28 provider relations specialist jobs found

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:  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...

For more than 170 years, The Hanover has been committed to delivering on our promises and being there when it matters the most. We live our values every day, demonstrating we  CARE  through our values,  Sustainability  initiatives and  inclusive corporate culture .   Our staff counsel team is currently seeking a Lead Attorney for its Michigan office.   As an insurance defense attorney in our Michigan office, you will be part of a team providing legal representation to Hanover/Citizens’ insureds and/or Hanover/Citizens Insurance before courts and arbitration panels in all aspects of litigation. This is hybrid/full time/exempt role. Fully remote candidates may be considered.   Position Overview: Investigates and manages and tries the most complex cases in the region. This attorney’s inventory will possess the largest and most complex matters referred from claims. Other attorney’s may be assigned to work under this attorney’s direction on case-by-case basis...

For more than 170 years, The Hanover has been committed to delivering on our promises and being there when it matters the most. We live our values every day, demonstrating we  CARE  through our values,  Sustainability  initiatives and  inclusive corporate culture .   Our staff counsel team is currently seeking a Lead Attorney for its Michigan office.   As an insurance defense attorney in our Michigan office, you will be part of a team providing legal representation to Hanover/Citizens’ insureds and/or Hanover/Citizens Insurance before courts and arbitration panels in all aspects of litigation. This is hybrid/full time/exempt role. Fully remote candidates may be considered.   Position Overview: Investigates and manages and tries the most complex cases in the region. This attorney’s inventory will possess the largest and most complex matters referred from claims. Other attorney’s may be assigned to work under this attorney’s direction on case-by-case basis...

Job Type: Full time   Exempt/Non Exempt:   Salary Job Description:   Location Details: Remote Position Schedule / Shift: Monday-Friday 8am-5pm ET Position Summary: The Auto Club Group is seeking a highly skilled Claim Investigator who would be responsible for reviewing and investigating insurance claims to determine their validity, accuracy, and compliance with company policies and regulatory requirements. They gather and analyze evidence, interview claimants, witnesses, medical providers, and other involved parties, and examine documentation such as police reports, medical records, and property damage assessments. Their goal is to identify potential fraud, verify claim details, and support fair and timely claim resolutions. Key Responsibilities: Independently perform comprehensive assessment and investigation of personal lines property & casualty claims for the potential of claim fraud.  Maintain a thorough...

Position Title Business Banking Specialist   Location Work From Home MI, MI 48098   Job Summary The Business Banking Specialist is a critical client-facing role within Flagstar's Business Banking division, responsible for client onboarding, ongoing servicing, and operational support for business clients within the $10M–$50M annual revenue segment. This role operates within a collaborative pod structure alongside a Business Development Officer (BDO) and Relationship Manager (RM), ensuring clients receive a seamless, high-quality banking experience from day one. The BBS serves as the operational backbone of the pod—coordinating across internal teams to deliver exceptional service, resolve client needs efficiently, and support the overall health and growth of the portfolio.   Job Responsibilities: JOB RESPONSIBILITIES Client Onboarding & Account Setup Lead the end-to-end client onboarding process for newly acquired business banking relationships Coordinate...

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 Legal Specialist 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 complaints, claims files, medical records, employment files, and other documents. Assist with processes, workflows, tasks, diaries, and activities. Monitor and review laws and regulations. Assist with claims,...

Job Type: Full time   Exempt/Non Exempt:   Salary Job Description:   Job Description Location Details: Hybrid Position Schedule / Shift: Monday-Friday 8am-5pm ET  Position Summary:    As a Claim Specialist, you will evaluate coverage, assess claim exposures, and make informed decisions that drive fair and timely resolutions. Working closely with members, medical providers, attorneys, and internal partners under minimal supervision, you'll manage challenging and complex claim scenarios while ensuring compliance with applicable regulations and company standards. The ideal candidate will have experience interpreting and applying Michigan No-Fault reform regulations to support accurate claim handling and benefit determinations. This role is ideal for a detail-oriented professional who thrives on problem-solving, sound judgment, and delivering positive outcomes for members.  Key Responsibilities:   Review assigned claims and initiate...

Plans and delivers safety/risk management services to insured customers and internal associates. We are currently seeking a risk control professional that is technically proficient, self-motivated and results driven to fill an open position within our East Shared Services division. You must be able to conduct comprehensive safety and risk management assessments, provide our Underwriting teams with a strong analytical opinion of risk to support our goal of profitable growth within variety of middle to large premium market segment for Dealerships, Construction, Manufacturing, Wholesale Trade, Retail, Commercial Real Estate and Service industries.  In addition, the successful candidate will develop close relationships with our agents and policyholders, conducting selected safety seminars and training, to build the value-added service that Sentry is known for. The ideal candidate will be based in the suburbs west of Detroit (Wayne, Livonia, Farmington Hills, etc.) with good...

As a Claims Specialist, your primarily responsible for providing a high level of customer service to all customers and retailer partners by utilizing soft skill techniques. You will provide this service daily through receiving and transmitting phone calls from retailers and customers alike, responding to emails, creating claims, reviewing documentation, monitoring progress queues, and authorizing services to facilitate the repair of furniture.  Claims Specialists must be proficient users of computers, exhibit excellent verbal and written communication, have a friendly tone, be resilient to change, and adapt to new procedures, while demonstrating professionalism with every client. Your Impact: Provide daily inbound and outbound communication coverage (phone, email, etc.) Manage inbound customer/retailer inquiries and follow-up relating to entire claim processes (determine coverage, send inspection packets, authorize technicians, order parts, recommend exchanges,...

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...

Description Summary: ​ Prepares and/or reviews loan documentation in accordance with legal requirements, regulatory statutes and Huntington credit policy and procedures. Advises lending personnel regarding credit policy, documentation and compliance. Determines deficiencies and exceptions in loan documentation for the purpose of exception reporting and/or correcting. Works with legal department and other outside professionals in coordinating efforts associated with loan documentation and exception clearing. May assist less experienced employees.               Duties and Responsibilities: Manage loan documentation processes and review/prepare loan documents. Ensure compliance with regulations and coordinate with internal departments/external partners. Resolve documentation issues and monitor loan documentation performance. Prepare and review loan reports and communicate with stakeholders. Track and...

Job Type: Full time   Exempt/Non Exempt:   Salary Job Description:   Job Description Location Details: Hybrid Position Schedule / Shift: Monday-Friday 8am-5pm ET  Position Summary:    As a Claim Specialist, you will evaluate coverage, assess claim exposures, and make informed decisions that drive fair and timely resolutions. Working closely with members, medical providers, attorneys, and internal partners under minimal supervision, you'll manage challenging and complex claim scenarios while ensuring compliance with applicable regulations and company standards. The ideal candidate will have experience interpreting and applying Michigan No-Fault reform regulations to support accurate claim handling and benefit determinations. This role is ideal for a detail-oriented professional who thrives on problem-solving, sound judgment, and delivering positive outcomes for members.  Key Responsibilities:   Review assigned claims and initiate...

Note: This position has a schedule requirement of 8pm shift end time on Mondays, the remainder of the week will be 5:30 shift end time. SUMMARY:  Primarily responsible for supporting the billing needs of agents and policyholders providing accurate and consistent services regarding invoice inquiries and premium transaction activity.  Approve changes in accordance with billing rules and procedures in compliance with Accident Fund and/or bureau rules and regulations. Contacts include Service Center staff, Finance Department, Premium Audit Department, Claims Department, agents, and policyholders. ESSENTIAL DUTIES AND RESPONSIBILITIES include the following. Other duties may be assigned.  •    Answers inquiries from agents and policyholders regarding invoices, disbursements, payments, and other billing transactions. •    Requests write offs to resolve small balance and NSF fee discrepancies within guidelines. •    Initiates, reviews, and approves disbursements. •    Reconciles and...

Position Title Commercial Loan Operations Construction Specialist Sr   Location Troy, MI 48098   Job Summary The Commercial Loan Operations Construction Specialist Sr provides advanced operational support to Commercial Real Estate or the Homebuilder Finance Groups, focusing on the servicing of complex residential and commercial construction and development loans. This role ensures accuracy and timeliness in all draw, funding, and collateral activities while offering subject matter expertise and process leadership. The senior specialist works closely with internal stakeholders and external partners to drive efficiency, mitigate risk, and support large-scale projects from pre-close through project completion.   Job Responsibilities: Lead the servicing of complex and high-value construction and development loans, ensuring accurate closing, funding loans and disbursement of draws and tracking of budgets. Ensure flood certificates are ordered and/or reviewed to...

SUMMARY:  In addition to fulfilling the primary responsibilities of a Renewal Specialist, this role will also focus on serving as a lead worker in the Renewal Specialist department by assisting with quality, compliance and customer facing measures. Assisting staff with technical questions and provide mentoring to current and new staff. This role will also serve as a Subject Matter Expert, as well as participating in enterprise projects. 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 Renewal Specialists 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...

About Acrisure :   Acrisure is a global Fintech leader that combines the best of humans and high tech to offer multiple financial products and services to millions of businesses and individual clients. We connect clients to solutions that help them protect and grow what matters, including Insurance, Reinsurance, Cyber Services, Mortgage Origination and more.   Acrisure employs over 17,000 entrepreneurial colleagues in 21 countries and   have   grown from $38 million to   $4. 5   billion   in revenue in just over ten years. Our culture is defined by our entrepreneurial spirit and all that comes with it: innovation, client   centricity   and an indomitable will to win.      Position Overview :   This is a high-visibility role   that reports to the Group’s Global Chief Audit Executive (CAE)   that is critical to supporting senior management and the Audit Committee with independent and objective assurance, advice,...

About Acrisure    A global fintech leader, Acrisure empowers millions of ambitious businesses and individuals with the right solutions to grow boldly forward. Bringing   cutting-edge   technology and top-tier human support together, we connect clients with customized solutions across a range of insurance, reinsurance, payroll, benefits, cybersecurity, mortgage services – and more .       In the last twelve years, Acrisure has grown in revenue from $38 million to almost   $5 billion   and employs over 19,000 colleagues in more than 20 countries. Acrisure was built on entrepreneurial spirit. Prioritizing leadership, accountability, and collaboration, we equip our teams to work at the highest levels possible.     Job Summary   Acrisure is seeking a   S enior   Employee Relations Partner   to join our   team.   This role   serves as a trusted advisor and subject matter expert responsible for managing workplace...

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....