18 claims manager jobs found in Detroit

Job Type: Full time   Exempt/Non Exempt:   Salary Job Description:   Location Details: Detroit, Michigan – Wayne, Oakland, and Macomb County Position Schedule / Shift: Hybrid – Field schedule Monday – Friday: 8:30 AM EST – 5:30 PM EST. Position Summary: Join our team as a Field Property Claim Specialist serving the Metro Detroit area, where you’ll be the face of our claims experience and make a meaningful difference for customers during challenging times. In this role, you’ll inspect property damage, investigate claims, and work directly with homeowners to provide exceptional service and fair claim resolutions. If you enjoy working independently, building relationships, and combining problem-solving skills with field-based work, this is an opportunity to grow your career while helping customers recover and move forward. Now offering a $2,500 Sign-On Bonus for qualified candidates Key Responsibilities: Reviewing assigned claims...

At Allstate, great things happen when our people work together to protect families and their belongings from life’s uncertainties. And for more than 90 years, our innovative drive has kept us a step ahead of our customers’ evolving needs. From advocating for seat belts, air bags and graduated driving laws, to being an industry leader in pricing sophistication, telematics, and, more recently, device and identity protection.  Job Description A day in the life of a Large Loss Field Property Adjuster, and what it takes to do the job! As a Large Loss Field Property Adjuster, you will provide exceptional service to our policyholders. Your primary responsibility will involve traveling to our customers' homes to conduct on-site inspections, investigate coverage, prepare estimates, and settle claims promptly and efficiently. Additionally, you will handle virtual claims countrywide, leveraging various platforms and software such as Xactimate and ClaimsX Video Collaboration....

Job Type: Full time   Exempt/Non Exempt:   Salary Job Description:   Location Details: Detroit, Michigan – Wayne, Oakland, and Macomb County Position Schedule / Shift: Hybrid – Field Schedule Monday – Friday: 8:30 AM EST – 5:30 PM EST. Position Summary: Join our team as a Field Property Claim Specialist serving the Metro Detroit area, where you’ll be the face of our claims experience and make a meaningful difference for customers during challenging times. In this role, you’ll inspect property damage, investigate claims, and work directly with homeowners to provide exceptional service and fair claim resolutions. If you enjoy working independently, building relationships, and combining problem-solving skills with field-based work, this is an opportunity to grow your career while helping customers recover and move forward. Now offering a $2500 sign on bonus to qualified candidates! Key Responsibilities: Reviewing assigned claims...

Job Type: Full time   Exempt/Non Exempt:   Salary Job Description:   Location Details: Detroit, Michigan Chicago, Illinois Minneapolis, Minnesota Travel within the assigned local market is required, approximately 10% of the time, with no overnight travel and company vehicle provided. Position Schedule / Shift: Hybrid– Field schedule Monday – Friday: 8:30 AM EST – 5:30 PM EST. Position Summary: As a Field Property Claims Specialist, you'll conduct on-site property inspections, assess damages, determine coverage, prepare estimates, and guide policyholders through the claims process with professionalism and empathy. This role combines property claims expertise, customer service, and problem-solving to deliver timely, accurate claim resolutions while helping customers recover from unexpected losses. You'll also have opportunities to support catastrophe (CAT) response efforts, assisting customers and communities impacted by large-scale...

Job Type: Full time   Exempt/Non Exempt:   Salary Job Description:   Location Details: Detroit, Michigan – Wayne, Oakland, and Macomb County Position Schedule / Shift: Hybrid – Field Schedule Monday – Friday: 8:30 AM EST – 5:30 PM EST. Position Summary: Join our team as a Field Property Claim Specialist serving the Metro Detroit area, where you’ll be the face of our claims experience and make a meaningful difference for customers during challenging times. In this role, you’ll inspect property damage, investigate claims, and work directly with homeowners to provide exceptional service and fair claim resolutions. If you enjoy working independently, building relationships, and combining problem-solving skills with field-based work, this is an opportunity to grow your career while helping customers recover and move forward. Now offering a $2500 sign on bonus to qualified candidates! Key Responsibilities: Reviewing assigned claims...

Customer Service Rep I Full-time Shift: 8:00 am to 8:00 pm (Shift bidding process based on seniority) Detroit, MI Assessment required - Customer Service Rep   Analyzes, evaluates, resolves and primarily responds to low complexity level membership issues under various product lines. Primarily conducts low complexity internal and external research to determine and request the data needed to handle inquiries regarding membership.  Analyze and service various product lines in the area (i.e., Facility, Professional). Provide responses by telephone, check-off letters, and/or automated letters. Follow department/corporate reporting requirements (i.e., PCRS, ICS, Special Surveys and Manual counts).  Organize work to meet National/Corporate/Department Production and Quality Standards.  Reroute misdirected inquiries.  Primarily evaluates membership issues/inquiries and price/adjudicates low complexity claims/inquiries.  Interact with others inside and outside the organization to...

This role is responsible for designing, optimizing, and governing the conversational content and prompt architecture that powers AI-enabled member self-service. The role translates complex healthcare, insurance, benefits, and operational terminology into clear member language and influences model behavior through grounded prompt design, conversational examples, testing, feedback, monitoring, and continuous refinement. This role will also partner with Product Management, Product Owners, design, engineering, data and AI teams, member experience, operations, legal, compliance, privacy, clinical, and business subject-matter experts to ensure conversations are understandable, accurate, trusted, accessible, and aligned to product outcomes and organizational standards. Lead conversational content and prompt strategy for AI-enabled member self-service. Define member-friendly wording, conversational tone, response length, response structure, progressive disclosure, follow-up patterns,...

Non-Exempt/Bargaining Unit Posting Shift – 9:00am-5:30pm M-F; shift bidding process based on seniority  Site/Location: Detroit, MI Status – Regular Full Time   Picks up and delivers materials from user areas for delivery throughout corporation as well as process requisitions and orders. Prepares/distributes incoming and outgoing mail. Responsible for analyzing and redirecting undesignated forms and correspondence to the proper area. Fulfill and deliver requisitions, work orders or requests for materials, other stock items and distribute items. Pick up and deliver return material and other items. Codes and delivers packages from outside sources.  Completes daily production sheets on duties performed. Sorts and prepares incoming/outgoing mail and delivers incoming mail. Process registered, certified insured, zip code sorted and UPS. Bursts, cuts and opens material when required. Palletize and prep materials for pickup by drivers or vendors. Assists in loading and...

Provide clinical expertise across the enterprise for various functions.  Responsible for corporate and medical policy interpretation, recommendation, and review within recognized areas of responsibility.  Advise and collaborate in the development of clinical programs. Provide clinical support and participate in utilization management, quality management, and care management programs in respective area and identify opportunities for improvement and efficiency. Assist in the design, development, implementation and assessment of disease state management and health enhancement programs that support the appropriate use of clinical resources in the delivery of consistent high-quality medical care. Provide clinical leadership for health promotion and education programs and the claims editing department. Assist in establishing corporate and regional programs to enhance quality of care, reduce medical costs and achieve positive health outcomes. Serves as clinical...

Perform technology functions to include but not limited to business and systems analysis, application development and process improvement. Serve as a liaison between the business area and the IT organization when needed. Identify, document and communicate system and process changes necessary to improve system and operational performance measures.  Possess an in-depth knowledge of line of business while contributing to the identification, analysis and recommendation of technical process improvement initiatives. Design, create and implement technical solutions. Support complex business processes. Conduct data gathering and analysis to understand business strategy requirements. Provide direction for short and long-term planning sessions and provide direction to ensure understanding of business goals and direction. Evaluate ongoing department activity and propose new tools or technologies Assist in the business process redesign and documentation as needed for new technology....

This position is located in Detroit, MI or Grand Rapids, MI This position is responsible for designing and developing procedural documentation, formal training modules, customer service alerts and conducting training and/or Train-the-Trainer sessions for Claims Training Division team members. This position demands that the incumbent works closely with managerial and supervisory-levels as well as Subject Matter Experts in order to assess needs and performance and to validate and evaluate training materials, to include representing the Department on various Committees and Workgroups. This position is responsible for developing, coordinating and managing Training Schedules for the Core Operations Claims Division. Works closely with the Training Team, Quality, Divisional Leadership and other Subject Matter Experts in order to analyze performance/new business issues and develop appropriate procedural documentation and training support materials.  Represents the Department on...

Department Summary This role requires a highly accountable, detail-oriented professional who can independently lead complex, time-sensitive work in a fast-paced, highly visible customer environment. The successful candidate will demonstrate strong project management, critical thinking, sound judgment, and exceptional attention to detail, with the ability to anticipate issues, manage competing priorities, and consistently deliver accurate, high-quality work under tight deadlines. The individual must be a confident communicator who takes ownership, drives accountability across teams and partners, asks the right questions, and translates complex issues into clear, complete responses for the customer and executives. Strong preparation, follow-through,  and the ability to constructively challenge and influence others are essential. Experience applying Six Sigma methodologies to solve problems, identify root causes, and improve processes highly preferred. Accountable for and...

Know your rights Inform yourself of your rights and responsibilities by reviewing the content provided in the list below. Employment Eligibility (e-Verify):  English & Spanish Right to work:  English  /  Spanish It's fun to work in a company where people truly BELIEVE in what they're doing! We're committed to bringing passion and customer focus to the business. Position Overview :  The primary duties of a field adjuster are to inspect the loss and prepare documents detailing the claim. Essential Job Functions Communicate with desk examiners, insureds, attorneys, and other experts to gather information on claims Negotiate settlements with the insured and/or their representatives Prepare reports based on the policy language and submit payment recommendations to the desk examiners Prepare detailed estimates of the damage Manage workload and submit closing documents in a timely fashion Regular and reliable attendance Marginal Job...

Departmental Summary: This position supports Medicare Part D pharmacy quality and medication adherence initiatives through data analysis, reporting, dashboard development, and operational support. Responsibilities include analyzing healthcare data, monitoring quality measures, providing actionable insights to business and clinical partners, and supporting initiatives that improve CMS Star Ratings. Required Skills and Qualifications: • Strong experience developing complex SQL queries and analyzing large healthcare datasets, including pharmacy claims, medical claims, membership, and provider data. • Proficiency in Python for healthcare analytics, reporting, process automation, and data quality validation. • Experience in writing and maintaining Spark SQL and Python code in Databricks to support process automation and data analytics • Familiarity with SAS programming for data manipulation, reporting, and analytics. • Strong Tableau experience in...

                                                                   Moderate travel, including nationwide travel, is required (up to 50%) Department Summary Serve as a subject matter expert for UAW Trust benefits, claims, and member advocacy. Possess NASCO claims processing knowledge and experience. Demonstrate strong understanding of MAPPO, Medicare Advantage, Commercial, HMO, and PPO benefit structures and claim processing differences. Investigate and resolve complex claims issues, benefit processing concerns, and member escalations. Support member meetings and travel team activities, including direct member interactions and issue resolution. Attend and actively participate in internal and external workgroup meetings representing the Trust account. Coordinate, submit, and oversee benefit implementation requests and ensure implementations are accurately configured and tested. Partner with operational, benefit, provider, and claims teams to identify and...

Join the Health Care Value Strategic Informatics and Program Performance team where you will be responsible for leveraging advanced analytics, predictive modeling, and data visualization to generate actionable insights that improve healthcare outcomes, optimize program performance, and support strategic decision-making. This role partners with business leaders, clinical teams, pharmacy services, and operational stakeholders to analyze healthcare data, identify trends, evaluate program effectiveness, and provide data-driven recommendations related to cost, quality, utilization, and member outcomes. ESSENTIAL DUTIES AND RESPONSIBILITIES include the following. Other duties may be assigned. Analyze large volume of health care claims data using advanced statistics/machine learning methods to understand existing and predict future health care trends and anomalies. Proactively discovers potential areas for medical cost improvement and management/healthcare initiative strategies....

Position Summary Responsible for planning, organizing, directing, and executing complex analytical initiatives that support Health Care Value programs and performance management activities. This position operates with a high degree of independence and is responsible for researching, analyzing, and interpreting healthcare data to identify trends, evaluate program performance, quantify savings, and provide actionable business recommendations. The Senior Healthcare Analyst partners with internal stakeholders, vendors, providers, and leadership teams to develop analytical solutions, monitor contractual performance, and deliver strategic insights that improve healthcare affordability, quality, and operational effectiveness. Key Responsibilities Healthcare Analytics & Performance Measurement Lead the research, analysis, and evaluation of healthcare claims, authorization, utilization, provider, and membership data to identify trends, risks, and opportunities....

The Internship Program at BCBSM is designed to enhance the skills and abilities of young professionals as well as to identify and attract future talent for our organization. Interns will gain practical hands-on work experience as well as a solid understanding of the health insurance industry. Our program is an excellent way for interns to get a good start on their careers by working on meaningful projects, learning valuable skills, and networking with employees throughout our organization, which could potentially allow interns to build a future career at BCBSM. Assist in preparing information and research materials to identify business problems, offer recommendations and assist  management with implementation of solutions.  Support leaders on projects designed to enhance the overall efficiency and effectiveness of the organization. Develop and maintain a solid understanding of BCBSM business, products, programs, data, organizational structure, controls, research.  Analyze...