Claims representative jobs 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.

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.

Provides analyst support for claims research activities including reviewing and researching claims to ensure regulatory requirements are appropriately applied, identifying root-cause of processing errors through research and analysis, coordinating and engaging with appropriate departments, developing and tracking remediation plans, and monitoring claims reprocessing through resolution. **Essential Job Duties** - Serves as claims subject matter expert - using analytical skills to conduct research and analysis to address issues, requests, and support high-priority claims inquiries and projects. - Interprets and presents in-depth analysis of claims research findings and results to leadership and respective operations teams. - Manages and leads major claims projects of considerable complexity and volume that may be initiated internally, or through provider inquiries/complaints, or legal requests. - Assists with reducing rework by identifying and remediating claims processing issues. - Locates and interprets claims-related regulatory and contractual requirements. - Tailors existing reports and/or available data to meet the needs of claims projects. - Evaluates claims using standard principles and applicable state-specific regulations to identify claims processing errors. - Applies claims processing and technical knowledge to appropriately define a path for short/long-term systematic or operational fixes. - Seeks to improve overall claims performance, and ensure claims are processed accurately and timely. - Identifies claims requiring reprocessing or readjudication in a timely manner to ensure compliance. - Works collaboratively with internal/external stakeholders to define claims requirements. - Recommends updates to claims standard operating procedures (SOPs) and job aids to increase the quality and efficiency of claims processing. - Fields claims questions from the operations team. - Interprets, communicates, and presents, clear in-depth analysis of claims research results, root-cause analysis, remediation plans and fixes, overall progress, and status of impacted claims. - Appropriately conveys claims-related information and tailors communication based on targeted audiences. - Provides sufficient claims information to internal operations teams that communicate externally with providers and/or members. - Collaborates with other functional teams on claims-related projects, and completes tasks within designated/accelerated timelines to minimize provider/member impacts and maintain compliance. - Supports claims department initiatives to improve overall claims function efficiency. **Required Qualifications** - At least 3 years of medical claims processing experience, or equivalent combination of relevant education and experience. - Medical claims processing experience across multiple states, markets, and claim types. - Knowledge of claims processing related to inpatient/outpatient facilities contracted with Medicare, Medicaid, and Marketplace government-sponsored programs. - Data research and analysis skills. - Organizational skills and attention to detail. - Time-management skills, and ability to manage simultaneous projects and tasks to meet internal deadlines. - Ability to work cross-collaboratively in a highly matrixed organization. - Customer service skills. - Effective verbal and written communication skills. - Microsoft Office suite (including Excel), and applicable software programs proficiency. **Preferred Qualifications** - Health care claims analysis experience. - Project management experience. To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V Pay Range: $21.16 - $46.42 / HOURLY *Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

We are Farmers! We are… more than just your favorite commercials. At Farmers, we strive to deliver peace of mind to our customers by providing protection and comprehensive advice and delivering in the moments of truth. That means having people who can help us meet changing customer and business needs. Farmers high-performance culture is focused on results and the people who achieve them. We hold ourselves and others accountable for sustainably growing the business and each other. We seek solutions, own our actions, and grow through discomfort. We see setbacks as opportunities while continuously asking ourselves how we impact our customers. Farmers is an award winning, equal opportunity employer, committed to the strength of an inclusive workforce. We are dedicated to supporting the well-being of our people through our extensive suite of benefits, as well as the well-being of the communities we serve through employee volunteer programs and nonprofit partnerships. Helping others in their time of need isn't just our business - it's our culture! To learn more about our high-performance culture and open opportunities, check out ********************************* and be sure to follow us on Instagram, LinkedIn, and TikTok. Workplace: Hybrid ( #LI-Hybrid ), Farmers believes in a culture of collaboration, creativity, and innovation, which thrives when we have the ability to work flexibly in a virtual setting as well as the opportunity to be together in person. Our hybrid work environment combines the best of both worlds with at least three (3) days in office and up to two (2) days virtual for employees who live within fifty (50) miles of a Farmers corporate office. Applicants beyond fifty (50) miles may still be considered. Job Summary Using claims systems to accurately document files, this role manages a diary and handles first and third party auto claims promptly, proactively and with a sense of urgency. Through training, continuously improves skill set directly applicable to this role including but not limited to claims investigation, liability determination, coverage confirmation, establishing damages, evaluating bodily injury claims with support from management, and negotiation of claims settlement. Essential Job Functions * Adjusts claims through professional,interpersonal interactions with key stakeholders. This may include policyholders, claimants, agents, witnesses, repair facilities, contractors, police and fire departments, state and county fraud and arson personnel, special investigators, members of the medical profession and all other persons incident to the investigation and processing of claims. * Conducts thorough investigations, confirms coverage, determines liability, establishes damages, reports status and negotiates the se ttlement of assigned claims. Has the authority to make payment of assigned claims within prescribed limits. Inspects damaged property and vehicles, and determines claims related damage. Estimates the cost of repair or replacement of damaged or stolen property and vehicles. * Determines and reports on subrogation potential. May initiate the sale of salvage vehicles, personal property, and miscellaneous salvage items. Reports theft, fraud, and arson losses as required to state and industry agencies. * Maintains job knowledge through intermittent training/learning and incorporates new information into daily tasks. Including training in claims investigation, liability determination, coverage confirmation, establishing damages, and negotiation of claims settlement. Performs other duties as assigned. Physical Actions Sits or stands for extended periods of time, up to a full work shift. Occasionally reaches overhead and below the knees, including bending, twisting, pulling, and stooping. Occasionally moves, lifts, carries, and places objects and supplies weighing 0-10 pounds without assistance. Listens to, interprets, and differentiates auditory information (e.g. others speaking) at normal speaking levels with or without correction. Visually verifies and reads information. Visually locates material, resources and other objects. Ability to continuously operate a computer for extended periods of time, up to a full work shift. Physical Environment This position operates in an open office working environment which will include normal and customary distractions, noise, and interruptions. Education Requirements High School Diploma or Equivalent required. Bachelors Degree preferred. Successful completion of claims training program required. Insurance Adjusters License in states where applicable required. Experience Requirements One year experience in a customer service related position preferred. Benefits * Farmers offers a competitive salary commensurate with experience, qualifications and location. * Medical * Dental * Vision * Health Savings and Flexible Spending Accounts * Life Insurance * Paid Time Off * For more information, review "What we offer" on https://*********************************/#offer Job Location(s): US - MI - Grand Rapids, US - KS - Kansas City Anticipated application deadline: At Farmers, the recruitment process is designed to ensure that we find the best talent to join our team. As part of this process, we typically close open positions within 8 to 21 days after posting. If you are interested in any of our open positions, we encourage you to submit your application promptly. Farmers will consider for employment all qualified applicants, including those with criminal histories, in accordance with the Los Angeles Fair Chance Initiative for Hiring Ordinance or other applicable law. Pursuant to 18 U.S.C. Section 1033, Farmers is prohibited from employing any individual who has been convicted of any criminal felony involving dishonesty or a breach of trust without prior written consent from the state Department of Insurance. It is unlawful in Massachusetts to require or administer a lie detector test as a condition of employment or continued employment. An employer who violates this law shall be subject to criminal penalties and civil liability. Farmers is an Equal Opportunity Employer and does not discriminate in any employer/employee relations based on race, color, religion, gender, sexual orientation, gender expression, genetic information, national origin, age, disability, marital status, military and veteran's status, or any other basis protected by applicable discrimination laws. Want to learn more about our culture & opportunities? Check out ********************************* and be sure to follow us on Instagram, LinkedIn, and TikTok. Spokane, WA only: Residents who prefer not to provide their address click here to submit your resume via email: *******************

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

The Claims Specialist is responsible for handling damage claims and property loss claims, to help resolve them efficiently and fairly. The successful Candidate needs to have automotive insurance claims experience. 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

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**

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.

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.

Alera Group is looking for a Claims Coordinator (Property & Casualty). We are seeking highly motivated colleagues who bring experience and enthusiasm to our team - joining us may be the perfect fit for you! Alera Group was founded in 2017 and has grown to become the 14th largest broker of US business. We are passionate about our clients' success in the areas of Employee Benefits, Property and Casualty Insurance, Retirement Plan Services, and Wealth Services. With a network of offices nationwide, our commitment to collaboration allows us to offer national resources combined with local service. RESPONSIBILITIES * Manage and coordinate the claims process from initial incident notification through resolution, ensuring accurate documentation, timely communication, and compliance with carrier and regulatory requirements * Collaborate with clients, carriers, and internal teams to investigate, process, and resolve claims efficiently-providing expert guidance, identifying potential issues, and escalating complex cases when necessary * Deliver exceptional client service by offering proactive communication, technical expertise, and support throughout the claims process while contributing to a positive, team-oriented work environment QUALIFICATIONS * 1+ years of experience in a claims handling or insurance-related role within Property and Casualty * Possess or willing to obtain a Property & Casualty license * Ability to read, analyze, and interpret insurance coverages ADDITIONAL INFORMATION This job requires presence in the office on a hybrid schedule as agreed with the manager. Alera Group offers comprehensive benefits to our colleagues, including medical, dental, life and disability insurance, 401k, generous paid time off and much more. Salary range is $50K to 65K per year. We're an equal opportunity employer. All applicants will be considered for employment without attention to race, color, religion, sex, sexual orientation, gender identity, national origin, veteran or disability status, or any other protected class. Alera Group is committed to protecting your privacy. Please review our Privacy Policy to understand what personal information we may collect and use as part of your application process. #LI-KL1 #LI-Hybrid Location Type Hybrid

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.

Provides analyst support for claims research activities including reviewing and researching claims to ensure regulatory requirements are appropriately applied, identifying root-cause of processing errors through research and analysis, coordinating and engaging with appropriate departments, developing and tracking remediation plans, and monitoring claims reprocessing through resolution. Essential Job Duties * Serves as claims subject matter expert - using analytical skills to conduct research and analysis to address issues, requests, and support high-priority claims inquiries and projects. * Interprets and presents in-depth analysis of claims research findings and results to leadership and respective operations teams. * Manages and leads major claims projects of considerable complexity and volume that may be initiated internally, or through provider inquiries/complaints, or legal requests. * Assists with reducing rework by identifying and remediating claims processing issues. * Locates and interprets claims-related regulatory and contractual requirements. * Tailors existing reports and/or available data to meet the needs of claims projects. * Evaluates claims using standard principles and applicable state-specific regulations to identify claims processing errors. * Applies claims processing and technical knowledge to appropriately define a path for short/long-term systematic or operational fixes. * Seeks to improve overall claims performance, and ensure claims are processed accurately and timely. * Identifies claims requiring reprocessing or readjudication in a timely manner to ensure compliance. * Works collaboratively with internal/external stakeholders to define claims requirements. * Recommends updates to claims standard operating procedures (SOPs) and job aids to increase the quality and efficiency of claims processing. * Fields claims questions from the operations team. * Interprets, communicates, and presents, clear in-depth analysis of claims research results, root-cause analysis, remediation plans and fixes, overall progress, and status of impacted claims. * Appropriately conveys claims-related information and tailors communication based on targeted audiences. * Provides sufficient claims information to internal operations teams that communicate externally with providers and/or members. * Collaborates with other functional teams on claims-related projects, and completes tasks within designated/accelerated timelines to minimize provider/member impacts and maintain compliance. * Supports claims department initiatives to improve overall claims function efficiency. Required Qualifications * At least 3 years of medical claims processing experience, or equivalent combination of relevant education and experience. * Medical claims processing experience across multiple states, markets, and claim types. * Knowledge of claims processing related to inpatient/outpatient facilities contracted with Medicare, Medicaid, and Marketplace government-sponsored programs. * Data research and analysis skills. * Organizational skills and attention to detail. * Time-management skills, and ability to manage simultaneous projects and tasks to meet internal deadlines. * Ability to work cross-collaboratively in a highly matrixed organization. * Customer service skills. * Effective verbal and written communication skills. * Microsoft Office suite (including Excel), and applicable software programs proficiency. Preferred Qualifications * Health care claims analysis experience. * Project management experience. To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V Pay Range: $21.16 - $46.42 / HOURLY * Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level. About Us Molina Healthcare is a nationwide fortune 500 organization with a mission to provide quality healthcare to people receiving government assistance. If you are seeking a meaningful opportunity in a team-oriented environment, come be a part of a highly engaged workforce dedicated to our mission. Bring your passion and talents and together we can make a difference in the lives of others. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.

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

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.

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.

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

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. Powered by JazzHR DxwYpIKhtn

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.

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.