25 claims processor jobs found in Lansing

SUMMARY: Primarily responsible for assisting Business Development Consultants (BDCs) in growing and maintaining a profitable book of business and assists agents with inquiries related to underwriting rules, procedures and regulations. Manages renewal book in accordance with the needs of the region they are aligned with. Mentors CSRs with complex agency/insured questions and policy information. Reviews policy structures to determine if changes need to be made to stay in compliance with bureau rules and regulations.  Provides customer service to agencies and policyholders related to complex underwriting inquiries, policy, and audit information. Contacts include state rating bureaus, Business Development Consultants, Business Development Directors, Service Center Managers, Underwriting Technical Advisor, Service Center staff, Finance Department, Claims Department, agents and policyholders.   ESSENTIAL DUTIES AND RESPONSIBILITIES include the following. Other duties may be assigned....

SUMMARY: This job is primarily responsible for payment application related to accounts receivable. This position requires working in several billing, receivable and ancillary systems that require manual intervention due to complexity of systems and products underwritten by the Enterprise. Responsible for providing accurate and timely payment application and balancing, along with other ad hoc requests. Contacts include various employees of the Enterprise, agents, policyholders, medical facilities, other insurance companies, NCCI and legal representatives. PRIMARY RESPONSIBILITIES: · Balances, validates, and posts incoming cash receipts and other receivable-based transactions to various billing and ancillary systems for the Enterprise. · Independently troubleshoots and researches issues related to cash receipts and accounts receivable; reaches out to other departments regarding issues as needed. · Initiates premium write-off requests for the Enterprise as applicable after...

SUMMARY:  Provider Relations Specialist I Responsible for servicing internal and external customers who contact AF Group via the ACD phone line. Responsible for providing quality, consistent and accurate medical payment information to internal and external customers.  Provider Relations Specialist II Responsible for analyzing billings including outpatient hospital and multiple surgeries by utilizing our Medical Bill Review (MBR) software and reference library to determine appropriateness of codes and excessive charges. Responsible for making coding determinations according to state rules and regulations.  PRIMARY RESPONSIBILITIES:  PRIMARY RESPONSIBILITIES: Provider Relations Specialist I •    Utilizes ACD phone lines to manage incoming calls and inquiries. •    Provides high level of customer service for all internal or external customers thru telephonic, email and fax. •    Demonstrates dependable work ethic. •    Manages confidential client information with discretion and good...

A career at Auto-Owners is challenging and rewarding.  Our group of caring associates create financial security by helping individuals and businesses make a new start when a loss occurs. Job Description 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 motivated nursing professional to join our team. The position requires the person to: ·        Collaborate with claims associates to provide medical expertise in the investigation, evaluation, and appropriate resolution of injury claims including workers’ compensation, personal injury protection (no fault), and liability. ·        Evaluate medical records for relatedness to the injury and appropriate utilization of medical treatment and services. ·        Prepare and deliver trainings to claims...

SUMMARY: (Brief 3-5 sentence paragraph outlining the main purpose of the job)   This is an entry-level position. This position leads to a Medical Only Claims Specialist I and is expected to last up to 12 months. Upon completion of the training plan the incumbent is expected to be proficient with the Medical Only Claims policies, processes, procedures, and terminology related to the job. In addition, the incumbent will be proficient in the job responsibilities and tasks of the Medical Only Claims Specialist I position description. The incumbent will be evaluated on their progress and successful completion of the training plan each quarter. Upon satisfactory completion, the incumbent will be eligible for the Medical Only Claims Specialist I position.  Medical Only Claims Associate will work with all members of the team and may receive direction, support, and instruction from the Manager or Medical Only Claims Specialists depending on the assignment....

SUMMARY:  This role will focus on maintenance of our incoming workload, issue resolution and first report of injury (FROI) issues. This position determines jurisdiction for entry of first notice of injury (FNOI) from multiple sources and distributes to the proper destination. Enters and supports priority and special requests, including correcting newly-created claims.   ESSENTIAL DUTIES AND RESPONSIBILITIES  · Identifies jurisdiction, date of injury and special/additional handling items; researches and re-indexes non-new claim submissions to route to appropriate handling. · Receives incoming general new claims calls for all entities; backup for ACD calls in the event of telephone system shutdown. · Makes changes, corrections and updates on newly created and/or existing claims or submissions as well as guiding end-users on process techniques in various applications. · May serve as a resource regarding intake-related issues, i.e., determine jurisdiction, assist in clearing...

A career at Auto-Owners is challenging and rewarding.  Our group of caring associates create financial security by helping individuals and businesses make a new start when a loss occurs. Job Description 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 an experienced and motivated Legal Support Specialist to join our eBilling team. We are looking for the right individual to join our team to assist our in-house attorneys in reviewing outside counsel invoices and undertaking related projects. The position requires the following, but is not limited to: Effectively communicate with Home Office Attorneys, outside counsel and other divisions through verbal and/or written correspondence. Accurately input data into various systems. Interpret and apply verbal...

SUMMARY:  Primarily responsible for scheduling audit appointments for Premium Auditors. Responsible for the Premium Technician Review OnBase queue and triages incoming phone calls to Premium Audit Department. Responsible for evaluation, approval, completion and processing of basic mail audits and estimating, in a multi functional business unit for a single state or states with similar rules. Provides technical assistance via phone, fax, and e-mail to internal and external customers including, but not limited to; Business Development Consultants and Service Center Representatives, Finance, and other Premium Audit staff, as well as agents, attorneys, NCCI/regulatory bureaus, and policyholders. EMPLOYMENT QUALIFICATIONS: A. EDUCATION REQUIRED:  Minimum 12 credit hours of coursework in Accounting, Business, Insurance, Finance or related field and progress towards or completion of Insurance Institute of America (IIA) or other insurance-related designation(s) such as an Associate in...

SUMMARY: Primarily responsible for evaluation, approval, completion, and processing of mail audits and reviewing phone audits in a multi-functional business unit.  Provides direct customer service via phone, fax, and e-mail to internal and external customers including, but not limited to; Business Development Consultants and service center representatives, finance, TPA representatives, and other premium audit staff, as well as agents, attorneys, NCCI / regulatory bureaus, and policyholders. Respond to telephone, mail, or email inquiries providing direct customer service to internal and external customers related to an audit and other policy concerns. PRIMARY RESPONSIBILITIES: •   Analyze, research, approve, complete and process mail audits. •   Analyze, research, approve, complete, and process the following audit adjustment types: waive, mail, and phone audits.  When an adjustment is denied, notify the parties involved.  •   Make necessary customer contacts to an insured,...

A career at Auto-Owners is challenging and rewarding.  Our group of caring associates create financial security by helping individuals and businesses make a new start when a loss occurs. Job Description We offer a merit-based work-from-home program based on job responsibilities. After initial training in-person, you could have the flexibility of work-from-home time as defined by the leadership team. Auto-Owners Insurance, a top-rated insurance carrier, is seeking an experienced and motivated Paralegal to join our team. We are looking for the right individual to join our team to assist our in-house attorneys in supervising claim files and undertaking related projects.  The position requires the following, but is not limited to: Review and summarize claims files, complaints, expert reports, and other documents. Draft legal correspondence and organize in electronic filing system Coordinate deadlines and organize workflow to improve efficiency of the team Research...

A career at Auto-Owners is challenging and rewarding.  Our group of caring associates create financial security by helping individuals and businesses make a new start when a loss occurs. Job Description 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 individual to assist policyholders with servicing policies and evaluating coverages for cross-selling opportunities. Additionally, this job processes requests from policyholders and answers policyholder questions regarding existing business. The position requires the person to: Communicate and work with policyholders and associates at all levels. Begin to establish working relationships with policyholders. Accurately answer questions from policyholders, in coordination with other departments...

Job Type: Full time   Exempt/Non Exempt:   Salary Job Description:   Location Details: Lansing, Michigan 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 Lansing, Michigan 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 Contacting the insured and other...

A career at Auto-Owners is challenging and rewarding.  Our group of caring associates create financial security by helping individuals and businesses make a new start when a loss occurs. Job Description We offer a merit-based work-from-home program based on job responsibilities. After initial training in-person, you could have the flexibility of work-from-home time as defined by the leadership team. Auto-Owners Insurance, a top-rated insurance carrier, is seeking a motivated Field Premium Auditor to join our team. The position requires the person to: Audit insured records to determine the proper exposure classifications and premium basis and provides reports and recommendations to Underwriting. For assigned policies, determine the proper exposure classification, premium basis and scope of operations through the use of observation, discussion with insureds and the review of accounting records. Report and discuss exposures present on an insured's property to...

SUMMARY:  Provider Relations Specialist I Responsible for servicing internal and external customers who contact AF Group via the ACD phone line. Responsible for providing quality, consistent and accurate medical payment information to internal and external customers.  Provider Relations Specialist II Responsible for analyzing billings including outpatient hospital and multiple surgeries by utilizing our Medical Bill Review (MBR) software and reference library to determine appropriateness of codes and excessive charges. Responsible for making coding determinations according to state rules and regulations.  PRIMARY RESPONSIBILITIES:  PRIMARY RESPONSIBILITIES: Provider Relations Specialist I •    Utilizes ACD phone lines to manage incoming calls and inquiries. •    Provides high level of customer service for all internal or external customers thru telephonic, email and fax. •    Demonstrates dependable work ethic. •    Manages confidential client information with discretion and good...

SUMMARY:  Provider Relations Specialist I Responsible for servicing internal and external customers who contact AF Group via the ACD phone line. Responsible for providing quality, consistent and accurate medical payment information to internal and external customers.  Provider Relations Specialist II Responsible for analyzing billings including outpatient hospital and multiple surgeries by utilizing our Medical Bill Review (MBR) software and reference library to determine appropriateness of codes and excessive charges. Responsible for making coding determinations according to state rules and regulations.  PRIMARY RESPONSIBILITIES:  PRIMARY RESPONSIBILITIES: Provider Relations Specialist I •    Utilizes ACD phone lines to manage incoming calls and inquiries. •    Provides high level of customer service for all internal or external customers thru telephonic, email and fax. •    Demonstrates dependable work ethic. •    Manages confidential client information with discretion and good...

SUMMARY:     The Medical Only Claims Specialist I is an entry level claims role. The incumbent is expected to be proficient with the Claims unit, policies, processes, procedures, and terminology.      The Medical Only Claims Specialist II is an experienced level claims role. The incumbent is expected to perform at a high level with minimum supervision.     Primarily responsible for the investigation and management of workers’ compensation claims. Conducts a 1 to 3-point contact on the managed claims, which is dependent on either the facts of the case or the claim type; determines compensability of claims, manages the medical treatment program, and assists in the return-to-work process. This includes calling and discussing potential claim activity and work-related injuries with policyholders, claimants, providers, attorneys, agents, and state agencies. Trains and mentors other team members. Provides backup support to other...

SUMMARY: (Brief 3-5 sentence paragraph outlining the main purpose of the job)     The Medical Only Claims Specialist I is an entry level claims role. The incumbent is expected to be proficient with the Claims unit, policies, processes, procedures, and terminology.      The Medical Only Claims Specialist II is an experienced level claims role. The incumbent is expected to perform at a high level with minimum supervision.     Primarily responsible for the investigation and management of workers’ compensation claims. Conducts a 1 to 3-point contact on the managed claims, which is dependent on either the facts of the case or the claim type; determines compensability of claims, manages the medical treatment program, and assists in the return-to-work process. This includes calling and discussing potential claim activity and work-related injuries with policyholders, claimants, providers, attorneys, agents, and state agencies....

SUMMARY: (Brief 3-5 sentence paragraph outlining the main purpose of the job)   This is an entry-level position. This position leads to a Medical Only Claims Specialist I and is expected to last up to 12 months. Upon completion of the training plan the incumbent is expected to be proficient with the Medical Only Claims policies, processes, procedures, and terminology related to the job. In addition, the incumbent will be proficient in the job responsibilities and tasks of the Medical Only Claims Specialist I position description. The incumbent will be evaluated on their progress and successful completion of the training plan each quarter. Upon satisfactory completion, the incumbent will be eligible for the Medical Only Claims Specialist I position.  Medical Only Claims Associate will work with all members of the team and may receive direction, support, and instruction from the Manager or Medical Only Claims Specialists depending on the assignment....

SUMMARY: (Brief 3-5 sentence paragraph outlining the main purpose of the job)   This is an entry-level position. This position leads to a Medical Only Claims Specialist I and is expected to last up to 12 months. Upon completion of the training plan the incumbent is expected to be proficient with the Medical Only Claims policies, processes, procedures, and terminology related to the job. In addition, the incumbent will be proficient in the job responsibilities and tasks of the Medical Only Claims Specialist I position description. The incumbent will be evaluated on their progress and successful completion of the training plan each quarter. Upon satisfactory completion, the incumbent will be eligible for the Medical Only Claims Specialist I position.  Medical Only Claims Associate will work with all members of the team and may receive direction, support, and instruction from the Manager or Medical Only Claims Specialists depending on the assignment....

SUMMARY: (Brief 3-5 sentence paragraph outlining the main purpose of the job)     The Medical Only Claims Specialist I is an entry level claims role. The incumbent is expected to be proficient with the Claims unit, policies, processes, procedures, and terminology.      The Medical Only Claims Specialist II is an experienced level claims role. The incumbent is expected to perform at a high level with minimum supervision.     Primarily responsible for the investigation and management of workers’ compensation claims. Conducts a 1 to 3-point contact on the managed claims, which is dependent on either the facts of the case or the claim type; determines compensability of claims, manages the medical treatment program, and assists in the return-to-work process. This includes calling and discussing potential claim activity and work-related injuries with policyholders, claimants, providers, attorneys, agents, and state agencies....