li>Ability to accurately deal with mathematical problems, including, geometry (area and volume) and financial areas (such as accuracy in sums, unit costs, and the capacity to read and develop understanding of personal and business finance documents). This job includes training and development completion of the Company’s claims training program for the assigned line of insurance and requires the person to:
Great Lakes and Great Times: Michigan boasts four Great Lakes, 11,000 inland lakes, 36,000 miles of rivers and streams, 20 million acres of forests, 100 state and national parks and recreation areas, 1,300 miles of bike trails, 6,500 miles of snowmobile trails, the second-most ski areas in the nation, 650 public golf courses, 600 campgrounds, and an international dark-sky park-just for starters. The Medical Benefit Reviewer is responsible for reviewing and resolving system edits on pended Medicaid Claims billed on the UB04 Claim Form, and submitted electronically through CHAMPS (Community Health Automated Medicaid Payments System).
Grand Rapids, MI20 days ago
Previous Experience: Demonstrated proficiency in covert surveillance techniques, capturing high-quality video footage, and preparing thorough, well-organized investigative reports. This role involves performing both stationary and mobile surveillance, obtaining video and photographic evidence, and preparing thorough, detailed reports for clients.
Administer employee benefit programs including medical, dental, vision, life insurance, long-term disability, flexible spending accounts, health savings accounts, and other benefit offerings. Strong interpersonal skills to maintain effective relationships with employees, administrators, medical providers, insurance carriers, and external agencies.
Lansing, Michigan30+ days ago
ul style="margin: 0px; padding: 0px; font-family: verdana;">Must possess a valid driver's license with at least one year of driving experience . - Join a well-established company with a strong reputation in the industry! .
Acquire and gather information through use of own discretion, and guidance from clients and case managers, by means of data collection, interviews, research and collaboration with other SIU entities, law enforcement and state Departments of Insurance. High School diploma or higher with a minimum of five (5) years of demonstrated professional law enforcement experience with specific attention to investigations related to fraud.
Grand Rapids, MI29 days ago
The Surveillance Investigator will perform discreet mobile and stationary surveillance of a Claimant to confirm current activities and capabilities to assist with the administration of an insurance claim. RESPONSIBILITIES:
- Conduct independent investigations of insurance claims across a range of coverage types, including workers' compensation, general liability, property and casualty, and disability.
Automobile Accidents, Case Management, Casualty Insurance, Claims Administration, Claims Litigation, Claims Resolution, Claims Review, Commercial General Liability Insurance, Commercial Liability, Complex Claims, Fractures, General Liability Claims, General Liability Insurance, Homeowners Claims, Homeowners Insurance, Homeowners Insurance Claims, Insurance Claim Handling, Insurance Policies, Liability Insurance, Litigation, Negotiation, Personal Injury Claims, Property Damage, Relationship Management. Through our subsidiaries, we provide a variety of insurance products, including personal and commercial automobile, homeowners, umbrella, recreational vehicle, supplemental health, lender-placed and other niche insurance products.
p>Automobile Accidents, Automobile Accidents, Case Management, Casualty Insurance, Claims Administration, Claims Litigation, Claims Resolution, Claims Review, Commercial General Liability Insurance, Commercial Liability, Complex Claims, Fractures, General Liability Claims, General Liability Insurance, Homeowners Claims, Homeowners Insurance, Homeowners Insurance Claims, Insurance Claim Handling, Insurance Litigation, Insurance Policies, Liability Insurance, Litigation, Litigation Management, Litigation Support, Negotiation {+ 2 more}. Through our subsidiaries, we provide a variety of insurance products, including personal and commercial automobile, homeowners, umbrella, recreational vehicle, supplemental health, lender-placed and other niche insurance products.
Auto Insurance Claims, Auto Insurance Claims, Automobile Accidents, Automobile Liability, Bodily Injury Claims, Case Management, Casualty Insurance, Claims Administration, Claims Resolution, Claims Review, Commercial Liability Claims, Complex Claims, Customer Service, De-Escalation, Fractures, General Liability Claims, Injury Assessment, Insurance Claims, Insurance Claims Investigations, Insurance Coverage, Insurance Coverage Analysis, Insurance Policies, Liability Insurance, Litigation, Multitasking {+ 5 more}. Through our subsidiaries, we provide a variety of insurance products, including personal and commercial automobile, homeowners, umbrella, recreational vehicle, supplemental health, lender-placed and other niche insurance products.
In terms of professional development, Everforth Apex hosts an on-demand training program, provides access to certification prep and a library of technical and leadership courses/books/seminars once you have 6+ months of tenure, and certification discounts and other perks to associations that include CompTIA and IIBA. Everforth Apex also offers a HSA (Health Savings Account on the HDHP plan), a SupportLinc Employee Assistance Program (EAP) with up to 8 free counseling sessions, a corporate discount savings program and other discounts.
Auto Collision (Inactive), Auto Collision Repair, Auto Insurance, Auto Insurance Claims, Automobile Accidents, Automobile Liability, Automotive Body Repair, Case Management, Claims Administration, Claims Resolution, Claims Review, Customer Service, Insurance Claims Investigations, Insurance Coverage. In this role, you'll be responsible for investigating and verifying the details of automobile accidents, including obtaining police reports, collecting witness statements, confirming coverage, and determining liability.
PORT HURON, MI27 days ago
Respect the Individual: Embraces differences in people cultures ideas and experiences creates a workplace where associates feel seen supported and connected through a culture of belonging creates opportunities for all associates to thrive and perform helps to attract the best talent. Serve our Customers and Members Makes decisions based reliable information balances short and longterm priorities and considers how own work impacts the teams ability to deliver on our purpose for all stakeholders.
p>Respect the Individual: Embraces differences in people cultures ideas and experiences creates a workplace where associates feel seen supported and connected through a culture of belonging creates opportunities for all associates to thrive and perform helps to attract the best talent. Serve our Customers and Members Makes decisions based reliable information balances short and longterm priorities and considers how own work impacts the teams ability to deliver on our purpose for all stakeholders.
Lansing, Michigan30+ days ago
li>Ability to accurately deal with mathematical problems, including, geometry (area and volume) and financial areas (such as accuracy in sums, unit costs, and the capacity to read and develop understanding of personal and business finance documents). This job includes training and development completion of the Company’s claims training program for the assigned line of insurance and requires the person to: - Investigate, evaluate, and settle entry-level insurance claims.
The individual grants settlement authority on the most complex claims valued in excess of Market Claim Office (MCO) and Regional Claim Office (RCO) limits, approving requests to go to trial on cases where the gross exposure is in excess of MCO authority, and general oversight of all large losses for a specific CSA or CSAs. Bodily Injury Claims, Client Counseling, Commercial Insurance Claims, Complex Claims, Conflict Management, General Liability Insurance, Homeowners Claims, Insurance Claims, Insurance Coverage Analysis, Large Loss Claims, Liability Insurance, Multitasking, Personal Injury Claims, Prioritization, Strategic Thinking, Task Management, Time Management.
Detroit Metro, MI30+ days ago
What you'll do: Proactively manages assigned claims caseload comprised of complex damages that require commensurate knowledge and understanding of claims coverage including potential legal liability. 2 years of relevant property claims adjusting experience of moderate complexity losses that includes writing estimates, involving dwelling and structural damages.