6 senior claims professional jobs found in Detroit, MI

This position is responsible for supporting clinical and operational processes for clinical pharmacy Star measures within Medicare. The Senior Pharmacy Technician will execute member interventions to resolve any barriers preventing a member from becoming adherent to their medication regimen. This position will also be responsible for making and/or triaging calls to appropriate staff based on the complexity of the call. The Pharmacy Technician will interact with pharmacists, interns, pharmacy students and analysts to support current programs and assist in quality reviews to ensure continued process improvement. Monitors and liaises toll free call center, handle in-coming and make outgoing member, provider and pharmacy calls Assist leadership by investigating challenges and issues to determine root cause and recommend innovative solutions to bring resolution Independently address and resolve adherence barriers at the member, provider or pharmacy, including...

It’s a great time to join AAA The Auto Club Group!   JOIN THE TEAM COMMITTED TO DRIVING YOUR CAREER FORWARD Job Type: Full time   Exempt/Non Exempt:   Salary Job Description:   This is a hybrid position reporting to an office once a month. Senior Trial Attorney – AAA/The Auto Club Group Reports to: Supervising Practice Leader Responsible for litigation of Circuit and Federal cases of unlimited exposure where there is a multiplicity of complicated legal and factual issues involving the more serious injuries, excess damages, and high exposure litigation of identified legal issues which the Company may pursue through the appeal process. To support those duties, we are applying a monthly cap on new case assignments. Primary Duties and Responsibilities: Case Management and Preparation: Analyzes, files, reviews all allegations, and renders legal opinions to Claims personnel regarding evaluation and disposition of...

SUMMARY:     Workers Compensation Defense Attorney needed for in-house litigation position, working under the direction of the General Counsel.  This position will work defending litigated Workers’ Compensation claims before hearing locations, primarily in and surrounding Detroit, MI. This attorney will conduct research where necessary, examine records, conducts investigations, attends depositions, consult with witnesses, insured(s), legal assistants, and/or personnel.  Participate in negotiations on behalf of the Company including settlements.  In addition, this position will provide leadership and expertise on major company projects as necessary. Claims Focus:  This position will provide  state specific legal representation before courts, arbitration panels and/or administrative bodies.  Serve in an advisory capacity to company and employees.  Prepare legal pleadings, motions, memorandums, trial briefs, etc. Conduct research where necessary, examine records, attend...

WHAT WE'RE LOOKING FOR Berkshire Hathaway Homestate Companies, Workers Compensation Division, is looking for a Business Development Manager in Michigan!  This individual will be responsible for business development efforts and brand strategy within a specified territory.  This involves evaluation of production patterns in new and renewal business to uncover opportunities for refinements to support profitable growth.  You will work collaboratively with other Business Development Managers, Underwriting management, and additional corporate resources to develop opportunities by industry, class code or segment, and to more effectively monitor/evaluate agency performance. You'll stay ahead of competitive intelligence and help prevent production barriers, as well as develop opportunities to improve ease of doing business with BHHC and provide input to improve overall customer experience.  Frequent travel within a specified territory required.   Must be legally authorized to...

The position is described below. If you want to apply, click the Apply button at the top or bottom of this page. You'll be required to create an account or sign in to an existing one. If you have a disability and need assistance with the application, you can request a reasonable accommodation. Send an email to Accessibility (accommodation requests only; other inquiries won't receive a response). Regular or Temporary: Regular Language Fluency:  English (Required) Work Shift: 1st Shift (United States of America) Please review the following job description: Underwrites new and renewal business, approves policy changes, maintain workload, and controls written business up to and including the time of binding according to Company guidelines and established internal and external procedures. Provides leadership to a production/underwriting team. Provides high quality professional service to Agents and Companies. ESSENTIAL DUTIES AND RESPONSIBILITIES...

The Director Government Programs- Planning & Consulting position is responsible for driving the execution of strategic analytic priorities for Government Programs and CFO areas through business planning, consultation, and delivery oversight of data, analytics, and modeling capabilities. This role promotes the use of AI, automation, and best-in-class technology across teams; drives organizational priorities and business outcomes as the consultative partner across analytics, operations, and modeling teams by managing and coordinating execution of insights, tools, and governance.  The Director leads, organizes and executes governance of Medicare Advantage analytics ecosystem working closely with MA segment leadership; establishes internal consultative intake and delivery of best-in-class data and advanced analytics / AI driven insights to support key segment initiatives and goals; partners with other government programs analytics functions and other key stakeholders...