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Claims representative jobs in Sterling Heights, MI

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Senior Claims Adjuster
  • Senior Claims Representative

    Amerisure Mutual Insurance Co 4.8company rating

    Claims representative job in Farmington Hills, MI

    Amerisure creates exceptional value for its partners, policyholders, and employees. As a property and casualty insurance company, Amerisure's promise to our partner agencies and policyholders begins with a comprehensive line of insurance products designed to protect businesses, as well as the health and safety of every employee. With an A.M. Best "A" (Excellent) rating, Amerisure serves mid-sized commercial enterprises focused in construction, manufacturing and healthcare. Ranked as one of the top 100 Property & Casualty companies in the United States, we proudly manage nearly $1 Billion of Direct Written Premium and maintain $1.21 billion in surplus. Amerisure is currently recruiting for a Senior Fast Track Auto Claims Representative. This position will handle commercial auto with a predominant focus on resolving the material damage components of the claim but does not include any aspect of bodily injury exposures. The role will be a hybrid approach with 2-days in the office. The ideal candidate will possess the following skills. Summary Statement Provides quality investigation and analysis to adjust claims at all levels to proper resolution. Promotes the success of the organization through development and advancement of relationships with agencies, policyholders and employees. Essential Tasks/Major Duties * Collaborate proactively with agents, policyholders and internal stakeholders on claims and book of business as needed. * Investigate losses, identify coverage, evaluate liability and damages. * Develop plan of action to proactively conclude claims, timely evaluate damages, engage other parties in negotiations and settle claims pursuant to guidelines and delegated authority. * Leverage past experience to review and analyze documents. * Establish and maintain proper reserves for each claim to accurately reflect the financial exposure. * Determine need for, identify and engage external resources as needed to execute proper resolutions while monitoring and controlling costs. * Review and interpret commercial insurance policies and accordingly communicate coverage issues verbally and in writing. Knowledge, Skills & Abilities * Bachelor's degree or equivalent combination of education and experience. * 1 year commercial claims adjusting experience. * AIC or SLA certification preferred. * Ability to obtain appropriate state licensing as required. * Proficient computer skills required including Microsoft Office Suite. * Demonstrated successful ability to build positive relationships and partnerships within department, across the organization and with external customers. * Ability to think strategically with supporting analytical skills. * Excellent verbal and written communication skills with the ability to interact with internal and external customers. * Ability to travel overnight up to 10% * Ability to travel daily between locations. * #LI-BR1 Just as we are committed to creating exceptional value for our Partners For Success agencies and policyholders, Amerisure also remains committed to being an employer of choice. We reinforce this commitment by adhering to an Employee Value Proposition that, in part, is provided through a competitive total rewards package. This package includes competitive base pay, performance-based incentive pay, comprehensive health and welfare benefits, a 401(k) savings plan with profit sharing, and generous paid time off programs. We also offer flexible work arrangements to promote work-life balance. Recognized as one of the Best and Brightest Companies to Work For in the Nation and one of Business Insurance magazine's Best Places to Work in Insurance, we provide a workplace that fosters excellence and professional growth. If you are looking for a collaborative and rewarding career, Amerisure is looking for you. Amerisure Insurance provides equal employment opportunities (EEO) to all employees and applicants for employment without regard to race, color, religion, sex, national origin, age, disability or genetics. In addition to federal law requirements, Amerisure Insurance complies with applicable state and local laws governing nondiscrimination in employment in every location in which the company has facilities. This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation and training. Amerisure Insurance expressly prohibits any form of workplace harassment based on race, color, religion, gender, sexual orientation, gender identity or expression, national origin, age, genetic information, disability, or veteran status. Improper interference with the ability of Amerisure's employees to perform their job duties may result in discipline up to and including discharge.
    $67k-134k yearly est. Auto-Apply 21d ago
  • Claims Representative

    The Strickland Group 3.7company rating

    Claims representative job in Detroit, MI

    Join Our Dynamic Insurance Team - Unlock Your Potential! Are you ready to take control of your future and build a career in one of the most stable and lucrative industries? We are seeking driven individuals to join our thriving insurance team, where you'll receive top-tier training, support, and unlimited income potential. NOW HIRING: ✅ Licensed Life & Health Agents ✅ Unlicensed Individuals (We'll guide you through the licensing process!) We're looking for our next leaders-those who want to build a career or an impactful part-time income stream. Is This You? ✔ Willing to work hard and commit for long-term success? ✔ Ready to invest in yourself and your business? ✔ Self-motivated and disciplined, even when no one is watching? ✔ Coachable and eager to learn? ✔ Interested in a business that is both recession- and pandemic-proof? If you answered YES to any of these, keep reading! Why Choose Us? 💼 Work from anywhere - full-time or part-time, set your own schedule. 💰 Uncapped earning potential - Part-time: $40,000 - $60,000 /month | Full-time: $70,000 - $150,000+++/month. 📈 No cold calling - You'll only assist individuals who have already requested help. ❌ No sales quotas, no pressure, no pushy tactics. 🧑 🏫 World-class training & mentorship - Learn directly from top agents. 🎯 Daily pay from the insurance carriers you work with. 🎁 Bonuses & incentives - Earn commissions starting at 80% (most carriers) + salary 🏆 Ownership opportunities - Build your own agency (if desired). 🏥 Health insurance available for qualified agents. 🚀 This is your chance to take back control, build a rewarding career, and create real financial freedom. 👉 Apply today and start your journey in financial services! ( Results may vary. Your success depends on effort, skill, and commitment to training and sales systems. )
    $41k-54k yearly est. Auto-Apply 30d ago
  • Auto Claims Representative

    Auto-Owners Insurance Co 4.3company rating

    Claims representative job in Troy, MI

    We offer a merit-based work-from-home program based on job responsibilities. After initial training in-person, this specific role could have the flexibility to work from home up to 3 days per week. 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
    $43k-56k yearly est. Auto-Apply 60d+ ago
  • Sr. Claims Examiner, Casualty

    Arch Capital Group Ltd. 4.7company rating

    Claims representative job in Garden City, MI

    With a company culture rooted in collaboration, expertise and innovation, we aim to promote progress and inspire our clients, employees, investors and communities to achieve their greatest potential. Our work is the catalyst that helps others achieve their goals. In short, We Enable Possibility℠. Arch Insurance Group Inc., AIGI, has an opening in the Claims Division is seeking a Senior Claims Examiner to join the Casualty Team. In this role, the responsibilities include actively managing commercial accounts claims caseload throughout the United States. Primary Responsibilities Specific duties include but not limited to the below: * Identify and assess coverage issues, draft coverage position letters, and retain coverage counsel, when necessary, as well as review coverage counsel's opinion letters and analysis * Develop and implement strategy relative to coverage issues which correlate with the overall strategy of matters entrusted to the handler's care * Develop and implement strategy to resolve matters of liability and damages of a particular case * Maintain contact with the business line leader, underwriter, defense counsel, program manager, and broker * Investigate claim and review the insureds' materials, pleadings, and other relevant documents * Identify and review of each jurisdiction's applicable statutes, rules, and case law * Review litigation materials including depositions and expert's reports * Analyze and direct risk transfer, additional insured issues, and contractual indemnity issues * Retain counsel when necessary and direct counsel in accordance with resolution strategy * Analyze coverage, liability and damages for purposes of assessing and recommending reserves * Prepare and present written/oral reports to senior management setting forth all issues influencing evaluation and recommending reserves * Travel to and from locations within the United States to attend mediations, trials, and other proceedings relevant to the resolution of the matter * Negotiate resolution of claims * Select and utilize structure brokers * Maintain a diary of all claims, post reserves in a timely fashion, and expeditiously respond to inquiries from the insured, counsel, underwriters, brokers, and senior management regarding claims Qualifications * Proper adjuster licensing in all applicable states * Exceptional communication (written and verbal), evaluating, influencing, negotiating, listening, and interpersonal skills to effectively develop productive working relationships with internal/external peers and other professionals across organizational lines * Strong time management and organizational skills * Ability to take part in active strategic discussions * Ability to work well independently and in a team environment * Hands-on experience and strong aptitude with Microsoft Excel, PowerPoint and Word * Willing and able to travel 20% * This role is hybrid with 2 days in office Education and Experience * Bachelor's degree; Juris Doctorate degree preferred * Five (5) years of working experience with a primary and / or excess carrier supporting commercial accounts for Casualty claims; Professional Liability claims #LI-SW1 #LI-HYBRID For individuals assigned or hired to work in the location(s) indicated below, the base salary range is provided. Range is as of the time of posting. Position is incentive eligible. For Jersey City, Morristown, NYC: $123,400 - $166,633/year For Hartford, Chicago, Long Island: $111,100 - $149,970/year * Total individual compensation (base salary, short & long-term incentives) offered will take into account a number of factors including but not limited to geographic location, scope & responsibilities of the role, qualifications, talent availability & specialization as well as business needs. The above pay range may be modified in the future. * Arch is committed to helping employees succeed through our comprehensive benefits package that includes multiple medical plans plus dental, vision and prescription drug coverage; a competitive 401k with generous matching; PTO beginning at 20 days per year; up to 12 paid company holidays per year plus 2 paid days of Volunteer Time Offer; basic Life and AD&D Insurance as well as Short and Long-Term Disability; Paid Parental Leave of up to 10 weeks; Student Loan Assistance and Tuition Reimbursement, Backup Child and Elder Care; and more. Click here to learn more on available benefits. Do you like solving complex business problems, working with talented colleagues and have an innovative mindset? Arch may be a great fit for you. If this job isn't the right fit but you're interested in working for Arch, create a job alert! Simply create an account and opt in to receive emails when we have job openings that meet your criteria. Join our talent community to share your preferences directly with Arch's Talent Acquisition team. For Colorado Applicants - The deadline to submit your application is: December 08, 2025 14400 Arch Insurance Group Inc.
    $123.4k-166.6k yearly Auto-Apply 4d ago
  • ESIS Claims Representative, WC

    Chubb 4.3company rating

    Claims representative job in Southfield, MI

    ESIS, Inc. (ESIS) provides sophisticated risk management services designed to reduce claims frequency and loss costs. ESIS, the Risk Management Services Company of ACE USA, provides claims, risk control & loss information systems to Fortune 1000 accounts. ESIS employs more than 1,500 professionals in nine regional centers and 15 major claims offices, as well as local representatives in select jurisdictions. We take our fiduciary responsibilities seriously and are proud to manage over $2.5 billion of customer losses and over 320,000 new claims annually. We specialize in large accounts which have multi-state operations. For information regarding ESIS please visit ************* Summary: ESIS is seeking an experienced workers' compensation claims representative for the Glen Allen, VA office. The person in this role will handle and maintain all workers' compensation claims and file reviews under the general supervision of a supervisor and as part of the ESIS team. QUALIFICATIONS Qualified ABOUT US Chubb is a world leader in insurance. With operations in 54 countries, Chubb provides commercial and personal property and casualty insurance, personal accident and supplemental health insurance, reinsurance, and life insurance to a diverse group of clients. The company is distinguished by its extensive product and service offerings, broad distribution capabilities, exceptional financial strength, underwriting excellence, superior claims handling expertise and local operations globally. At Chubb, we are committed to equal employment opportunity and compliance with all laws and regulations pertaining to it. Our policy is to provide employment, training, compensation, promotion, and other conditions or opportunities of employment, without regard to race, color, religious creed, sex, gender, gender identity, gender expression, sexual orientation, marital status, national origin, ancestry, mental and physical disability, medical condition, genetic information, military and veteran status, age, and pregnancy or any other characteristic protected by law. Performance and qualifications are the only basis upon which we hire, assign, promote, compensate, develop and retain employees. Chubb prohibits all unlawful discrimination, harassment and retaliation against any individual who reports discrimination or harassment.
    $51k-67k yearly est. 6d ago
  • Claims Representative

    Everstaff 3.8company rating

    Claims representative job in Troy, MI

    Join a Leading Team - Direct Hire | Sign-On Bonus | Hybrid Opportunity! We're hiring detail-oriented and customer-focused Claims Representatives for a reputable client located in Troy. In this role, you'll be responsible for efficiently reviewing, processing, and resolving insurance claims while ensuring full compliance with internal policies and industry regulations. What's In It for You? Direct hire opportunity with a stable organization Sign-on bonus available Hybrid schedule available after training Comprehensive benefits package: medical, dental, and vision insurance Ongoing professional development and training opportunities Work Schedule Training: Monday-Friday, 8:00 AM - 4:30 PM Post-Training: Flexible shifts available between 6:00 AM - 8:00 PM Key Responsibilities Accurately review and process insurance claims within specified timeframes Communicate with policyholders, claimants, and other involved parties to gather information and provide claim updates Maintain thorough and accurate records in internal claims systems Ensure adherence to regulatory guidelines and company policies Keep current with industry standards and procedural updates Qualifications & Skills High school diploma or equivalent required Experience in claims processing, insurance, or customer service is a plus Strong problem-solving and analytical abilities Clear and professional verbal and written communication skills Ability to handle multiple tasks and prioritize effectively in a fast-paced environment Proficiency in Microsoft Office Suite; experience with claims management software is a bonus Familiarity with insurance procedures and compliance regulations is preferred Ready to bring your attention to detail and customer service skills to a growing team? Apply today! All qualified applicants will receive consideration for employment without regard to race, color, religion, ethnicity, national origin, sex, gender identity, sexual orientation, disability status, protected veteran status or any other protected status under the law. EverStaff is an equal opportunity employer (M/F/D/V/SO/GI).
    $35k-44k yearly est. 60d+ ago
  • Workers' Compensation Claim Supervisor

    Ford Motor 4.7company rating

    Claims representative job in Dearborn, MI

    ... The Workers' Compensation Claim Supervisor, working under general direction, is responsible for supporting the administration of workers' compensation policies and procedures related to claim filing, claim fulfillment, incident investigations, etc., with fairness and consistency in a timely manner. Additionally, the role is responsible for staying updated on trends and industry practices within the workers' compensation domain, collaborating with teams to implement training programs, and ensuring compliance with policies. The role would also maintain accurate and confidential records and data related to workers' compensation matters. Responsibilities What you'll do... Implements the execution of the organization's workers' compensation policies and procedures, with fairness and consistency in a timely manner. Ensures compliance with employment laws, regulations, and company policies. Offers expert technical and jurisdictional guidance to claim staff regarding complex compensability, investigation and litigation issues. Supports handling the workers' compensation claims from initial report to resolution and investigates accidents involving company staff, vehicles, and equipment. Performs regular workers' compensation operations review with each plant location to ensure each case has an action plan in place. Ensures necessary documentation is obtained and provided to the claim adjusters. Determines the need to report claims and maintains regular communication/review with claim adjusters to ensure excellent management of claims. Represents the company at workers' compensation claim review meetings as required. Coordinates modified duty return-to-work efforts with the claim adjusters, HR, and plant operations. Participates in the delivery of workers' compensation special projects by representing the team as the prime contact, coordinating with senior internal and industry personnel, integrating data and information from multiple sources to identify trends, and innovating solutions to minimize the overall cost of workers' compensation claims through effective claims management and loss prevention strategies. Stays updated on workers' compensation laws and regulations to ensure program compliance. Monitors claims status, maintains files, and provides necessary support in defense of claims. May maintain occupational safety and health agency records if necessary. Supports the preparation of regular reports on workers' compensation program performance, trends, and metrics for management. Compiles and analyzes data related to workplace injuries, claims, and costs. Maintains important records related to claim processing such as medical bills, treatment plans, etc. Provides input on risk assessments, development of strategies, action plans, and associated recommendations to move claims to settlement or closure. Participates in the annual audit process for the company's workers' compensation programs including claims administration, cost analysis, injured employee communications, and return-to-work programs, and updates existing policies related to the workers' compensation function, whilst maintaining compliance and consistency with relevant laws and companywide policies. Supports the development of trainings to educate employees about the workers' compensation processes, their rights, and responsibilities. Demonstrates full knowledge of industry best practices in workers' compensation subjects such as loss prevention and rehabilitation management programs along with a strong understanding and application of related concepts and principles. Attends conferences, and other trainings to stay current on risk, claims, and safety developments. Coaches and guides managers and employees on matters related to workers' compensation. Qualifications You'll have... Bachelor's Degree in Human Resources, Risk Management, or any other related discipline or commensurate work experience in workers' compensation. Minimum 7 years of experience managing multi-state workers' compensation claims and navigating diverse regulatory environments. Work Requirements… Involves frequent (defined as one to two-thirds of the time) lifting of more than 10 to 25 pounds. Work performed requires a good deal of walking or standing and may include some sedentary work and working conditions that include moderate noise levels related to the use of office equipment or machinery. May involve exposure to varying outside temperatures. This description outlines the general nature and scope of work typically performed in this job. It is not intended to be an exhaustive list of all duties, responsibilities, knowledge, skills, work requirements, etc. It may vary slightly based on business or geographic needs and is subject to being reviewed and updated periodically. You may not check every box, or your experience may look a little different from what we've outlined, but if you think you can bring value to Ford Motor Company, we encourage you to apply! As an established global company, we offer the benefit of choice. You can choose what your Ford future will look like: will your story span the globe, or keep you close to home? Will your career be a deep dive into what you love, or a series of new teams and new skills? Will you be a leader, a changemaker, a technical expert, a culture builder…or all the above? No matter what you choose, we offer a work life that works for you, including: Immediate medical, dental, vision and prescription drug coverage Flexible family care days, paid parental leave, new parent ramp-up programs, subsidized back-up childcare and more Family building benefits including adoption and surrogacy expense reimbursement, fertility treatments, and more Vehicle discount program for employees and family members and management leases Tuition assistance Established and active employee resource groups Paid time off for individual and team community service A generous schedule of paid holidays, including the week between Christmas and New Year's Day Paid time off and the option to purchase additional vacation time. This position is a salary grade 7. For more information on salary and benefits, click here: New Hire Benefits Visa sponsorship is not available for this position. Candidates for positions with Ford Motor Company must be legally authorized to work in the United States. Verification of employment eligibility will be required at the time of hire. We are an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, religion, color, age, sex, national origin, sexual orientation, gender identity, disability status or protected veteran status. In the United States, if you need a reasonable accommodation for the online application process due to a disability, please call **************. This position is hybrid (onsite four days per week) for candidates who are in commuting distance to a Ford hub location. #LI-Hybrid #LI-LP3
    $96k-127k yearly est. Auto-Apply 60d+ ago
  • Independent Insurance Claims Adjuster in Sterling Heights, Michigan

    Milehigh Adjusters Houston

    Claims representative job in Sterling Heights, MI

    IS IT TIME FOR A CAREER CHANGE? INDEPENDENT INSURANCE CLAIMS ADJUSTERS NEEDED NOW! Are you ready to embark on a dynamic and in-demand career as an Independent Insurance Claims Adjuster? This is your chance to join a thriving industry with endless opportunities for growth and advancement. Why This Opportunity Matters: With the current surge in storm-related events sweeping across the nation, there's an urgent need for new adjusters to meet the escalating demand. As a Licensed Claims Adjuster, you'll play a crucial role in helping individuals and businesses recover from unforeseen disasters and rebuild their lives. This is not just a job-it's a rewarding career path where you can make a real difference in people's lives while enjoying flexibility, autonomy, and competitive compensation. Join Our Team: Are you actively working as a Licensed Claims Adjuster with 100 claims or more under your belt? If so, that's great! If not, no problem! Let us help you on your career path as a Licensed Claims Adjuster. You're welcome to sign up on our jobs roster if you meet our guidelines. How We Can Help You Succeed: At MileHigh Adjusters Houston, we offer comprehensive training programs tailored to equip you with the essential skills and knowledge needed to excel in the field of claims adjusting. Our expert instructor, with years of industry experience, will provide you with hands-on training, insider tips, and practical insights to prepare you for real-world challenges. Whether you're a seasoned professional or a newcomer to the field, our training programs are designed to meet you where you are and help you reach your full potential as a claims adjuster. Don't miss out on this opportunity-let us assist you in advancing your career in claims adjusting and achieving your professional goals. With our guidance and support, you'll have the opportunity to thrive in a dynamic and rewarding industry, making a positive impact on the lives of others while achieving your professional goals. Seize the Opportunity Today! Contact us now at ************ or [email protected] to learn more about our training programs and take the first step towards a fulfilling career as a Licensed Claims Adjuster. Visit our website at ******************************** to explore our offerings and view our 375+ Five-Star Google Reviews. You can also find us on YouTube at: (********************************************************* and Facebook at: (************************************************** for additional resources and updates. APPLY HERE #AdjustersNeeded #CareerOpportunity #ClaimsAdjusterTraining #MileHighAdjustersHouston By applying to this position, you consent to receive informational and promotional messages from MileHigh Adjusters Houston about training opportunities and related career programs. You may opt out at any time.
    $47k-59k yearly est. Auto-Apply 60d+ ago
  • Senior Litigation Adjuster

    Hanover Insurance Group, Inc. 4.9company rating

    Claims representative job in Howell, MI

    Our Claims team is currently seeking a Senior Litigation Adjuster for either Commercial General Liability (CGL) or Auto Bodily Injury (ABI). This is a full-time, exempt role with a hybrid work schedule (two days in the office) or fully remotely for those not near a Hanover office. POSITION OVERVIEW: This position requires daily telephone contacts with the policyholders, risk managers, and agents. Fully responsible for the analysis, investigation, evaluation, negotiation and resolution of complex claims requiring thorough investigations including telephone contacts with the involved parties; technical expertise and complex analysis. Claim assignments are multi-state and involve customers. IN THIS ROLE, YOU WILL: Must have or secure and maintain appropriate states adjuster license (s) and continuing education credits. Responsible for the settlement of litigated cases, involving disputes over coverage, liability, and damages issues. Gather the facts and analyze the statements/testimony and declaration of damages to develop claims resolution strategies. Work in partnership with defense counsel and all other parties/vendors to bring about a timely cost effective conclusion. Identifies possibly suspicious claims Claims handled are transferred existing losses or first notice lawsuits over disputed issues of great complexity where the policyholder's coverage is in question. These claims require the highest level of investigation, analysis, evaluation, and negotiation. 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. Will be utilized as a technical resource by adjusters. Will represent the company at mediation, arbitration and trials. Review and analyze contracts, leases, and identify risk transfer opportunities Demonstrate ability to write positional coverage letters. Manage litigation expenses. Reports into Unit Manager WHAT YOU NEED TO APPLY: Typically has 5 + years of litigation experience with insurance carrier. (TPA experience will not be considered) Bachelor's degree or equivalent experience, industry designation preferred. 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 Considers the perspectives of others and gives them credibility 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 Thinks critically and anticipates, recognizes, identifies and develops solutions to problems in a timely manner. Easily adapts to new or different changing situations, requirements or priorities. Cultivates an environment of teamwork and collaboration Operates with latitude for un-reviewed action or decision. Computer experience (MS Office, excel, word, etc) Ability to work in a paperless environment. 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.
    $62k-111k yearly est. 26d ago
  • Quality and Claims Coordinator

    General Motors 4.6company rating

    Claims representative job in Warren, MI

    The Finished Vehicle Quality and Claims Coordinator is accountable for minimizing the occurrence of damage to finished vehicles throughout the transportation network and overseeing the collection of claims related to such incidents. This role requires close collaboration with Plant Quality, the Finished Vehicle Operations Team, and suppliers to accurately identify points of damage and implement effective preventive measures. Additionally, the coordinator will provide essential support to the third-party claims administrator, ensuring the prompt and efficient recovery of transportation-related claims for finished vehicles. Responsibilities: + Analyze data, supplier escalations, onsite audits, and cross-functional communications to identify recurring damage trends within the network. + Investigate root causes of vehicle damage and work proactively with suppliers and Plant Quality teams to establish and monitor corrective actions. + Serve as the primary escalation point for complex claims, aged claims, contractual clarifications, and other matters requiring support for the third-party claims administrator. + Facilitate efficient claim recovery processes and ensure timely resolution of transportation claims. **Required Qualifications:** + 2+ years relevant post-graduate work experience in purchasing, supply chain, program/product management, manufacturing, logistics or product development + Ability to work in a fast-paced environment and meet deadlines. + Good problem-solving, critical thinking and decision-making skills + Highly comfortable working with data and analytics to enable decision making + 5% Travel Domestically **Preferred Skills:** + Bachelor's degree in Business, Supply Chain, Finance, related field + Previous experience with finished vehicle claims processes + Previous experience with within the quality or damage prevention + Knowledge of Finished Vehicle Logistics operations and primary modes of transportation (rail, haulaway and ocean) + Understanding of key customer functions (VSSM and Order Fulfillment) GM does not provide immigration-related sponsorship for this role. Do not apply for this role if you will need GM immigration sponsorship now or in the future. This includes direct company sponsorship, entry of GM as the immigration employer of record on a government form, and any work authorization requiring a written submission or other immigration support from the company (e.g., H1-B, OPT, STEM OPT, CPT, TN, J-1, etc). This role is categorized as hybrid. This means the selected candidate is expected to report to a specific location at least 3 times a week {or other frequency dictated by their manager}. This job is not eligible for relocation benefits. Any relocation costs would be the responsibility of the selected candidate. **About GM** Our vision is a world with Zero Crashes, Zero Emissions and Zero Congestion and we embrace the responsibility to lead the change that will make our world better, safer and more equitable for all. **Why Join Us** We believe we all must make a choice every day - individually and collectively - to drive meaningful change through our words, our deeds and our culture. Every day, we want every employee to feel they belong to one General Motors team. **Benefits Overview** From day one, we're looking out for your well-being-at work and at home-so you can focus on realizing your ambitions. Learn how GM supports a rewarding career that rewards you personally by visiting Total Rewards resources (************************************************************* . **Non-Discrimination and Equal Employment Opportunities (U.S.)** General Motors is committed to being a workplace that is not only free of unlawful discrimination, but one that genuinely fosters inclusion and belonging. We strongly believe that providing an inclusive workplace creates an environment in which our employees can thrive and develop better products for our customers. All employment decisions are made on a non-discriminatory basis without regard to sex, race, color, national origin, citizenship status, religion, age, disability, pregnancy or maternity status, sexual orientation, gender identity, status as a veteran or protected veteran, or any other similarly protected status in accordance with federal, state and local laws. We encourage interested candidates to review the key responsibilities and qualifications for each role and apply for any positions that match their skills and capabilities. Applicants in the recruitment process may be required, where applicable, to successfully complete a role-related assessment(s) and/or a pre-employment screening prior to beginning employment. To learn more, visit How we Hire (********************************************* . **Accommodations** General Motors offers opportunities to all job seekers including individuals with disabilities. If you need a reasonable accommodation to assist with your job search or application for employment, email (Careers.Accommodations@GM.com) us or call us at ************. In your email, please include a description of the specific accommodation you are requesting as well as the job title and requisition number of the position for which you are applying. We are leading the change to make our world better, safer and more equitable for all through our actions and how we behave. Learn more about: **Our Company (************************************************** **Our Culture** **How we hire (************************************************ Our diverse team of employees bring their collective passion for engineering, technology and design to deliver on our vision of a world with Zero Crashes, Zero Emissions and Zero Congestion. We are looking for adventure-seekers and imaginative thought leaders to help us transform mobility. Explore our global locations (******************************************** We are determined to lead change for the world through technology, ingenuity and harnessing the creativity of our diverse team. Join us to help lead the change that will make our world better, safer and more equitable for all by becoming a member of GM's Talent Community (beamery.com) (*********************************************** . As a part of our Talent Community, you will receive updates about GM, open roles, career insights and more. Please note that filling out the form below will not add you to our Talent Community automatically; you will need to use the link above. If you are seeking to apply to a specific role, we encourage you to click "Apply Now" on the job posting of interest. The policy of General Motors is to extend opportunities to qualified applicants and employees on an equal basis regardless of an individual's age, race, color, sex, religion, national origin, disability, sexual orientation, gender identity/expression or veteran status. Additionally, General Motors is committed to being an Equal Employment Opportunity Employer and offers opportunities to all job seekers including individuals with disabilities. If you need a reasonable accommodation to assist with your job search or application for employment, email us at Careers.Accommodations@GM.com .In your email, please include a description of the specific accommodation you are requesting as well as the job title and requisition number of the position for which you are applying.
    $48k-55k yearly est. 9d ago
  • Analyst, Claims Research

    Molina Healthcare 4.4company rating

    Claims representative job in Ann Arbor, MI

    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.
    $21.2-46.4 hourly 10d ago
  • Workers' Compensation Claim Supervisor

    Ford Global

    Claims representative job in Dearborn, MI

    ... The Workers' Compensation Claim Supervisor, working under general direction, is responsible for supporting the administration of workers' compensation policies and procedures related to claim filing, claim fulfillment, incident investigations, etc., with fairness and consistency in a timely manner. Additionally, the role is responsible for staying updated on trends and industry practices within the workers' compensation domain, collaborating with teams to implement training programs, and ensuring compliance with policies. The role would also maintain accurate and confidential records and data related to workers' compensation matters. You'll have... Bachelor's Degree in Human Resources, Risk Management, or any other related discipline or commensurate work experience in workers' compensation. Minimum 7 years of experience managing multi-state workers' compensation claims and navigating diverse regulatory environments. Work Requirements… Involves frequent (defined as one to two-thirds of the time) lifting of more than 10 to 25 pounds. Work performed requires a good deal of walking or standing and may include some sedentary work and working conditions that include moderate noise levels related to the use of office equipment or machinery. May involve exposure to varying outside temperatures. This description outlines the general nature and scope of work typically performed in this job. It is not intended to be an exhaustive list of all duties, responsibilities, knowledge, skills, work requirements, etc. It may vary slightly based on business or geographic needs and is subject to being reviewed and updated periodically. You may not check every box, or your experience may look a little different from what we've outlined, but if you think you can bring value to Ford Motor Company, we encourage you to apply! As an established global company, we offer the benefit of choice. You can choose what your Ford future will look like: will your story span the globe, or keep you close to home? Will your career be a deep dive into what you love, or a series of new teams and new skills? Will you be a leader, a changemaker, a technical expert, a culture builder…or all the above? No matter what you choose, we offer a work life that works for you, including: Immediate medical, dental, vision and prescription drug coverage Flexible family care days, paid parental leave, new parent ramp-up programs, subsidized back-up childcare and more Family building benefits including adoption and surrogacy expense reimbursement, fertility treatments, and more Vehicle discount program for employees and family members and management leases Tuition assistance Established and active employee resource groups Paid time off for individual and team community service A generous schedule of paid holidays, including the week between Christmas and New Year's Day Paid time off and the option to purchase additional vacation time. This position is a salary grade 7. For more information on salary and benefits, click here: New Hire Benefits Visa sponsorship is not available for this position. Candidates for positions with Ford Motor Company must be legally authorized to work in the United States. Verification of employment eligibility will be required at the time of hire. We are an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, religion, color, age, sex, national origin, sexual orientation, gender identity, disability status or protected veteran status. In the United States, if you need a reasonable accommodation for the online application process due to a disability, please call **************. This position is hybrid (onsite four days per week) for candidates who are in commuting distance to a Ford hub location. #LI-Hybrid #LI-LP3 What you'll do... Implements the execution of the organization's workers' compensation policies and procedures, with fairness and consistency in a timely manner. Ensures compliance with employment laws, regulations, and company policies. Offers expert technical and jurisdictional guidance to claim staff regarding complex compensability, investigation and litigation issues. Supports handling the workers' compensation claims from initial report to resolution and investigates accidents involving company staff, vehicles, and equipment. Performs regular workers' compensation operations review with each plant location to ensure each case has an action plan in place. Ensures necessary documentation is obtained and provided to the claim adjusters. Determines the need to report claims and maintains regular communication/review with claim adjusters to ensure excellent management of claims. Represents the company at workers' compensation claim review meetings as required. Coordinates modified duty return-to-work efforts with the claim adjusters, HR, and plant operations. Participates in the delivery of workers' compensation special projects by representing the team as the prime contact, coordinating with senior internal and industry personnel, integrating data and information from multiple sources to identify trends, and innovating solutions to minimize the overall cost of workers' compensation claims through effective claims management and loss prevention strategies. Stays updated on workers' compensation laws and regulations to ensure program compliance. Monitors claims status, maintains files, and provides necessary support in defense of claims. May maintain occupational safety and health agency records if necessary. Supports the preparation of regular reports on workers' compensation program performance, trends, and metrics for management. Compiles and analyzes data related to workplace injuries, claims, and costs. Maintains important records related to claim processing such as medical bills, treatment plans, etc. Provides input on risk assessments, development of strategies, action plans, and associated recommendations to move claims to settlement or closure. Participates in the annual audit process for the company's workers' compensation programs including claims administration, cost analysis, injured employee communications, and return-to-work programs, and updates existing policies related to the workers' compensation function, whilst maintaining compliance and consistency with relevant laws and companywide policies. Supports the development of trainings to educate employees about the workers' compensation processes, their rights, and responsibilities. Demonstrates full knowledge of industry best practices in workers' compensation subjects such as loss prevention and rehabilitation management programs along with a strong understanding and application of related concepts and principles. Attends conferences, and other trainings to stay current on risk, claims, and safety developments. Coaches and guides managers and employees on matters related to workers' compensation.
    $56k-104k yearly est. Auto-Apply 60d+ ago
  • Claims Analyst

    Global Information Technology

    Claims representative job in Southfield, MI

    The EDI Claims Analyst is responsible for analyzing and processing electronic data interchange (EDI) transactions, including claims and eligibility inquiries. This role involves reviewing and resolving claim rejections, ensuring accurate data submission, and supporting various EDI transactions. The analyst will work closely with provider relations, IT, and other internal teams to ensure smooth and efficient claims processing. Requirement: Strong understanding of EDI transactions and claims processing Proficiency in SQL and data analysis Knowledge of Edifecs Smart-Trading platform, Availity Essentials, Informatica, and Apigee Familiarity with CBH systems, including Connects and Flexicare Excellent problem-solving and analytical skills Ability to mentor and train team members Executive leadership client facing Interested candidates can send their updated resumes at ********************* Job Posted by ApplicantPro
    $45k-76k yearly est. Easy Apply 24d ago
  • Field Claims Adjuster

    EAC Claims Solutions 4.6company rating

    Claims representative job in Detroit, MI

    At EAC Claims Solutions, we are dedicated to resolving claims with integrity and efficiency. Join us in delivering exceptional service while upholding the highest standards of professionalism and compliance. Explore more about our commitment to innovation and community impact at ********************** Overview: Join EAC Claims Solutions as a Property Field Adjuster, where you will be managing insurance claims from inception to resolution. Key Responsibilities: - Planning and organizing daily workload to process claims and conduct inspections - Investigating insurance claims, including interviewing claimants and witnesses - Handling property claims involving damage to buildings, structures, contents and/or property damage - Conducting thorough property damage assessments and verifying coverage - Evaluating damages to determine appropriate settlement - Negotiating settlements - Uploading completed reports, photos, and documents using our specialized software systems Requirements: - Ability to perform physical tasks including standing for extended periods, climbing ladders, and navigating tight spaces - Strong interpersonal communication, organizational, and analytical skills - Proficiency in computer software programs such as Microsoft Office and claims management systems - Self-motivated with the ability to work independently and prioritize tasks effectively - High school diploma or equivalent required - Previous experience in insurance claims or related field is a plus but not required Next Steps: If you're passionate about making a difference, thrive on challenges, and deeply value your work, we invite you to apply. Should your application progress, a recruiter will reach out to discuss the next steps. Join us at EAC Claims Solutions, where your passion meets purpose, and where your contributions truly matter.
    $48k-59k yearly est. 60d+ ago
  • Saginaw Michigan Field Property Claim Specialist

    AAA Southern New England 4.3company rating

    Claims representative job in Troy, MI

    Eligible candidates for this role should reside within a commutable distance of Saginaw, Michigan. Job Title- Field Property Claim Specialist Reports to: Claim Manager II What you will do: Work under minimal supervision with a high-level approval authority to handle complex technical issues and complex claims. * Review assigned claims, * Contacting the insured and other affected parties, set expectations for the remainder of the claim process, and initiate documentation in the claim handling system. * Complete complex coverage analysis. * Ensure all possible policyholder benefits are identified. * Create additional sub-claims if needed. * Complete an investigation of the facts regarding the claim to further and in more detail determine if the claim should be paid, the applicable limits or exclusions and possible recovery potential. * Conduct thorough reviews of damages and determine the applicability of state law and other factors related to the claim. * Evaluate the financial value of the loss. * Approve payments for the appropriate parties accordingly. * Refer claims to other company units when necessary (e.g., Underwriting, Recovery Units or Claims Special Investigation Unit). * Thoroughly document and/or code the claim file and complete all claim closure and related activities in the assigned claims management system. * Utilize strong negotiating skills. Employees will be assigned to the Michigan Homeowner claim unit and will handle claims generally valued between $10,000 and $75,000 and occasionally over $100,000 for field role. Investigate claims requiring coverage analysis. When handling claims in the field, must prepare damage estimates using Xactimate estimating software. Review estimates for accuracy. May monitor contractor repair status and updates. Supervisory Responsibilities: None How you will benefit: * A competitive annual salary between $65,700 - $82,000 * ACG offers excellent and comprehensive benefits packages, including: * Medical, dental and vision benefits * 401k Match * Paid parental leave and adoption assistance * Paid Time Off (PTO), company paid holidays, CEO days, and floating holidays * Paid volunteer day annually * Tuition assistance program, professional certification reimbursement program and other professional development opportunities * AAA Membership * Discounts, perks, and rewards and much more We're looking for candidates who: Required Qualifications (these are the minimum requirements to qualify) Education: * Associate degree in Business Administration, Insurance or a related field or the equivalent in related work experience * Completion of the Insurance Institute of America's: General Insurance Program, Associate in Claims, associate in management or equivalent * CPCU coursework or designation * Xactware Training * Complete ACG Claim Representative Training Program or demonstrate equivalent knowledge or experience. * In states where an Adjuster's license is required, the candidate must be eligible to acquire a State Adjuster's license within 90 days of hire and maintain as specified for appropriate states. * Must have a valid State Driver's License Ability to: * Lift up to 25 pounds * Climb ladders. * Walk on roofs. Experience: * Three years of experience or equivalent training in the following: * Negotiation of claim settlements * Securing and evaluating evidence * Preparing manual and electronic estimates * Subrogation claims * Resolving coverage questions * Taking statements * Establishing clear evaluation and resolution plans for claims Knowledge and Skills: Advanced knowledge of: * Fair Trade Practices Act as it relates to claims * Subrogation procedures and processes * Intercompany arbitration * Handling simple litigation * Advanced knowledge of building construction and repair techniques Ability to: * Handle claims to the line Claim Handling Standards * Follow and apply ACG Claim policies, procedures and guidelines * Work within assigned ACG Claim systems including basic PC software * Perform basic claim file review and investigations * Demonstrate effective communication skills (verbal and written) * Demonstrate customer service skills by building and maintaining relationships with insureds/claimants while exhibiting understanding of their problems and responding to questions and concerns * Analyze and solve problems while demonstrating sound decision-making skills * Prioritize claim related functions * Process time sensitive data and information from multiple sources * Manage time, organize and plan workload and responsibilities * Safely operate a motor vehicle in order to visit repair facilities, homes (for inspections), patients, etc. * Research analyze and interpret subrogation laws in various states * May travel outside of assigned territory which may involve overnight stay Preferred Qualifications: Education: * Associate degree in Business Administration, Insurance or a related field or the equivalent in related work experience * Completion of the Insurance Institute of America's: General Insurance Program, Associate in Claims, Associate in Management or equivalent * CPCU coursework or designation * Xactware/Xactimate Training or equivalent Work Environment This position is currently able to work remotely from a home office location for day-to-day operations, with traveling to field locations as necessary to complete job responsibilities, unless occasional team building activities is specified by leadership. This is subject to change based on amendments and/or modifications to the ACG Flex Work policy. Who We Are Become a part of something bigger. The Auto Club Group (ACG) provides membership, travel, insurance, and financial service offerings to approximately 14+ million members and customers across 14 states and 2 U.S. territories through AAA, Meemic, and Fremont brands. ACG belongs to the national AAA federation and is the second largest AAA club in North America. By continuing to invest in more advanced technology, pursuing innovative products, and hiring a highly skilled workforce, AAA continues to build upon its heritage of providing quality service and helping our members enjoy life's journey through insurance, travel, financial services, and roadside assistance. And when you join our team, one of the first things you'll notice is that same, whole-hearted, enthusiastic advocacy for each other. We have positions available for every walk of life! AAA prides itself on creating an inclusive and welcoming environment of diverse backgrounds, experiences, and viewpoints, realizing our differences make us stronger. To learn more about AAA The Auto Club Group visit *********** Important Note: ACG's Compensation philosophy is to provide a market-competitive structure of fair, equitable and performance-based pay to attract and retain excellent talent that will enable ACG to meet its short and long-term goals. ACG utilizes a geographic pay differential as part of the base salary compensation program. Pay ranges outlined in this posting are based on the various ranges within the geographic areas which ACG operates. Salary at time of offer is determined based on these and other factors as associated with the job and job level. The above statements describe the principal and essential functions, but not all functions that may be inherent in the job. This job requires the ability to perform duties contained in the job description for this position, including, but not limited to, the above requirements. Reasonable accommodations will be made for otherwise qualified applicants, as needed, to enable them to fulfill these requirements. The Auto Club Group, and all its affiliated companies, is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, gender identity, sexual orientation, national origin, disability or protected veteran status. Regular and reliable attendance is essential for the function of this job. AAA The Auto Club Group is committed to providing a safe workplace. Every applicant offered employment within The Auto Club Group will be required to consent to a background and drug screen based on the requirements of the position.
    $65.7k-82k yearly Auto-Apply 7d ago
  • Mortgage Claims Default Specialist

    The Emac Group

    Claims representative job in Troy, MI

    The EMAC Group is a provider of mortgage recruiting services, we offer an extensive network of mortgage professionals and proven expertise developed over 20 years of experience identifying, attracting and recruiting mortgage talent for our clients. Job Description POSITION SUMMARY The Claims Specialist is responsible for processing required claims to Fannie Mae, Mortgage Insurance Companies, FHA, VA or other investors to recover advances incurred throughout the default process. The Claims Specialist will file required claims; meet investor time frames, and complete audits of claims processes for validation. Responsibilities as well will entail tracking of claim payments received for proper application, and filing of any required supplemental claims as necessary, and respond regarding any contested claim information as required. ESSENTIAL POSITION FUNCTIONS • Review, analyze, and ensure timely settlement of investor and mortgage insurance claims and manage aging claims to determine status and bring to closure and request extensions as needed. • Document and maintain all systems necessary for proper claim handling and follow-up. • Research issues and obtain proper supporting documentation in a timely manner as requested by investor or mortgage insurance company. • Manage application of all claim funds received and provide additional information as necessary in order to validate all available funds received prior to claim being closed. • Monitor claim process reports to ensure all required responses are timely filed. • Complete timely audits of all assigned claims to ensure all requirements have been met, and claim process can be validated. Qualifications EDUCATION / EXPERIENCE REQUIREMENTS • Graduation from a 4-year college or university with major course work in a discipline related to the requirements of the position is preferred. Will consider the equivalent combination of job experience & education that demonstrates the ability to perform the essential functions of this job. • Knowledge of Microsoft Office a must; knowledge of YARDI, LoanSphere, VALERI, USDA LINC and Workout Prospector a plus. • Previous work with mortgage claim filing is a requirement. Additional Information Please contact Tabitha Wolf at: ************
    $41k-69k yearly est. 18h ago
  • Mortgage Claims Default Specialist

    The EMAC Group

    Claims representative job in Troy, MI

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

    URS Group 4.5company rating

    Claims representative job in Plymouth, MI

    Job Details 00005 Plymouth Corporate - Plymouth, MIDescription The Cargo Claim Analyst will support the Risk Management Department in Cargo claims processing, analytical, reporting and record keeping functions. The primary responsibility of this position is to analyze each cargo claim based on investigation findings and documentation to determine claim validity and process for best resolution. The Cargo Claims Analyst aids the Cargo Claims Supervisor in achieving the department's goals and initiatives. Job Duties Manage cargo claims; gather all facts concerning a claim and provide direction to facilitate claim resolution by working directly with Customers, United Road Operational staff, Independent Contractors and 3 rd party carriers, claim adjusters, industry consultants and insurance companies to mitigate losses and ensure claims are resolved in a timely, cost effective manner Investigate the nature of the incident, collect all necessary documents, determine claim validity, determine and communicate resolution Track and report outstanding claims, determining equitable settlements and managing daily work queues. Maintain customer cargo claim aging on assigned accounts within customer guidelines Process rebuttals, negotiations, and declinations for claim settlement Accountable to achieve quotas and goals as assigned Optimize work processes by investigating and employing best practices with a focus on continuous improvement Data analytics with the use of Excel as the department requires Support CSI tasks as directed by the Cargo Claim Supervisor Qualifications Ability to succeed in a fast-paced environment and work under pressure Proficiency in web-based programs (OVISS, Origami or similar programs) Proficient use of Microsoft Products, with emphasis on Word, Excel, Teams and Outlook Strong analytical skills with the ability to collect, organize, analyze, and disseminate information arising from the Claim processing duties Adept at queries, report writing and presenting findings Ability to exercise good judgement in a variety of situations Ability to solve problems and think quickly under pressure Effective oral and written communication skills Process improvement catalyst Demonstrated poise, tact, and diplomacy Maintain a positive work atmosphere by acting and communicating in a manner which facilitates the success of business operations in order to meet company demands and expectations Two years of experience in trucking industry preferred Two-year college degree preferred United Road is proud to offer our full-time employees best-in-class benefits designed to support your health, well-being, and financial security. From comprehensive medical, dental, and vision coverage to generous retirement savings options and paid time off, we provide a benefits package that goes beyond the basics. We also offer unique perks like a zero-dollar-out-of-paycheck medical plan, telehealth, wellness discounts, and employee assistance resources, ensuring that our team is fully supported both at work and in life. These benefits reflect our commitment to attracting and retaining top talent while helping employees thrive every day. Health & Wellness BCBS PPO Medical with Telehealth Delta Dental NVA Vision Company Paid Life and AD&D Supplemental Life Dependent Life Short-Term Disability Employee Assistance Program (EAP) New Vehicle Supplier Discounts Financial Benefits 401(k) with Company Match Work-Life Balance PTO Program (Vacation, Sick, Personal, Jury, Bereavement) 6 Paid Holidays Hybrid Work Options Available for Select Positions
    $43k-69k yearly est. 60d+ ago
  • Homeowner Field Claim Specialist- Metro Detroit Area

    Auto Club Group 4.2company rating

    Claims representative job in Detroit, MI

    Field Property Claim Specialist - The Auto Club Group What you will do: The Auto Club Group is seeking prospective Field Property Claim Specialists who can work under minimal supervision with a high-level approval authority to handle complex technical issues and complex claims. In this position, you will have the opportunity to: Review assigned claims, Contacting the insured and other affected parties, set expectations for the remainder of the claim process, and initiate documentation in the claim handling system. Complete complex coverage analysis. Ensure all possible policyholder benefits are identified. Create additional sub-claims if needed. Complete an investigation of the facts regarding the claim to further and in more detail determine if the claim should be paid, the applicable limits or exclusions and possible recovery potential. Conduct thorough reviews of damages and determine the applicability of state law and other factors related to the claim. Evaluate the financial value of the loss. Approve payments for the appropriate parties accordingly. Refer claims to other company units when necessary (e.g., Underwriting, Recovery Units or Claims Special Investigation Unit). Thoroughly document and/or code the claim file and complete all claim closure and related activities in the assigned claims management system. Utilize strong negotiating skills. Employees will be assigned to the Michigan Homeowner claim unit and will handle claims generally valued between $10,000 and $75,000 and occasionally over $100,000 for field role. Investigate claims requiring coverage analysis. When handling claims in the field, must prepare damage estimates using Xactimate estimating software. Review estimates for accuracy. May monitor contractor repair status and updates. We're looking for candidates who: Education: Associate degree in Business Administration, Insurance or a related field or the equivalent in related work experience Completion of the Insurance Institute of America's: General Insurance Program, Associate in Claims, associate in management or equivalent CPCU coursework or designation Xactware Training Complete ACG Claim Representative Training Program or demonstrate equivalent knowledge or experience. In states where an Adjuster's license is required, the candidate must be eligible to acquire a State Adjuster's license within 90 days of hire and maintain as specified for appropriate states. Must have a valid State Driver's License Ability to: Lift up to 25 pounds Climb ladders. Walk on roofs. Experience: Three years of experience or equivalent training in the following: Negotiation of claim settlements Securing and evaluating evidence Preparing manual and electronic estimates Subrogation claims Resolving coverage questions Taking statements Establishing clear evaluation and resolution plans for claims Knowledge and Skills: Advanced knowledge of: Fair Trade Practices Act as it relates to claims Subrogation procedures and processes Intercompany arbitration Handling simple litigation Advanced knowledge of building construction and repair techniques Ability to: Handle claims to the line Claim Handling Standards Follow and apply ACG Claim policies, procedures and guidelines Work within assigned ACG Claim systems including basic PC software Perform basic claim file review and investigations Demonstrate effective communication skills (verbal and written) Demonstrate customer service skills by building and maintaining relationships with insureds/claimants while exhibiting understanding of their problems and responding to questions and concerns Analyze and solve problems while demonstrating sound decision-making skills Prioritize claim related functions Process time sensitive data and information from multiple sources Manage time, organize and plan workload and responsibilities Safely operate a motor vehicle in order to visit repair facilities, homes (for inspections), patients, etc. Research analyze and interpret subrogation laws in various states May travel outside of assigned territory which may involve overnight stay Resides in the State of Michigan only (Territory Specific: Wayne County, Oakland County and Washtenaw County) Preferred Qualifications: 1-2 years of full cycle homeowners claims handling experience Experience handling personal property and additional living expense claims Experience with internal water loss, fire, and smoke claims Michigan Adjuster's License preferred, but not required Associate degree in Claims Work Environment This is a hybrid work arrangement (time spent in office and remote). Depending on the employee's role and leadership's assessment, some employees will come into an ACG facility on a weekly basis, a monthly basis, or on an "as needed" basis for key meetings and collaborative activities. Most employees will be required to come into the office, at a minimum, for important departmental meetings or teambuilding events. Applicants for this position should reside in the metro Detroit, Michigan area. With our powerful brand and the mentoring, we offer, you will find your position as a Field Property Claims Specialist can lead to a rewarding career at our growing organization. How you will benefit: Our Auto Club Group Claim Specialist earns a competitive salary of $73,000 - $85,000 to start along with the opportunity for an annual company bonus incentive. Excellent and comprehensive benefits packages are just another reason to work for the Auto Club Group. Benefits include: 401k Match Medical Dental Vision PTO Paid Holidays Tuition Reimbursement 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.
    $100k yearly Auto-Apply 56d ago
  • Outside Property Claim Adjuster

    Travelers 4.8company rating

    Claims representative job in Detroit, MI

    Who Are We? Taking care of our customers, our communities and each other. That's the Travelers Promise. By honoring this commitment, we have maintained our reputation as one of the best property casualty insurers in the industry for over 160 years. Join us to discover a culture that is rooted in innovation and thrives on collaboration. Imagine loving what you do and where you do it. Job CategoryClaimCompensation Overview The annual base salary range provided for this position is a nationwide market range and represents a broad range of salaries for this role across the country. The actual salary for this position will be determined by a number of factors, including the scope, complexity and location of the role; the skills, education, training, credentials and experience of the candidate; and other conditions of employment. As part of our comprehensive compensation and benefits program, employees are also eligible for performance-based cash incentive awards. Salary Range$65,300.00 - $107,600.00Target Openings1What Is the Opportunity?Under moderate supervision, this position is responsible for the handling of first party property claims including: investigating, evaluating, estimating and negotiating to ensure optimal claim resolution for personal or business claims of moderate severity and complexity. Handles claims and other functional work involving one or more lines of business other than property (i.e. auto, workers compensation, premium audit, underwriting) may be required. Provides quality claim handling throughout the claim life cycle (customer contacts, coverage, investigation, evaluation, reserving, negotiation and resolution) including maintaining full compliance with internal and external quality standards and state specific regulations. This position is based 100% remotely and may include a combination of mobile work and/or work from your primary residence. LOCATION REQUIREMENT: This position services Insureds/Agents in the Ann Arbor, MI, area. The selected candidate must reside in or be willing to relocate at their own expense to the assigned territory. Ideal locations include Ann Arbor, MI, Dearborn Heights and Farmington Hills, areas.What Will You Do? Handles 1st party property claims of moderate severity and complexity as assigned. Completes field inspection of losses including accurate scope of damages, photographs, written estimates and/or computer assisted estimates. Broad scale use of innovative technologies. Investigates and evaluates all relevant facts to determine coverage, damages and liability of first-party property damage claims (including but not limited to analyzing leases, contracts, by-laws and other relevant documents which may have an impact), damages, business interruption calculations and liability of first-party property claims under a variety of policies. Secures recorded or written statements as appropriate. Establishes timely and accurate claim and expense reserves. Determines appropriate settlement amount based on independent judgment, computer assisted building and/or contents estimate, estimation of actual cash value and replacement value, contractor estimate validation, appraisals, application of applicable limits and deductibles and work product of Independent Adjusters. Negotiates with multiple constituents, i.e.; contractors or insured's representatives and conveys claim settlements within authority limits. Writes denial letters, Reservation of Rights and other complex correspondence. Properly assesses extent of damages and manages damages through proper usage of cost evaluation tools. Meets all quality standards and expectations in accordance with the Knowledge Guides. Maintains diary system, capturing all required data and documents claim file activities in accordance with established procedures. Manages file inventory to ensure timely resolution of cases. Handles files in compliance with state regulations, where applicable. Provides excellent customer service to meet the needs of the insured, agent and all other internal and external customers/business partners. Recognizes when to refer claims to Travelers Special Investigations Unit and/or Subrogation Unit. Identifies and refers claims with Major Case Unit exposure to the manager. Performs administrative functions such as expense accounts, time off reporting, etc. as required. Provides multi-line assistance in response to workforce management needs; including but not limited to claim handling for Auto, Workers Compensation, General Liability and other areas of the business as needed. May provides mentoring and coaching to less experienced claim professionals. May attend depositions, mediations, arbitrations, pre-trials, trials and all other legal proceedings, as needed. CAT Duty ~ This position will require participation in our Catastrophe Response Program, which could include deployment away for a minimum of 16 days (includes 2 travel days) to assist our customers in other states. Must secure and maintain company credit card required. In order to perform the essential functions of this job, acquisition and maintenance of Insurance License(s) may be required to comply with state and Travelers requirements. Generally, license(s) must be obtained within three months of starting the job and obtain ongoing continuing education credits as mandated. On a rotational basis, engage in resolution desk technical work and resolution desk follow up call work. This position requires the individual to access and inspect all areas of a dwelling or structure, which is physically demanding requiring the ability to carry, set up and climb a ladder weighing approximately 38 to 49 pounds, walk on roofs, and enter tight spaces (such as attic staircases and entries, crawl spaces, etc.). While specific territory or day-to-day responsibilities may not require an individual to climb a ladder, the incumbent must be capable of safely climbing a ladder when deploying to a catastrophe which is a requirement of the position. Perform other duties as assigned. What Will Our Ideal Candidate Have? Bachelor's Degree preferred. General knowledge of estimating system Xactimate preferred. Two or more years of previous outside property claim handling experience preferred. Interpersonal and customer service skills - Advanced Organizational and time management skills- Advanced Ability to work independently - Intermediate Judgment, analytical and decision making skills - Intermediate Negotiation skills - Intermediate Written, verbal and interpersonal communication skills including the ability to convey and receive information effectively -Intermediate Investigative skills - Intermediate Ability to analyze and determine coverage - Intermediate Analyze, and evaluate damages -Intermediate Resolve claims within settlement authority - Intermediate Valid passport preferred. What is a Must Have? High School Diploma or GED required. A minimum of one year previous outside property claim handling experience or successful completion of Travelers Outside Claim Representative training program required. Valid driver's license required. What Is in It for You? Health Insurance: Employees and their eligible family members - including spouses, domestic partners, and children - are eligible for coverage from the first day of employment. Retirement: Travelers matches your 401(k) contributions dollar-for-dollar up to your first 5% of eligible pay, subject to an annual maximum. If you have student loan debt, you can enroll in the Paying it Forward Savings Program. When you make a payment toward your student loan, Travelers will make an annual contribution into your 401(k) account. You are also eligible for a Pension Plan that is 100% funded by Travelers. Paid Time Off: Start your career at Travelers with a minimum of 20 days Paid Time Off annually, plus nine paid company Holidays. Wellness Program: The Travelers wellness program is comprised of tools, discounts and resources that empower you to achieve your wellness goals and caregiving needs. In addition, our mental health program provides access to free professional counseling services, health coaching and other resources to support your daily life needs. Volunteer Encouragement: We have a deep commitment to the communities we serve and encourage our employees to get involved. Travelers has a Matching Gift and Volunteer Rewards program that enables you to give back to the charity of your choice. Employment Practices Travelers is an equal opportunity employer. We value the unique abilities and talents each individual brings to our organization and recognize that we benefit in numerous ways from our differences. In accordance with local law, candidates seeking employment in Colorado are not required to disclose dates of attendance at or graduation from educational institutions. If you are a candidate and have specific questions regarding the physical requirements of this role, please send us an email so we may assist you. Travelers reserves the right to fill this position at a level above or below the level included in this posting. To learn more about our comprehensive benefit programs please visit *********************************************************
    $65.3k-107.6k yearly Auto-Apply 60d+ ago

Learn more about claims representative jobs

How much does a claims representative earn in Sterling Heights, MI?

The average claims representative in Sterling Heights, MI earns between $35,000 and $73,000 annually. This compares to the national average claims representative range of $28,000 to $53,000.

Average claims representative salary in Sterling Heights, MI

$51,000

What are the biggest employers of Claims Representatives in Sterling Heights, MI?

The biggest employers of Claims Representatives in Sterling Heights, MI are:
  1. EverStaff
  2. Auto-Owners Insurance
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