4 claims administrator jobs found in Detroit, MI

SUMMARY:  The Analyst applies analytical skills and specialized knowledge to identify Medicare Part C/D members  with other primary health information and pursue recovery of associated claim overpayments. The  position is responsible for establishing, updating, and/or correcting Part C/D coordination of benefits  (COB) records by utilizing knowledge of the Centers for Medicare and Medicaid (CMS), Medicare  Secondary Payer (MSP) rules, and Part C/D Medicare plan requirements. The role also supports claim  overpayment recovery and reconciliation efforts. Research and analyze data to support the reconciliation  and restoration of MA plan payment reductions due to MSP status.    ESSENTIAL DUTIES AND RESPONSIBILITIES   Other duties may be assigned. • Verifies and reconciles provider/vendor identified claim overpayments. Updates records and  prepares responses to providers.  • Researches and analyzes MA Plan payment data, CMS COB data, OHI records, and CMS ECRS  system to...

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 Field Property Adjuster, and what it takes to do the job! As a Field Property Adjuster, you will be dedicated to providing 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. Your...

The Enterprise Security Officer II position is an essential member of the enterprise security team and is focused on providing a safe, secure, and friendly environment for all individuals on our property.  The primary duties of a security officer II consist of Security Officer I responsibilities in addition to enterprise command center responsibilities.  Individuals in this position must be professional in their appearance and conduct and assist in the enforcement of corporate policies, guidelines, procedures, rules, regulations, laws, and ordinances. The security officer II will protect BCBSM property against damage, fire, theft, trespassing, and illegal or unauthorized entry. They will also provide an emergency response for major events and provide high quality customer service and educate stakeholders to take an active role in maintaining a secure workplace.  The Security Officer II must remain calm under pressure and can make decisions quickly to protect people or property...

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 Allstate’s sales organization is growing its virtual workforce, and we are looking for highly motivated individuals that thrive in a sales environment and enjoy being rewarded for their efforts. At Allstate, we are committed to offering a reputable product suite that protects people from life’s uncertainties so they can realize their hopes and dreams. As a full-time Inside Sales Representative, you will: Engage with active insurance shoppers via inbound/outbound calls, live chat, SMS, and more. Use your insurance expertise to...