Current jobs related to WC Claims Specialist - Grand Rapids, MI - UFP Industries, Inc

  • Pharmaceutical Care Specialist

    7 days ago

    Grand Rapids, MI, United States Walgreens Full time

    Join Our Team at Walgreens as a Pharmaceutical Care Specialist! Why Choose Walgreens - Investing in You and Your Future At Walgreens, our pharmacists are vital medication experts and trusted healthcare providers dedicated to reshaping patient-focused care. With top-tier resources, strong career advancement opportunities, and a commitment to work-life...

  • Customer Accounts Coding Specialist

    1 week ago

    Grand Rapids, MI, United States Life EMS Ambulance Full time

    This is a part-time, hybrid position working 28 hours a week during normal business hours. Pay is $21.24/hrSUMMARY: Responsible for accurate and responsive billing of ambulance and wheelchair claims to patients, facilities and all third party insurance companies. ESSENTIAL DUTIES AND RESPONSIBILITIES: Ensure daily customer happiness Verify insurance...

  • Customer Accounts Coding Specialist

    6 days ago

    Grand Rapids, MI, United States Life EMS Ambulance Full time

    This is a part-time, hybrid position working 28 hours a week during normal business hours. Pay is $21.24/hrSUMMARY: Responsible for accurate and responsive billing of ambulance and wheelchair claims to patients, facilities and all third party insurance companies. ESSENTIAL DUTIES AND RESPONSIBILITIES: Ensure daily customer happiness Verify insurance...

  • Customer Accounts Coding Specialist

    7 days ago

    Grand Rapids, MI, United States Life EMS Ambulance Full time

    This is a part-time, hybrid position working 28 hours a week during normal business hours. Pay is $21.24/hrSUMMARY: Responsible for accurate and responsive billing of ambulance and wheelchair claims to patients, facilities and all third party insurance companies. ESSENTIAL DUTIES AND RESPONSIBILITIES: Ensure daily customer happiness Verify insurance...

  • Product Specialist Lead

    2 weeks ago

    Grand Rapids, MI, United States Corewell Health Full time

    Job Summary We are seeking a highly skilled Lead Payment Integrity Specialist to drive cost containment initiatives and ensure optimal payment accuracy across our healthcare programs. This role requires a strategic thinker with deep expertise in payment methodologies, medical spend analysis, and trend identification. The ideal candidate is passionate about...

  • Customer Service Representative, Capital Equipment

    2 weeks ago

    Grand Rapids, MI, United States Skytron Full time

    Join a team committed to advancing patient outcomes through adaptable healthcare solutions. Skytron isn't just a place to work - it's a place to grow, collaborate, and help improve healthcare outcomes. As a family-owned company, we believe in supporting our people, driving innovation, and creating solutions that truly make a difference. Comprehensive health...

  • Patient Registration Manager Full Time

    2 weeks ago

    Grand Rapids, MI, United States Pine Rest Christian Mental Health Services Full time

    Cost Center 151 Contact Center Scheduled Weekly Hours 40 Work Shift First Shift (United States of America) Shift & Status Who Are We? We at Pine Rest believe in the power of healing and that everyone in our community has the right to expert care for mental health and substance use disorders. We are much more than just the third largest non-profit behavioral...

  • Patient Registration Manager Full Time

    2 weeks ago

    Grand Rapids, MI, United States Pine Rest Christian Mental Health Services Full time

    Cost Center 151 Contact Center Scheduled Weekly Hours 40 Work Shift First Shift (United States of America) Shift & Status Who Are We? We at Pine Rest believe in the power of healing and that everyone in our community has the right to expert care for mental health and substance use disorders. We are much more than just the third largest non-profit behavioral...

  • Patient Registration Manager Full Time

    6 days ago

    Grand Rapids, MI, United States Pine Rest Christian Mental Health Services Full time

    Cost Center 151 Contact Center Scheduled Weekly Hours 40 Work Shift First Shift (United States of America) Shift & Status Who Are We? We at Pine Rest believe in the power of healing and that everyone in our community has the right to expert care for mental health and substance use disorders. We are much more than just the third largest non-profit behavioral...

  • UI Claims Specialist

    1 week ago

    Grand Island, United States Nebraska Government Full time

    divh2UI Claims Specialist (Open)/h2pAre you ready to make an impact in the lives of Nebraskans? The Department of Labor has a great opportunity to join a dynamic group of teammates in the Grand Island Career Center as an Unemployment Insurance (UI) Claims Specialist and help support individuals needing assistance when filing for unemployment insurance...

  • Workers' Compensation Claims Specialist | Texas

    2 weeks ago

    Grand Prairie, United States King's Insurance Staffing Full time

    Workers' Compensation Claims Specialist | Texas King's Insurance Staffing provided pay range This range is provided by King's Insurance Staffing. Your actual pay will be based on your skills and experience — talk with your recruiter to learn more. Base pay range $75,000.00/yr - $90,000.00/yr Additional compensation types Annual Bonus Direct message the job...

  • Texas Workers' Comp Claims Specialist — Remote

    2 weeks ago

    Grand Prairie, United States King's Insurance Staffing Full time

    An insurance staffing agency is seeking a Workers' Compensation Claims Specialist in Grand Prairie, TX. This mid-senior level position requires expertise in Texas Workers' Compensation claims, strong analytical skills, and a commitment to customer service. The successful candidate will manage claims from inception to conclusion and must possess an active TX...

  • Loss Claims Specialist M-F 8am-5pm

    2 weeks ago

    Grand Rapids, United States Michigan Staffing Full time

    Loss Claims SpecialistMake banking a Fifth Third better We connect great people to great opportunities. Are you ready to take the next step? Discover a career in banking at Fifth Third Bank.General Function: Under moderate supervision, collects and documents accounts involved in total or repairable loss claims involving a primary insurance carrier and/or GAP...

  • Medical Billing Specialist

    4 weeks ago

    Grand Rapids, United States Mary Free Bed Rehabilitation Hospital Full time

    Medical Billing Specialist - Commercial Billing Medical Billing Specialist - Commercial Billing Mary Free Bed Summary We have the great privilege of helping patients and families re-build their lives. It's extraordinarily meaningful work and the reason we greet the day with optimism and anticipation. When patients "Ask for Mary," they experience a culture...

  • Medical Billing Specialist

    4 weeks ago

    Grand Rapids, United States Mary Free Bed Full time

    Medical Billing Specialist - Commercial BillingWe have the great privilege of helping patients and families re-build their lives. It's extraordinarily meaningful work and the reason we greet the day with optimism and anticipation. When patients "Ask for Mary," they experience a culture that has been sculpted for more than a century. Our hallmark is to...

  • Senior Disability Claims Specialist

    10 hours ago

    Cedar Rapids, United States Sedgwick Full time

    A leading risk management firm in Cedar Rapids, IA, is seeking a Disability Representative Senior to provide disability case management and claim determinations. The role involves analyzing complex medical documentation, determining benefits, and managing disability claims with a high degree of accuracy. The ideal candidate will have a bachelor's degree and...

  • Medical Billing Specialist

    2 weeks ago

    Grand Rapids, Michigan, United States Orthopaedic Associates of Michigan Full time

    Job DescriptionTitle: Medical Billing SpecialistLocation: 1111 Leffingwell Ave. NE, Grand Rapids, MI 49525 (Candidates must live in Michigan or plan to relocate.)Hours: Typical schedule is 8:00AM-5:00PM, Monday-Friday (After training, there is the potential to work 4 10's)Work Environment: Remote (Will be expected to report to above address for training and...

  • Medical Billing Specialist

    2 weeks ago

    Grand Rapids, MI, United States Mary Free Bed Full time

    Medical Billing Specialist - Auto/Work Compensation Billing We have the great privilege of helping patients and families re-build their lives. Our hallmark is to carefully listen to patients and innovatively serve them. This is true of every employee, from support staff and leadership, to clinicians and care providers. Mary Free Bed is a not-for-profit,...

  • Employee Relations Specialist

    1 week ago

    Grand Rapids, Michigan, United States Hope Network Careers Full time

    Employee Relations SpecialistWe are helping people overcome. Join us.Each year at Hope Network, 2,800+ talented professionals serve individuals across 280 unique locations. Some serve by providing hands-on care or medical treatment, others serve by assisting behind the scenes, but they all play an integral part in creating comebacks. Click here to watch what...

WC Claims Specialist

3 weeks ago

Grand Rapids, MI, United States UFP Industries, Inc Full time

The WC Claims Specialist is responsible for claims management and issues related to work comp. This position works under general supervision; exercises discretion and relies on experience and judgment to plan and accomplish goals; and requires a certain degree of creativity and autonomy to perform the job.

Principal Duties and Responsibilities

  • Serves as primary contact for the field operations on WC related claim procedures and claims management issues

  • May serve as a back-up for FMLA, ADA, and disability related claim procedures and claims management issues

  • Assists with updating documentation and communication associated with related leaves of absences

  • Trains new plant HR/safety personnel, including acquisitions, on related leave of absence procedures

  • Produces quarterly trend reports and other related reports as requested

  • Assists with monitoring federal and state leave regulations and with working with vendors and plants to implement any necessary updates to existing procedures

  • Monitors claim activity to ensure timely and accurate delivery of benefits

  • Provides assistance to the field regarding medical management and return to work

  • Reviews claim data to ensure that claims are managed, paid, and resolved according to service criteria

  • Ensures that all claims are reviewed for appropriateness of acceptance or denial

  • Advises the field in identifying and maintaining quality medical providers

  • Assists in the identification of legal counsel with assistance from the claim managers/TPA

  • Assists in developing legal strategy for each litigated case

  • Advises the field in transitional and long-term return-to-work strategies

  • Ensures that the claim managers/TPA pay medical bills and other related invoices promptly

  • Provides guidance and related training to plant personnel with work comp responsibilities

  • Helps maintain documentation, legal evidence, and other related file administration

  • Maintains updated knowledge of state comp laws or other legal changes impacting areas of responsibility

  • Advises the field and claim managers/TPA in investigating aspects of serious or questionable claims

  • Acts as a liaison between injured worker and TPA/carrier

  • Prepares and participates in strategic claim resolution meetings

  • Assists with providing information to TPA/legal counsel in response to subpoena requests

  • May assist with training for other related areas of responsibility

  • May assist with policy updates for related areas of responsibility

  • May serve as backup for Substance Abuse policy administration

  • May serve as backup for other various safety related program administration

  • Performs other duties as required.

Job Specifications

Knowledge

  • Bachelor's degree or equivalent experience in a related field

  • Formal, working knowledge of claims management protocol and related employment law

  • Some knowledge and understanding of medical terminology

Skills and abilities

  • Ability to solve problems and apply knowledge and education in complex situations

  • Ability to maintain and safeguard confidential information

  • Verbal and written skills with the ability to communicate at all levels within the organization

  • Interpersonal and problem-solving skills

  • Demonstrated ability to use computers and related business software and experience with advanced excel or other report writing programs

  • Ability to understand, analyze, and communicate financial information as a management tool

  • Ability to coordinate and prioritize case load

  • Ability to travel as required

Conduct

  • Team player and goal oriented

  • Leads by example

The Company is an Equal Opportunity Employer.