Senior Claims Examiner

2 weeks ago

Lansing, Michigan, United States Accident Fund Holdings, Inc. Full time
Job Summary

We are seeking a highly skilled and experienced Claims Representative to join our team at Accident Fund Holdings, Inc. As a Claims Representative, you will be responsible for examining, investigating, and settling or denying insurance claims in a timely and efficient manner.

Key Responsibilities
  • Adjust a caseload of assigned files, including complex claims, in accordance with company policies and procedures.
  • Maintain an active diary on 100% of caseload files, with a current plan of action.
  • Adhere to assigned authority limits for reserving and payments.
  • Exercise independent decision-making skills with minimal supervision and direction on claims assigned.
  • Verify coverage, investigate the loss, and evaluate the claim.
  • Negotiate settlements or deny payments where no coverage, liability, or compensability exists.
  • Record statements, obtain documentation, and process claims in accordance with company best practices.
  • Evaluate loss, assess reserve, and settle cases with claimants, insureds, and attorneys.
  • Decide on denial of coverage, liability, or compensability.
  • Identify and investigate all possible recovery and subrogation opportunities.
  • File all state and/or federal forms, filings, and reports in accordance with statutory guidelines.
  • Return all telephone calls within one business day, when possible.
Requirements
  • Bachelor's degree in a related field or relevant combination of education and experience.
  • Seven years of progressively more responsible experience in a claims environment.
  • Ability and proficiency in the use of computers and company standard software specific to position.
  • Effective oral and written communication skills.
  • Effective customer service skills.
  • Ability to negotiate, build consensus, and resolve conflict.
  • Ability to act as a representative of the Company and establish effective working relationships.
  • Ability to manage multiple priorities and meet established deadlines.
  • Attention to detail and analytical skills.
  • Ability to make independent decisions.
  • Ability to solve highly complex problems.
  • Ability to train and mentor others.
  • Ability to lead others.
Working Conditions

Work is mostly performed in an office setting with no unusual hazards. Travel is required. Must be able to drive an automobile and have a valid operator's license.

While performing the duties of this job, the employee is frequently required to handle documents, books, manuals; reach with hands and arms; talk; and hear.

  • Senior Claims Examiner

    3 weeks ago

    Lansing, Michigan, United States Accident Fund Holdings, Inc. Full time

    Job SummaryWe are seeking a highly skilled and experienced Claims Examiner to join our team at Accident Fund Holdings, Inc. As a Claims Examiner, you will be responsible for examining and investigating insurance claims to determine their validity and extent of coverage.Key ResponsibilitiesExamine and investigate insurance claims to determine their validity...

  • Senior Claims Representative

    2 weeks ago

    Lansing, Michigan, United States Emergent Holdings Full time

    Job Title: Senior Claims RepresentativeWe are seeking a highly skilled Senior Claims Representative to join our team at Emergent Holdings. As a key member of our claims team, you will be responsible for handling complex claims, negotiating with policyholders, and ensuring that all claims are handled in good faith.Key Responsibilities:Handle negotiations on...

  • Senior Claims Representative

    4 weeks ago

    Lansing, Michigan, United States Farm Bureau Insurance Full time

    Job SummaryWe are seeking a highly skilled Senior AMD Claims Representative to join our team at Farm Bureau Insurance. As a Senior AMD Claims Representative, you will be responsible for providing efficient settlement of automobile physical damage losses while delivering a WOW customer experience.Key ResponsibilitiesComplete appraisals and evaluate damage on...

  • Senior Claim Investigator

    3 weeks ago

    Lansing, Michigan, United States Emergent Holdings Full time

    Job DescriptionThis is an advanced-level position in the claim handler career path, requiring significant discretion in determining the compensability of claims. The successful candidate will investigate claims, exercise independent judgment, and negotiate settlements within given authority. This role involves handling large, complex customers requiring...

  • Senior Claims Investigator

    3 weeks ago

    Lansing, Michigan, United States Emergent Holdings Full time

    Job SummaryWe are seeking a highly skilled and experienced Claims Resolution Manager to join our team at Emergent Holdings. As a key member of our claims team, you will be responsible for investigating and resolving complex claims in a timely and efficient manner.Key ResponsibilitiesInvestigate and analyze complex claims to determine compensability and...

  • Automobile Damage Claims Specialist

    1 month ago

    Lansing, Michigan, United States Farm Bureau Insurance Full time

    Job SummaryFarm Bureau Insurance is seeking a highly skilled Senior Claims Representative to join our team. As a Senior Claims Representative, you will be responsible for providing an efficient settlement of automobile physical damage losses while delivering a WOW! customer experience.Key ResponsibilitiesComplete appraisals and evaluate damage on vehicles to...

  • Insurance Claims Analyst Intern

    3 weeks ago

    Lansing, Michigan, United States Auto-Owners Insurance Full time

    Auto-Owners Insurance Claims Representative InternshipA career at Auto-Owners Insurance is challenging and rewarding, offering a unique opportunity to create financial security for individuals and businesses. Our team of caring associates is dedicated to helping people make a new start when a loss occurs.Job SummaryWe are seeking a motivated individual to...

  • Senior Risk Management Consultant

    3 days ago

    Lansing, Michigan, United States Accident Fund Holdings, Inc. Full time

    Job Title: Senior Loss Control ConsultantAccident Fund Holdings, Inc. is seeking a highly skilled Senior Loss Control Consultant to join our team. As a key member of our loss control team, you will be responsible for providing expert consultation and training to employers in our Central Western Tennessee and Southwestern Kentucky markets.Key...

  • Senior Java Developer and Technical Lead

    2 weeks ago

    Lansing, Michigan, United States A-Line Staffing Solutions Full time

    Job Title: Senior Java Developer and Technical Lead Job Summary: We are seeking a highly skilled Senior Java Developer and Technical Lead to join our team at A-Line Staffing Solutions. As a key member of our development team, you will be responsible for maintaining and enhancing complex Java applications critical to healthcare organizations. Key...

  • Senior Java Developer

    3 weeks ago

    Lansing, Michigan, United States A-Line Staffing Solutions Full time

    Senior Java Developer & Technical LeadWe are seeking a highly skilled Senior Java Developer & Technical Lead to join our team at A-Line Staffing Solutions. As a key member of our team, you will be responsible for maintaining and enhancing complex Java applications critical to healthcare organizations.This role ensures that our systems, used by physicians and...

  • Senior Java Developer

    2 weeks ago

    Lansing, Michigan, United States A-Line Staffing Solutions Full time

    Senior Java Developer & Technical LeadWe are seeking a highly skilled Senior Java Developer & Technical Lead to join our team at A-Line Staffing Solutions. As a technical lead, you will be responsible for maintaining and enhancing complex Java applications critical to healthcare organizations.This role ensures that our systems, used by physicians and...

  • Senior Java Developer with Healthcare Experience

    2 weeks ago

    Lansing, Michigan, United States GDI Infotech, Inc Full time

    Job OpportunityGDI Infotech, Inc is seeking a skilled Senior Java Developer to join our team. As a key member of our development team, you will be responsible for designing, developing, and maintaining complex computer systems using Java, Java IDEs, and other relevant technologies.Key ResponsibilitiesDesign and develop software applications using Java,...

  • Senior Nuclear Materials Engineer

    7 days ago

    East Lansing, Michigan, United States Michigan State University(MSU) Full time

    Job Title: Senior Nuclear Materials EngineerMichigan State University (MSU) is seeking a highly skilled Senior Nuclear Materials Engineer to join the FRIB Laboratory team. As a key member of our team, you will be responsible for leading the engineering, testing, and certification of beam-intercepting materials.Key Responsibilities:Lead the certification...

  • Executive Director of Risk Management and Insurance

    4 weeks ago

    Lansing, Michigan, United States InsideHigherEd Full time

    Job SummaryThe Executive Director of Risk Management and Insurance is a key leadership position responsible for developing and implementing strategies to reduce risks associated with university operations and activities. Reporting to the Senior Vice President/CFO/Treasurer, this role requires a strong understanding of the property and casualty insurance...

  • Senior Risk Management Consultant

    3 weeks ago

    Lansing, Michigan, United States Accident Fund Holdings, Inc. Full time

    Job SummaryWe are seeking a highly skilled Safety and Risk Advisor to join our team at Accident Fund Holdings, Inc. As a key member of our loss control team, you will play a critical role in helping our clients reduce their risk exposure and improve their overall safety performance.Key ResponsibilitiesConduct on-site safety surveys and assessments to...

  • Senior Java Developer

    4 weeks ago

    Lansing, Michigan, United States HighCloud Solutions Full time

    About the RoleWe are seeking a highly skilled and experienced Java Developer to join our team at HighCloud Solutions. As a Java Developer, you will play a critical role in the development and maintenance of our complex Java applications.Key ResponsibilitiesDesign, develop, and maintain complex Java applications using Java 8 and Spring Boot.Develop business...

  • Executive Director of Risk Management and Insurance

    2 weeks ago

    East Lansing, Michigan, United States Michigan State University Full time

    Job SummaryThe Executive Director of Risk Management and Insurance is responsible for leading the risk management and insurance functions for Michigan State University. This role reports to the Senior Vice President/CFO/Treasurer and is responsible for developing and implementing strategies to reduce risks associated with university operations and...

  • Advanced Practice Nurse Specialist

    2 weeks ago

    Lansing, Michigan, United States Abode Care Partners Full time

    About the Role:Abode Care Partners is seeking a compassionate and skilled Nurse Practitioner to join our team. As a key member of our healthcare team, you will provide high-quality medical care to seniors and individuals with complex needs in various settings.Responsibilities:• Perform evidence-based medical care by planning, directing, and evaluating...

  • Premium Auditor

    4 weeks ago

    Lansing, Michigan, United States Western National Insurance Group Company Full time

    {"title": "Premium Auditor", "description": "Job SummaryWe are seeking a skilled Premium Auditor to join our team at Western National Insurance Group Company. As a Premium Auditor, you will play a critical role in ensuring the accuracy and integrity of our commercial lines classifications and exposures.Key ResponsibilitiesConduct audits of selected...

  • Medical Assistant

    2 weeks ago

    Lansing, Michigan, United States McLaren Greater Lansing Full time

    Job SummaryWe are seeking a highly skilled Medical Assistant to join our team at McLaren Greater Lansing. As a Medical Assistant, you will play a vital role in providing excellent patient care and supporting our healthcare team.Key ResponsibilitiesProvide exceptional patient care by performing various medical procedures and tests, including vital signs,...