11 claims director jobs found in Detroit, MI

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....

National General is a part of The Allstate Corporation, which means we have the same innovative drive that keeps us a step ahead of our customers’ evolving needs. We offer home, auto and accident and health insurance, as well as other specialty niche insurance products, through a large network of independent insurance agents, as well as directly to consumers.  Job Description Responsible for creating or auditing a comprehensive estimate of damages for 1st and 3rd party material damage claims in either the auto or specialty lines leading to the proper disposition. Responsible for training, mentoring, controlling quality and providing technical assistance on material damage claims. This is a field adjuster position in Wayne County, Michigan. Candidates should be local and able to travel within the Detroit, Michigan area. Key Responsibilities • Possesses strong estimating fundamentals in order to create or audit estimates of damages on 1st and 3rd party material...

Job Type: Full time   Exempt/Non Exempt:   Hourly Job Description:   Location: Dearborn, Michigan   Position Schedule / Shift: Rotating hybrid schedule Monday – Friday: 8:30 AM EST – 5:00 PM EST. In office reporting will rotate based on role responsibilities. All employees will be notified of in office reporting days as applicable. Training for this position will be in office for the first initial 90 days of employment. Rotating schedule will begin after training is completed. Position Summary: Join our Claims team in a role where your analytical skills, attention to detail, and problem-solving abilities make a direct impact on the customer experience and the financial integrity of our claims operations. As a claims operations professional, you'll take ownership of complex payment and reconciliation processes, resolve challenging issues, and serve as a trusted resource for teammates while helping ensure accurate, timely claim outcomes. If you...

                                                                   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...

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 fast-paced 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 Insurance Sales Representative, you will: Engage with active insurance shoppers via inbound/outbound calls, live chat, SMS, and more in a work from home call...

Why USAA? At USAA, our mission is to empower our members to achieve financial security through highly competitive products, exceptional service and trusted advice. We seek to be the #1 choice for the military community and their families. Embrace a fulfilling career at USAA, where our core values – honesty, integrity, loyalty and service – define how we treat each other and our members. Be part of what truly makes us special and impactful. We are proud to support active-duty military spouses. USAA roles may offer remote or hybrid flexibility for active-duty military spouses consistent with applicable policy and business needs. The Opportunity This is a field-based role in the Detroit, MI area. Candidates who are willing and able to work in Detroit are encouraged to apply.   Within defined guidelines and framework responsible for the investigation, negotiation, evaluation and appraisal of vehicle damage claims for both repairable and total loss vehicles to...

Provides technical, data and analytical support to customer departments such as Quality, Value Partnerships, Hospital Contracting, Care Management, Risk Adjustment and HCV.   ESSENTIAL DUTIES AND RESPONSIBILITIES  include the following. Other duties may be assigned.  Leads or participates, with some direction, in projects where data solutions are necessary. Provides programming and data expertise for simple and moderately complex projects and ad-hoc requests.   Presents data and solutions to internal and/or external customers in a logical way. Provides data support and analysis for programs supporting over 4 million BCBSM beneficiaries using administrative claims and supplemental data.    Provides analysis and data support for various corporate departments including Quality, Risk Adjustment, Value Partnership, Care Management, and Hospital Contracting, in support of major corporate initiatives such as EMR Connectivity, PGIP, Risk Adjustment, STARS and...

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 – 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...

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...