39 claims service specialist jobs found

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:   Sr. Claim Specialist - Michigan PIP & Litigation – The Auto Club Group ****$5,000 Sign-On Bonus for qualified candidates. This Michigan-based position requires residency within the State of Michigan due to in-person court appearances. What you will do: The Auto Club Group is seeking prospective  Senior   Claim Specialist who can work under less supervision with a high-level of authority to handle highly complex technical issues and the most complex claims.  In this position, you will have the opportunity to: Review assigned claims, contact the insured and other affected parties, set expectations for the remainder of the claim process, and initiate documentation in the claim handling system.   Complete coverage analysis on the most complex...

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:   Claim Specialist - Michigan PIP – The Auto Club Group Reports to : Claim Manager as appropriate What you will do: The Auto Club Group is seeking prospective Claim Specialist who will work under minimal supervision with a high-level approval authority to handle complex technical issues and complex claims. In this position, you will have the opportunity to: Claim handling responsibilities will include the following: reviewing assigned claims, contacting the insured and other affected parties, setting expectations for the remainder of the claim process, and initiating documentation in the claim handling system. Complete complex coverage analysis. Ensure all possible policyholder benefits are identified. Create additional sub-claims if needed....

By joining Sedgwick, you'll be part of something truly meaningful. It’s what our 33,000 colleagues do every day for people around the world who are facing the unexpected. We invite you to grow your career with us, experience our caring culture, and enjoy work-life balance. Here, there’s no limit to what you can achieve. Newsweek Recognizes Sedgwick as America’s Greatest Workplaces National Top Companies Certified as a Great Place to Work® Fortune Best Workplaces in Financial Services & Insurance Field Investigator This position works in the office M-F in Auburn Hills, MI. PRIMARY PURPOSE :  To independently conduct insurance defense investigations to include recorded statements, accident scene Investigations, AOE/COE investigations as assigned; to identify red flag indicators and evidence that support the objectives of the investigation; to document findings in detailed, professional investigative reports and make recommendations as appropriate....

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:   Eligible candidates for this role should reside within the metro Detroit Michigan area. Preferred candidates should reside in Canton, MI, Ypsilanti, MI, or west Oakland County. Metro Detroit Field Property Claim Specialist -AAA The Auto Club Group Reports to: Claim Manager as appropriate What you will do: Work under minimal supervision with a high-level approval authority to handle complex technical issues and complex claims.  Review assigned claims, Contacting the insured and other affected parties, set expectations for the remainder of the claim process, and initiate documentation in the claim handling system.   Complete complex coverage analysis. Ensure all possible policyholder benefits are identified.  Create additional sub-claims if...

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 position is currently able to work remotely from a home office location for day-to-day operations unless occasional travel for meetings, collaborative activities, or team building activities is specified by leadership. This is subject to change based on amendments and/or modifications to the ACG Flex Work policy. *** Claim Specialist – Bodily Injury – The Auto Club Group Reports to: Casualty Claim Manager II What you will do: (Primary Duties & Responsibilities) ACG is seeking a prospective Claim Specialist to work under minimal supervision.  In this position, you will: Handle highly complex new and reassigned auto and homeowner bodily injury liability claims. Adhere to ACG claim handling procedures, processes and guidelines. Complete...

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 Medical Bill Review Specialist I Primarily responsible for analyzing bills for multi-state Workers Compensation medical claims to determine appropriateness of services billed. Responsible for analyzing simple billings by utilizing our Medical Bill Review (MBR) software to determine appropriateness of codes. Responsible for making bill review processing determinations according to rules, regulations, and/or third-party partners. Medical Bill Review Specialist II Primarily responsible for performing technical review of more complex medical bills, including modifiers, anesthesia, & psychiatric. Responsible for analyzing billings including outpatient hospital and multiple surgeries by utilizing our Medical Bill Review (MBR) software to determine appropriateness of codes and excessive charges. Also responsible for analyzing assigned medical bills to determine compliance with business rules, client specific requirements and multiple state rules, regulations and...

SUMMARY:  Perform production and quality audits to ensure operations are effective, consistent and in compliance with business rules and processes.  Primary focus includes, but is not limited to, auditing the Service Center teams Claims Support, Business Development, Billing Service Center.   Responsible for performing administrative and support tasks which may be highly confidential and sensitive in nature. PRIMARY RESPONSIBILITIES:  ·    Conducts and executes the production statistics and quality audits of completed work in comparison to established documented procedures to determine accuracy within the Service Center in a timely fashion while being in compliance with statutory regulations (30%). ·    Partner with management, union representatives, human resources, and team members to establish and maintain production and quality standards for Service Center teams (15%).  ·    Compile, create, prepare and review information, audits and reports for accuracy as requested or...

OBJECTIVE Property Claims Specialist Objective To assure and be accountable for the consistent application of company procedures and practices in commercial, residential, farm property and property damage liability claim handling of large losses, so as to have a significant and positive overall effect on the company. To provide quality service to insureds and aid in the retention of business. To ensure that claims are properly investigated, evaluated and resolved within the company's contractual and legal obligations. To ensure timely service, while providing appropriate and equitable resolution to insureds, claimants and the company. RESPONSIBILITIES Property Claims Specialist Responsibilities Investigate, evaluate and control claims under minimal supervision.   Maintain up-to-date advanced knowledge of various types of buildings, construction, repair cost and methods, repair-estimating system and scoping damages....

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:   Claim Specialist – Michigan PIP – The Auto Club Group Reports to: Claim Manager as appropriate What you will do : The Auto Club Group is seeking prospective Claim Specialist who will work under minimal supervision with a high-level approval authority to handle complex technical issues and complex claims. In this position, you will have the opportunity to: Claim handling responsibilities will include the following: reviewing assigned claims, contacting the insured and other affected parties, setting expectations for the remainder of the claim process, and initiating documentation in the claim handling system. Complete complex coverage analysis. Ensure all possible policyholder benefits are identified. Create additional sub-claims if needed....

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:   Claim Specialist – Michigan PIP – The Auto Club Group Reports to: Claim Manager as appropriate What you will do : The Auto Club Group is seeking prospective Claim Specialist who will work under minimal supervision with a high-level approval authority to handle complex technical issues and complex claims. In this position, you will have the opportunity to: Claim handling responsibilities will include the following: reviewing assigned claims, contacting the insured and other affected parties, setting expectations for the remainder of the claim process, and initiating documentation in the claim handling system. Complete complex coverage analysis. Ensure all possible policyholder benefits are identified. Create additional sub-claims if needed....

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:   Eligible candidates must reside within the metro Detroit Michigan area for consideration and have a valid state driver's license. Preferred candidates should reside in Oakland, Macomb, or Wayne County. Metro Detroit Field Property Claim Specialist -AAA The Auto Club Group Reports to: Claim Manager as appropriate What you will do: Work under minimal supervision with a high-level approval authority to handle complex technical issues and complex claims.  Review assigned claims, Contacting the insured and other affected parties, set expectations for the remainder of the claim process, and initiate documentation in the claim handling system.   Complete complex coverage analysis. Ensure all possible policyholder benefits are identified.  Create...

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:   Michigan Personal Injury Protection Claim Specialist – The Auto Club Group What you will do: The Auto Club Group is seeking prospective Claim Specialist who will work under minimal supervision with a high-level approval authority to handle complex technical issues and complex claims. In this position, you will have the opportunity to: Claim handling responsibilities will include the following: reviewing assigned claims, contacting the insured and other affected parties, setting expectations for the remainder of the claim process, and initiating documentation in the claim handling system. Complete complex coverage analysis. Ensure all possible policyholder benefits are identified. Create additional sub-claims if needed. Complete an...

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:   Eligible candidates for this role must reside within a commutable distance of the Oakland County Detroit, Michigan area for consideration and have a valid state driver's license. Metro Detroit Field Property Claim Specialist -AAA The Auto Club Group Reports to: Claim Manager as appropriate What you will do: Work under minimal supervision with a high-level approval authority to handle complex technical issues and complex claims.  Review assigned claims, Contacting the insured and other affected parties, set expectations for the remainder of the claim process, and initiate documentation in the claim handling system.   Complete complex coverage analysis. Ensure all possible policyholder benefits are identified.  Create additional sub-claims if...

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:   Intermediate Michigan PIP Claim Specialist – The Auto Club Group Reports to: Claim Manager as appropriate What you will do : The Auto Club Group is seeking prospective Claim Specialist who will work under minimal supervision with a high-level approval authority to handle complex technical issues and complex claims. In this position, you will have the opportunity to: Claim handling responsibilities will include the following: reviewing assigned claims, contacting the insured and other affected parties, setting expectations for the remainder of the claim process, and initiating documentation in the claim handling system. Complete complex coverage analysis. Ensure all possible policyholder benefits are identified. Create additional sub-claims...

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:   Michigan Personal Injury Protection Claim Specialist – The Auto Club Group Reports to : Claim Manager as appropriate What you will do: The Auto Club Group is seeking prospective Claim Specialist who will work under minimal supervision with a high-level approval authority to handle complex technical issues and complex claims. In this position, you will have the opportunity to: Claim handling responsibilities will include the following: reviewing assigned claims, contacting the insured and other affected parties, setting expectations for the remainder of the claim process, and initiating documentation in the claim handling system. Complete complex coverage analysis. Ensure all possible policyholder benefits are identified. Create additional...

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:   Eligible candidates for this role should reside within a commutable distance of Lansing, Michigan. Territory coverage includes Lansing, Jackson, Howell, and Flint Michigan areas. Job Title- Field Property Claim Specialist Reports to: Claim Manager as appropriate What you will do: Work under minimal supervision with a high-level approval authority to handle complex technical issues and complex claims.  Review assigned claims, Contacting the insured and other affected parties, set expectations for the remainder of the claim process, and initiate documentation in the claim handling system.   Complete complex coverage analysis. Ensure all possible policyholder benefits are identified.  Create additional sub-claims if needed.  Complete an...

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:   Michigan Personal Injury Protection Claim Specialist – The Auto Club Group Reports to: Claim Manager as appropriate What you will do: The Auto Club Group is seeking prospective Claim Specialist who will work under minimal supervision with a high-level approval authority to handle complex technical issues and complex claims. In this position, you will have the opportunity to: Claim handling responsibilities will include the following: reviewing assigned claims, contacting the insured and other affected parties, setting expectations for the remainder of the claim process, and initiating documentation in the claim handling system. Complete complex coverage analysis. Ensure all possible policyholder benefits are identified. Create additional...

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:   Claim Specialist – Michigan PIP – The Auto Club Group Reports to: Claim Manager as appropriate What you will do : The Auto Club Group is seeking prospective Claim Specialist who will work under minimal supervision with a high-level approval authority to handle complex technical issues and complex claims. In this position, you will have the opportunity to: Claim handling responsibilities will include the following: reviewing assigned claims, contacting the insured and other affected parties, setting expectations for the remainder of the claim process, and initiating documentation in the claim handling system. Complete complex coverage analysis. Ensure all possible policyholder benefits are identified. Create additional sub-claims if needed....

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 role reports to the Meemic Insurance sector of AAA Auto-Club Group. Eligible candidates must reside within the metro Detroit Michigan area for consideration and have a valid state driver's license. Metro Detroit Field Property Claim Specialist -AAA The Auto Club Group Reports to: Claim Manager as appropriate What you will do: Work under minimal supervision with a high-level approval authority to handle complex technical issues and complex claims.  Review assigned claims, Contacting the insured and other affected parties, set expectations for the remainder of the claim process, and initiate documentation in the claim handling system.   Complete complex coverage analysis. Ensure all possible policyholder benefits are identified....