3503 claims processor jobs found

Title: Claims Processor 1                             Department: Claims Union: OPEIU 29                                               Grade: 16 Position Summary The Claims Processor provides customer service and processes routine health and welfare claims on assigned accounts according to plan guidelines and adhering to Company policies and regulatory requirements. "Has minimum necessary access to Protected Health Information (PHI) and Personally Identifiable Information (PII) by Job Description/Role." Key Duties and Responsibilities Maintains current knowledge of assigned Plan(s) and effectively applies that knowledge in the payment of claims. Processes routine claims which could include medical, dental, vision, prescription, death, Life and AD&D, Workers’ Compensation, or disability.  May provide customer service by responding to and documenting telephone, written, electronic, or in-person inquiries. Performs other duties as assigned....

Title: Claims Processor 1                             Department: Claims Union: OPEIU 29                                               Grade: 16 Position Summary The Claims Processor provides customer service and processes routine health and welfare claims on assigned accounts according to plan guidelines and adhering to Company policies and regulatory requirements. "Has minimum necessary access to Protected Health Information (PHI) and Personally Identifiable Information (PII) by Job Description/Role." Key Duties and Responsibilities Maintains current knowledge of assigned Plan(s) and effectively applies that knowledge in the payment of claims. Processes routine claims which could include medical, dental, vision, prescription, death, Life and AD&D, Workers’ Compensation, or disability.  May provide customer service by responding to and documenting telephone, written, electronic, or in-person inquiries. Performs other duties as assigned....

Title:   Claims Processor 2   Department:   Claims Bargaining Unit:   OPEIU 29   Grade:   17 Position Type:   Non-Exempt   Hours per Week:   40 Position   Summary The Claims Processor 2 provides customer service and processes routine health and welfare claims on assigned accounts according to plan guidelines and adhering to Company policies and regulatory requirements. "Has minimum necessary access to Protected Health Information (PHI) and Personally Identifiable Information (PII) by Job Description/Role." Key   Duties   and   Responsibilities Maintains current knowledge of assigned Plan(s) and effectively applies that knowledge in the payment of claims. Processes routine claims which could include medical, dental, vision, prescription, death, Life and AD&D, Workers' Compensation, or disability. May provide customer service by responding to and documenting telephone, written, electronic, or in-person inquiries....

Title: Claims Processor 3                             Department: Claims Union: OPEIU 29                                               Grade: 18 Position Summary: Responsible for independently processing all types of health claims on an assigned Plan(s), and for assuming primary or back-up customer service responsibilities as necessary. General Duties: Independently process all types of health claims in accordance with assigned Plan(s). Perform customer service responsibilities for providers and members as needed. Generate correspondence and form letters. Maintain current knowledge of assigned Plan(s) and effectively apply this knowledge in the payment of claims. Assist other processors with claims as needed to minimize backlog. Perform other related duties and special projects as assigned. Minimum Qualifications: High school diploma or general education degree (GED); two years related experience processing all types of group health and/or dental...

Job Type: Full time   Exempt/Non Exempt:   Hourly Job Description:   Location Details: Dearborn, Michigan Position Schedule / Shift: Monday-Friday 8am-5pm ET Position Summary: The Claims Support Processor in the Medical Bill Review Unit provides clerical and administrative support to ensure the accurate and timely processing of medical bills and claim-related documentation. This position is responsible for data entry, document management, record maintenance, correspondence handling, and supporting bill review specialists and claims staff. The role requires strong attention to detail, organizational skills, and the ability to work efficiently in a fast-paced environment while maintaining confidentiality and delivering exceptional service to internal and external customers. Key Responsibilities: In this position, day-to-day routine tasks include: Copying paper Printing, stapling & mailing documents Scanning documents...

As one of the leading writers of Federal Crop Insurance, AgriSompo North America combines industry experience, resources, capital and talent to deliver both traditional and innovative crop insurance and productivity tools to farmers, ranchers, insurers and agribusinesses in the United States. Our organization operates within a culture rooted in ethics, integrity and a belief that accountability, collaboration and agility are crucial to long-term success.  AgriSompo North America is a part of AgriSompo, Sompo International’s global agriculture platform. This platform is an integrated underwriting, technology and distribution platform delivering innovate insurance and reinsurance solutions to agriculture partners worldwide.  Sompo International, AgriSompo’s parent company, is a global organization driven by its core values, a carrier that holds promise, trust and the commitment to protect.  Through operating subsidiaries, Sompo International writes agriculture, casualty and...

Job Type: Full time   Exempt/Non Exempt:   Hourly Job Description:   Location: Dearborn, Michigan Position Schedule / Shift: Hybrid schedule Monday – Friday: 8:00 AM EST – 5:00 PM EST. Employees will report once per week to the Dearborn Administrative Office Building and work remaining days from their home office. Position Summary: Join a fast-paced Claims team where your work directly impacts the customer experience during some of their most important moments. In this role, you'll leverage your problem-solving skills and attention to detail to support claim operations, coordinate Total Loss processes, and connect with customers to provide timely solutions and guidance. Working across multiple systems and business areas, you'll play a key role in keeping claims moving efficiently while building valuable industry knowledge and experience in a collaborative environment. Key Responsibilities: Provide support to the Claim department by...

The Cross Family of Agencies welcomes you. We need your talent and expertise. Personal Lines Processor A Personal Lines Processor is primarily responsible for processing documents related to personal lines insurance and providing administrative support to the Producers and Account Managers. Standard duties of a Personal Lines Processor include but are not limited to : Understanding and following the Cross Basic Procedure Manual. Understanding and following the Personal Lines Workflow Manual. Auditing transaction to ensure that the correct Action Codes are being used. Following up and completing open suspense’s daily. Running the download reports daily. Processing the download report which includes reviewing new business, endorsements, renewals, cancellations, and reinstatements for accuracy. Invoicing all types of download transactions. Mailing new business letters to clients. Entering claims acknowledgements as received. Following up on...

Company: NICO National Indemnity Company Want to work for a company with unparalleled financial strength and stability that offers “large company” benefits with an exciting, friendly, and “small company” atmosphere?  Our companies, as members of the Berkshire Hathaway group of Insurance Companies, provides opportunities for professionals interested in just that.   Company: NICO National Indemnity Company Want to work for a company with unparalleled financial strength and stability that offers “large company” benefits with an exciting, friendly, and “small company” atmosphere?  Our companies, as members of the Berkshire Hathaway group of Insurance Companies, provides opportunities for professionals interested in just that.   A Brief Overview Processes and delivers incoming and outgoing mail per established procedures and deadlines. Enters data and check information into designated computer systems. Maintains confidentiality at all times. Performs all duties in a safe...

The Cross Family of Agencies welcomes you. We need your talent and expertise. Personal Lines Processor A Personal Lines Processor is primarily responsible for processing documents related to personal lines insurance and providing administrative support to the Producers and Account Managers. Standard duties of a Personal Lines Processor include but are not limited to : Understanding and following the Cross Basic Procedure Manual. Understanding and following the Personal Lines Workflow Manual. Auditing transaction to ensure that the correct Action Codes are being used. Following up and completing open suspense’s daily. Running the download reports daily. Processing the download report which includes reviewing new business, endorsements, renewals, cancellations, and reinstatements for accuracy. Invoicing all types of download transactions. Mailing new business letters to clients. Entering claims acknowledgements as received. Following up on...

Company: NICO National Indemnity Company Want to work for a company with unparalleled financial strength and stability that offers “large company” benefits with an exciting, friendly, and “small company” atmosphere?  Our companies, as members of the Berkshire Hathaway group of Insurance Companies, provides opportunities for professionals interested in just that.   Company: NICO National Indemnity Company Want to work for a company with unparalleled financial strength and stability that offers “large company” benefits with an exciting, friendly, and “small company” atmosphere?  Our companies, as members of the Berkshire Hathaway group of Insurance Companies, provides opportunities for professionals interested in just that.   A Brief Overview Processes and delivers incoming and outgoing mail per established procedures and deadlines. Enters data and check information into designated computer systems. Maintains confidentiality at all times. Performs all duties in a safe...

The Litigation Processor is responsible for providing clerical support to the General Claims Legal Department by reviewing, analyzing, and processing incoming complaints directed to the Company. Essential Duties and Responsibilities: Provide support to staff attorneys in processing complaints. Provide support to the PIP Litigation team in processing PIP arbitration demands. Provide support as needed to FNOL (First Notice of Loss) Dept in taking claims. Receive, analyze, and process complaints, determine type of lawsuit, and prepare investigation file accordingly.  Assign trail adjuster, submit complaint to staff attorney for review. Process various types of legal letters to defense firms and insureds. Maintain Legal Exchange (electronic billing site) by creating matters, closing matter and processing attorney invoices for payment. Periodic telephone communications with insureds, plaintiff counsel and defense firms regarding the status of legal pleadings....

Description As a Director II, Claims Process , you will be leading governance and investment prioritization for Claims and Service, shaping which initiatives get resourced and why. That takes real fluency in claims and operations, a strategic eye, and the judgment to navigate ambiguity when priorities compete and the answer isn't obvious. You'll work daily across business, technology, finance, analytics, and actuarial, bringing distinct perspectives into alignment and building the kind of trust that makes change stick. You’ll lead a PMO team through a genuinely broad portfolio, developing people while keeping a lot of moving pieces on track. If you want a role where your influence spans strategy, people, and execution, this is it.   **This role may have in-office requirements depending on candidate location** Candidates who live within 50 miles of Boston, MA; Portsmouth, NH; Seattle, WA; Columbus, OH; or Plano, TX will follow a hybrid schedule, coming...

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 As a dedicated Director, Business Process Ownership for Claims Optimization Property , you will oversee a team of business professionals that are responsible for the end-to-end aspects and overall ownership of assigned processes. Guides team members to collaborate with enterprise partners in the facilitation and development...

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 As a dedicated Business Process Owner Senior , you will plan, direct, and coordinate activities for complex processes, including problem definition, evaluation of requirements, design, testing, and implementation of business processes. Understands the process operating objectives, business rules, performance requirements,...

Berkshire Hathaway Homestate Companies, Workers Compensation Division, is searching for a Claims Communication and Process Enablement Lead to join its Adjusting Team! This individual is responsible for translating Claims strategy, system changes, and workflow design into clear, consistent, and executable practices across the Claims organization. This individual establishes and maintains disciplined standards for workflow documentation, job-level execution, and practical job aids, ensuring that leadership intent is understood, adopted, and executed consistently along frontline teams. Partners closely with Claims leadership, Transformation, and Technology to ensure change is implemented with clarity, consistency, and accountability.    ESSENTIAL RESPONSIBILITIES:   WORKFLOW DOCUMENTATION AND STANDARDIZATION Owns end-to-end documentation of critical Claims workflows across Adjusting, Medical Management, and operational support functions. Translates complex...

Berkshire Hathaway Homestate Companies, Workers Compensation Division, is searching for a Claims Communication and Process Enablement Lead to join its Adjusting Team! This individual is responsible for translating Claims strategy, system changes, and workflow design into clear, consistent, and executable practices across the Claims organization. This individual establishes and maintains disciplined standards for workflow documentation, job-level execution, and practical job aids, ensuring that leadership intent is understood, adopted, and executed consistently along frontline teams. Partners closely with Claims leadership, Transformation, and Technology to ensure change is implemented with clarity, consistency, and accountability.    ESSENTIAL RESPONSIBILITIES:   WORKFLOW DOCUMENTATION AND STANDARDIZATION Owns end-to-end documentation of critical Claims workflows across Adjusting, Medical Management, and operational support functions. Translates complex...

Berkshire Hathaway Homestate Companies, Workers Compensation Division, is searching for a Claims Communication and Process Enablement Lead to join its Adjusting Team! This individual is responsible for translating Claims strategy, system changes, and workflow design into clear, consistent, and executable practices across the Claims organization. This individual establishes and maintains disciplined standards for workflow documentation, job-level execution, and practical job aids, ensuring that leadership intent is understood, adopted, and executed consistently along frontline teams. Partners closely with Claims leadership, Transformation, and Technology to ensure change is implemented with clarity, consistency, and accountability.    ESSENTIAL RESPONSIBILITIES:   WORKFLOW DOCUMENTATION AND STANDARDIZATION Owns end-to-end documentation of critical Claims workflows across Adjusting, Medical Management, and operational support functions. Translates complex...

Berkshire Hathaway Homestate Companies, Workers Compensation Division, is searching for a Claims Communication and Process Enablement Lead to join its Adjusting Team! This individual is responsible for translating Claims strategy, system changes, and workflow design into clear, consistent, and executable practices across the Claims organization. This individual establishes and maintains disciplined standards for workflow documentation, job-level execution, and practical job aids, ensuring that leadership intent is understood, adopted, and executed consistently along frontline teams. Partners closely with Claims leadership, Transformation, and Technology to ensure change is implemented with clarity, consistency, and accountability.    ESSENTIAL RESPONSIBILITIES:   WORKFLOW DOCUMENTATION AND STANDARDIZATION Owns end-to-end documentation of critical Claims workflows across Adjusting, Medical Management, and operational support functions. Translates complex...