driving progress, and making a real impact. At Hastings Insurance, we foster a culture of collaboration, continuous learning, and appreciation for the diverse skills and ideas our employees bring.
Our Commitment as an Employer:
We believe that diverse perspectives and inclusive teams drive innovation and strengthen our organization. We're committed to fostering a workplace where every employee feels valued, respected, and empowered to contribute their best.
We are proud to be an equal opportunity employer, and we make employment decisions based on business needs, role requirements, and individual qualifications-without regard to race, color, religion, gender, sexual orientation, gender identity, national origin, age, appearance, disability, veteran status, family status, marital status, or any other legally protected characteristic.
We also understand the importance of providing a welcoming and accessible experience for all candidates. If you require accommodation during the application or interview process, please reach out to our Talent Acquisition Specialist or contact us at ************.
Fremont Property Desk Claims Specialist
Claims adjuster job in Fremont, MI
Fremont Property Desk Claims Specialist- AAA The Auto Club Group
Reports to: Claim Manager as appropriate
What you will do:
Work under minimal supervision with a high-level approval authority to handle complex technical issues and complex claims.
Claim handling responsibilities will include the following: reviewing assigned claims, contacting the insured and other affected parties, setting expectations for the remainder of the claim process, and initiating documentation in the claim handling system. Complete complex coverage analysis. Ensure all possible policyholder benefits are identified. Create additional sub-claims if needed. Complete an investigation of the facts regarding the claim to further and in more detail determine if the claim should be paid, the applicable limits or exclusions and possible recovery potential. Conduct thorough reviews of damages and determine the applicability of state law and other factors related to the claim. Evaluate the financial value of the loss. Approve payments for the appropriate parties accordingly. Refer claims to other company units when necessary (e.g., Underwriting, Recovery Units or Claims Special Investigation Unit). Thoroughly document and/or code the claim file and complete all claim closure and related activities in the assigned claims management system. Utilize strong negotiating skills.
Claim Specialists assigned to Homeowner/CAT claim unit handle claims valued over $25,000 (for the inside desk role) and over $100,000 (for field role). Investigate claims requiring in-depth coverage analysis. When handling claims in the field, must prepare damage estimates using claims software. Review estimates for accuracy. May monitor contractor repair status. May assist Claim Manager with file reviews and training.
Supervisory Responsibilities:
None
How you will benefit:
A competitive annual salary between $74,900.00 - $90,000.00
ACG offers excellent and comprehensive benefits packages, including:
Medical, dental and vision benefits
401k Match
Paid parental leave and adoption assistance
Paid Time Off (PTO), company paid holidays, CEO days, and floating holidays
Paid volunteer day annually
Tuition assistance program, professional certification reimbursement program and other professional development opportunities
AAA Membership
Discounts, perks, and rewards and much more
We are looking for candidates who:
II. Required Qualifications (these are the minimum requirements to qualify)
Education:
Complete ACG Claim Representative Training Program or demonstrate equivalent knowledge or experience
In states where an Adjuster's license is required, the candidate must be eligible to acquire a State Adjuster's license within 90 days of hire and maintain as specified for appropriate states.
A valid driver's license is required if the primary responsibilities of the role involve conducting in-person inspections or frequent in-person meetings with members.
Experience:
Three years of experience or equivalent training in the following:
negotiation of claim settlements
securing and evaluating evidence
preparing manual and electronic estimates
subrogation claims
resolving coverage questions
taking statements
establishing clear evaluation and resolution plans for claims
Knowledge and Skills:
Advanced knowledge of:
Essential Insurance Act (Michigan)
Fair Trade Practices Act as it relates to claims
subrogation procedures and processes
intercompany arbitration
handling simple litigation
advanced knowledge of building construction and repair techniques
Ability to:
handle claims to the line Claim Handling Standards
follow and apply ACG Claim policies, procedures and guidelines
work within assigned ACG Claim systems including basic PC software
perform basic claim file review and investigations
demonstrate effective communication skills (verbal and written)
demonstrate customer service skills by building and maintaining relationships with insureds/claimants while exhibiting understanding of their problems and responding to questions and concerns
analyze and solve problems while demonstrating sound decision making skills
prioritize claim related functions
process time sensitive data and information from multiple sources
manage time, organize and plan work load and responsibilities
safely operate a motor vehicle in order to visit repair facilities, homes (for inspections), patients, etc.
research analyze and interpret subrogation laws in various states
travel outside of assigned territory which may involve overnight stay
relocate, work evenings or weekends
Preferred Qualifications
Education:
Associate degree in Business Administration, Insurance or a related field or the equivalent in related work experience
Completion of the Insurance Institute of America's: General Insurance Program, Associate in Claims, Associate in Management or equivalent
CPCU coursework or designation
Xactware Training
Work Environment
This position is currently able to work remotely from a home office location for day-to-day operations unless occasional travel for meetings, collaborative activities, or team building activities is specified by leadership. This is subject to change based on amendments and/or modifications to the ACG Flex Work policy.
Who We Are
Become a part of something bigger.
The Auto Club Group (ACG) provides membership, travel, insurance, and financial service offerings to approximately 14+ million members and customers across 14 states and 2 U.S. territories through AAA, Meemic, and Fremont brands. ACG belongs to the national AAA federation and is the second largest AAA club in North America.
By continuing to invest in more advanced technology, pursuing innovative products, and hiring a highly skilled workforce, AAA continues to build upon its heritage of providing quality service and helping our members enjoy life's journey through insurance, travel, financial services, and roadside assistance.
And when you join our team, one of the first things you'll notice is that same, whole-hearted, enthusiastic advocacy for each other.
We have positions available for every walk of life! AAA prides itself on creating an inclusive and welcoming environment of diverse backgrounds, experiences, and viewpoints, realizing our differences make us stronger.
To learn more about AAA The Auto Club Group visit ***********
Important Note:
ACG's Compensation philosophy is to provide a market-competitive structure of fair, equitable and performance-based pay to attract and retain excellent talent that will enable ACG to meet its short and long-term goals. ACG utilizes a geographic pay differential as part of the base salary compensation program. Pay ranges outlined in this posting are based on the various ranges within the geographic areas which ACG operates. Salary at time of offer is determined based on these and other factors as associated with the job and job level.
The above statements describe the principal and essential functions, but not all functions that may be inherent in the job. This job requires the ability to perform duties contained in the job description for this position, including, but not limited to, the above requirements. Reasonable accommodations will be made for otherwise qualified applicants, as needed, to enable them to fulfill these requirements.
The Auto Club Group, and all its affiliated companies, is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, gender identity, sexual orientation, national origin, disability or protected veteran status.
Regular and reliable attendance is essential for the function of this job.
AAA The Auto Club Group is committed to providing a safe workplace. Every applicant offered employment within The Auto Club Group will be required to consent to a background and drug screen based on the requirements of the position.
Auto-ApplyPharmacy 340B Claims Specialist
Claims adjuster job in White Cloud, MI
Family Health Care is currently seeking applications for the position of Pharmacy 340B Claims Specialist! General Function: This position functions at the highest level (III) in the series of Pharmacy Technician roles within Family Health Care. The individual in this role is a "work-leader" serving as the expert on prescription claims reimbursement and performing self-auditing for the pharmacy department. This individual will ensure prescription claim integrity by having advanced knowledge of claim requirements for the various pharmacy benefit managers (PBM) and shall use that information to identify areas of improvement by performing targeted claim audits and will provide education to the pharmacy staff on billing requirements, when needed.
Responsibilities:
* Acts as pharmacy claims auditor and will audit claims daily into order to track claims accuracy, trends, anomalies and other critical information to help BFHC ensuring appropriate reimbursement while mitigating organizational risk for claims remediations resulting from claim processing errors.
* Acts as pharmacy 340B claims auditor and audits claims on a scheduled basis into order to track 340B claims accuracy, trends, anomalies, and other critical information to help BFHC maintain 340B claim integrity while ensuring adherence to 340B policies, procedures, rules and regulations.
* Ensures timely and accurate billing/collections of all pharmacy charges and reimbursement activities through the use of reporting and reconciliation.
* Ensures integrity if financial reports and provides necessary reports to the finance department upon request.
* Assists the Chief Pharmacist and pharmacy staff in the research, development and implementation of new and existing pharmacy services.
Location(s): White Cloud, MI
Employment Type: Full Time
Exempt/Non-Exempt: Non-Exempt
Benefits: Competitive wage and excellent benefits package. FHC is an eligible organization for State and Federal Loan Repayment Programs.
Family Health Care is an Equal Opportunity Employer.
Field Property Claim Adjuster - Western Michigan
Claims adjuster job in Hastings, MI
Deliver fair, timely, and customer-focused property claim resolutions from first notice through settlement.
As a Field Property Claim Adjuster, you'll manage a portfolio of first-party property claims including residential, farm, and commercial losses from start to finish. You'll interpret policy coverage, investigate facts, scope and estimate losses, and bring claims to resolution, ensuring each customer receives the attentive, high-quality service Hastings is known for.
Location & Schedule:
This is a field-based position that will travel (generally same day) throughout its assigned region to locations for submitted property claims. When not travelling, this role will work remotely from home.
Candidates will ideally reside in central or western Michigan (i.e. Battle Creek, Grand Rapids, Kalamazoo, or Lansing Metro areas)
Regardless of location, this role will generally work within our standard office hours of Monday - Friday, 8:00 AM - 4:30 PM.
What You'll Do:
Handle a personal caseload of property claims from minor to moderate complexity.
Investigate losses by gathering statements, reviewing documentation, and evaluating coverage and damages.
Negotiate settlements that are fair, equitable, and consistent with policy provisions and company standards.
Maintain proactive communication with insureds, agents, contractors, and vendors to move claims toward resolution.
Accurately document claim activity in the claims system and maintain adequate case reserves.
Identify subrogation and salvage opportunities to minimize loss costs.
Collaborate with internal teams such as Underwriting and Loss Control for information sharing and process improvement.
Stay current with state licensing and continuing education requirements.
Additional Role Highlights:
Company vehicle is provided to carry out the duties of this position.
May be called upon to assist with catastrophe-related claim volumes.
Works within established authority limits on commercial, farm, and personal lines property claims.
What You'll Bring:
Bachelor's degree preferred, or equivalent combination of education and experience.
At least two years of property claim handling or adjusting experience preferred.
Strong investigative, analytical, and negotiation skills.
Proficiency in Microsoft Office and claims management systems.
Exceptional written and verbal communication skills.
Customer-focused mindset with the ability to manage multiple priorities in a fast-paced environment.
Valid driver's license and ability to travel regularly within the territory.
Ability to obtain and maintain required state adjuster licenses.
About Us:
At Hastings Insurance, we're more than an insurance provider- we're a trusted partner to our agents, policyholders, and the communities we serve. For over 135 years, we've been helping individuals, families, and businesses protect what matters most and rebuild after loss. We're proud to be rated A (Excellent) by A.M. Best Company, recognizing our enduring financial strength and stability.
While our heritage runs deep, we're always looking ahead. We embrace emerging technologies, cultivate strong partnerships with independent agents, and continuously evolve our products to meet the needs of today's customers. Our strategy is focused on responsible growth, expanding our reach while staying innovative, agile, and committed to personalized service.
Our people are the heart of everything we do. Our talented team members -many recognized as industry experts- are passionate about delivering exceptional service, driving progress, and making a real impact. At Hastings Insurance, we foster a culture of collaboration, continuous learning, and appreciation for the diverse skills and ideas our employees bring.
Our Commitment as an Employer:
We believe that diverse perspectives and inclusive teams drive innovation and strengthen our organization. We're committed to fostering a workplace where every employee feels valued, respected, and empowered to contribute their best.
We are proud to be an equal opportunity employer, and we make employment decisions based on business needs, role requirements, and individual qualifications-without regard to race, color, religion, gender, sexual orientation, gender identity, national origin, age, appearance, disability, veteran status, family status, marital status, or any other legally protected characteristic.
We also understand the importance of providing a welcoming and accessible experience for all candidates. If you require accommodation during the application or interview process, please reach out to our Talent Acquisition Specialist or contact us at ************.
Field Claims Adjuster
Claims adjuster job in Kalamazoo, 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.
Independent Insurance Claims Adjuster in Muskegon, Michigan
Claims adjuster job in Muskegon, 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.
Auto-ApplyAuto Claims Representative
Claims adjuster job in Muskegon, 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 claims trainee to join our team. This job handles entry-level insurance claims under close supervision through the life-cycle of a claim including but not limited to: investigation, evaluation, and claim resolution. This job provides service to agents, insureds, and others to ensure claims resolve accurately and timely. This job includes training and development completion of the Company's claims training program for the assigned line of insurance and requires the person to:
* Investigate, evaluate, and settle entry-level insurance claims
* Study insurance policies, endorsements, and forms to develop foundational knowledge on Company insurance products
* Learn and comply with Company claim handling procedures
* Develop entry-level claim negotiation and settlement skills
* Build skills to effectively serve the needs of agents, insureds, and others
* Meet and communicate with claimants, legal counsel, and third-parties
* Develop specialized skills including but not limited to, estimating and use of designated computer-based programs for loss adjustment
* Study, obtain, and maintain an adjuster's license(s), if required by statute within the timeline established by the Company or legal requirements
Desired Skills & Experience
* Bachelor's degree or direct equivalent experience with property/casualty claims handling
* Ability to organize data, multi-task and make decisions independently
* Above average communication skills (written and verbal)
* Ability to write reports and compose correspondence
* Ability to resolve complex issues
* Ability to maintain confidentially and data security
* Ability to effectively deal with a diverse group individuals
* Ability to accurately deal with mathematical problems, including, geometry (area and volume) and financial areas (such as accuracy in sums, unit costs, and the capacity to read and develop understanding of personal and business finance documents)
* Ability to drive an automobile, possess a valid driver license, and maintain a driving record consistent with the Company's underwriting guidelines for coverage
* Continually develop product knowledge through participation in approved educational programs
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
Auto-ApplyRegional General Adjuster - Midwest Region
Claims adjuster job in Grand Rapids, MI
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
Regional General Adjuster - Midwest Region
**PRIMARY PURPOSE** **:** To handle losses or claims regionally unassisted up to $10M, including having the ability to address most complex adjustment issues pertaining to damages and coverage; to assist on even larger losses and manage smaller and non-complex National Accounts.
**ESSENTIAL FUNCTIONS and RESPONSIBILITIES**
+ Examines claim forms and other records to determine insurance coverage.
+ Administers and reconciles complex catastrophic claims for property.
+ Interviews, telephones, or corresponds with claimant and witnesses regarding claim.
+ Consults police and hospital records; and inspects property damage to determine extent of company's liability and varying methods of investigation according to type of insurance.
+ Estimates cost of repair, replacement, or compensation.
+ Prepares report of findings and negotiates settlement with claimant.
+ Recommends litigation by legal department when settlement cannot be negotiated.
+ Attends litigation hearings.
+ Revises case reserves in assigned claims files to cover probable costs.
+ Prepares loss experience reports to help determine profitability and calculates adequate future rates.
+ Interacts with excess carrier to determine coverages, excess insurance levels, and potential reimbursements.
**ADDITIONAL FUNCTIONS and RESPONSIBILITIES**
+ Performs other duties as assigned.
+ Travels as required.
**QUALIFICATIONS**
**Education & Licensing**
Bachelor's degree from an accredited college or university preferred. Must have earned the IIA-AIC designation and be actively pursuing another professional insurance designation. Appropriate state adjuster license is required.
**Experience**
Five (5) years of related experience or equivalent combination of education and experience required.
**Skills & Knowledge**
+ Strong oral and written communication, including presentation skills
+ PC literate, including Microsoft Office products
+ Strong customer service skills
+ Attention to detail and accuracy
+ Good time management and organizational skills
+ Ability to work independently or in a team environment
+ Ability to meet or exceed Performance Competencies
**WORK ENVIRONMENT**
When applicable and appropriate, consideration will be given to reasonable accommodations.
Mental: Clear and conceptual thinking ability; excellent judgment and discretion; ability to handle work-related stress; ability to handle multiple priorities simultaneously; and ability to meet deadlines
Physical:
+ Must be able to stand and/or walk for long periods of time.
+ Must be able to kneel, squat or bend.
+ Must be able to work outdoors in hot and/or cold weather conditions.
+ Have the ability to climb, crawl, stoop, kneel, reaching/working overhead
+ Be able to lift/carry up to 50 pounds
+ Be able to push/pull up to 100 pounds
+ Be able to drive up to 4 hours per day.
+ Must have continual use of manual dexterity
Auditory/Visual: Hearing, vision and talking
The statements contained in this document are intended to describe the general nature and level of work being performed by a colleague assigned to this description. They are not intended to constitute a comprehensive list of functions, duties, or local variances. Management retains the discretion to add or to change the duties of the position at any time.
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 61,857.00 - 86,600.00. (Bonus or commission eligibility, if applicable). 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.
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**
Field Adjuster (Residential or Commercial) - Grand Rapids, MI
Claims adjuster job in Grand Rapids, MI
Job Description
CCMS & Associates is looking for a 1099 Field Adjuster in Michigan, specifically the Grand Rapids area. We are looking to add to our existing roster. The time is now to get on board with our team! We are seeking a residential or commercial field adjuster with at least 1 year of field experience.
Requirements:
Minimum 1 year first-party commercial and/or residential property adjusting experience
Maintain own current estimating software - Xactimate preferred (Symbility experience a plus)
Working computer - internet access and Microsoft Word required
Must demonstrate strong time management and customer service skills
Experience in preparing Statement of Loss, Proof of Loss, and denial letters
Must have a valid drivers license
Responsibilities:
Complete residential and commercial field property inspections utilizing Xactimate software
Investigate claims by obtaining recorded statements from insureds, claimants, or witnesses and by interviewing fire, police, or other governmental officials as well as inspecting claimed damages
Recommend claim reserves based on investigation, through well-supported reserve report
Obtain and interpret official reports
Review applicable coverage forms and endorsements, provide a thorough analysis of coverage and any coverage issues in a well-documented initial captioned report to the client
Maintain acceptable product quality through compliance with established best practices
Knowledge and Skills:
In-depth knowledge of property and liability insurance coverage and industry standards
Ability to prepare full-captioned reports by collecting and summarizing required information
Strong verbal and written communications skills
Prompt, reliable, and friendly
Preferred but Not Required:
College degree
AIC, IICRC, HAAG or other professional designations
All candidates must pass a full background check (void in states where prohibited)
CCMS & Associates offers multi-line claim adjusting and third-party administration services dedicated to solving the challenges of the complex claim in the property and casualty insurance industry. We create programs that drive a successful claim life cycle while strategically managing all aspects of the complicated issues carriers and policyholders are facing. Servicing excess and surplus/domestic carriers in the United States.
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Pharmacy 340B Claims Specialist
Claims adjuster job in White Cloud, MI
Family Health Care is currently seeking applications for the position of Pharmacy 340B Claims Specialist!
General Function: This position functions at the highest level (III) in the series of Pharmacy Technician roles within Family Health Care. The individual in this role is a “work-leader” serving as the expert on prescription claims reimbursement and performing self-auditing for the pharmacy department. This individual will ensure prescription claim integrity by having advanced knowledge of claim requirements for the various pharmacy benefit managers (PBM) and shall use that information to identify areas of improvement by performing targeted claim audits and will provide education to the pharmacy staff on billing requirements, when needed.
Responsibilities:
Acts as pharmacy claims auditor and will audit claims daily into order to track claims accuracy, trends, anomalies and other critical information to help BFHC ensuring appropriate reimbursement while mitigating organizational risk for claims remediations resulting from claim processing errors.
Acts as pharmacy 340B claims auditor and audits claims on a scheduled basis into order to track 340B claims accuracy, trends, anomalies, and other critical information to help BFHC maintain 340B claim integrity while ensuring adherence to 340B policies, procedures, rules and regulations.
Ensures timely and accurate billing/collections of all pharmacy charges and reimbursement activities through the use of reporting and reconciliation.
Ensures integrity if financial reports and provides necessary reports to the finance department upon request.
Assists the Chief Pharmacist and pharmacy staff in the research, development and implementation of new and existing pharmacy services.
Location(s): White Cloud, MI
Employment Type: Full Time
Exempt/Non-Exempt: Non-Exempt
Benefits: Competitive wage and excellent benefits package. FHC is an eligible organization for State and Federal Loan Repayment Programs.
Family Health Care is an Equal Opportunity Employer.
Pharmacy 340B Claims Specialist
Claims adjuster job in White Cloud, MI
Job DescriptionSalary: Starting at $21.00 p/hr
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.