- Ford Motor Company (Dearborn, MI)
- …over one hundred countries around the world. **In this position ** + This is a Claims Examiner for AMRO Services who perform work on behalf of The American Road ... Ford Motor Remarketing and Ford Motor Damaged Vehicles Office (DVO). + The Claims Examiner position is involved in processing claims for in-transit claims… more
- Robert Half Accountemps (Grand Rapids, MI)
- Description We are looking for an experienced Claims Examiner specializing in Lost Time claims to join our team in Jersey City, New Jersey. This is a ... * Minimum of three years' experience as a Workers' Compensation Lost Time Claim Examiner or equivalent experience in claims handling. * Familiarity with workers'… more
- Integra Partners (Troy, MI)
- Integra is seeking a results-oriented, dynamic, proven Claims Examiner , with a specific background in the complex rehab technology (CRT) space. This role is ... Responsibilities and Duties + Be prepared to appeal or correct CRT claims in compliance with Medicare, Medicaid, and commercial insurance guidelines. + Ensure… more
- Sedgwick (Lansing, MI)
- …to work. Great Place to Work(R) Most Loved Workplace(R) Forbes Best-in-State Employer Claims Examiner , Bodily Injury (Auto) **PRIMARY PURPOSE** : To analyze and ... process complex auto and bodily injury claims by reviewing coverage, completing investigations, determining liability and evaluating the scope of damages.… more
- Intermountain Health (Lansing, MI)
- **Job Description:** The Claims Examiner I is responsible for inbound calls from providers and health plans and adjudicates physician claims , in a timely and ... to and supports the corporation's quality improvement efforts. Processes medical claims (CPT, ICD, and Revenue Coding) at production standards, including timely… more
- TEKsystems (Grand Rapids, MI)
- …and Responsibilities: - Handles all aspects of workers compensation lost time claims from set-up to case closure ensuring strong customer relations are maintained ... denials when applicable. - Prepares reports on investigation settlements denials of claims and evaluations of involved parties etc. - Timely administration of… more
- Sedgwick (Grand Rapids, MI)
- …Apply your examiner knowledge and experience to adjudicate complex customer claims in the context of an energetic culture. + Deliver innovative customer-facing ... to advance to the next round, a recruiter will be in touch. \#claimsexaminer # claims _As required by law, Sedgwick provides a reasonable range of compensation for… more
- Prime Therapeutics (Lansing, MI)
- …and/or prescriber fraud, waste and abuse (FWA). This position conducts claims data mining, fraud analysis and auditing/monitoring activities and proactively ... compliance with federal, state and local laws pertaining to investigations and fair claims handling practices; evaluate risk to determine how best to proceed with… more
- Prime Therapeutics (Lansing, MI)
- … claims processing environment **Preferred Qualifications** + Certified Fraud Examiner or Accredited Health Care Fraud Investigator + National Pharmacy Technician ... and client initiatives; engage in cross functional analysis of medical and pharmacy claims ; lead FWA investigations for federal employee program + Stay current on… more
- Highmark Health (Lansing, MI)
- …**Required** + None **Preferred** (any of the following) + Certified Fraud Examiner (CFE) + Certified Professional Coder (CPC) + Certified Outpatient Coder (COC) ... (AHFI) **SKILLS** + Must have knowledge of provider facility payment methodology, claims processing systems and coding and billing proficiency + Must have… more
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