Claims Analyst (Troy, MI)
Troy, MI · Remote
Each Analyst will specialize in a particular group but is expected to handle claims processing for multiple groups. Applicants for this remote role will only be considered if they live in these ...
New
Claims Analyst (Troy, MI)
Troy, MI · Remote
Each Analyst will specialize in a particular group but is expected to handle claims processing for multiple groups. Applicants for this remote role will only be considered if they live in these ...
New
Resolves Provider Reconsideration Requests (PRR) from providers relating to claims payment and requests for claim adjustments Researches claims processing guidelines, provider contracts, fee ...
Resolves Provider Reconsideration Requests (PRR) from providers relating to claims payment and requests for claim adjustments Researches claims processing guidelines, provider contracts, fee ...
Setting expectations for the remainder of the claim process, and initiating documentation in the ... Refer claims to other company units when necessary (e.g., Underwriting, Recovery Units or Claims ...
Setting expectations for the remainder of the claim process, and initiating documentation in the ... Refer claims to other company units when necessary (e.g., Underwriting, Recovery Units or Claims ...
You will conduct thorough investigations, evaluate damage, determine coverage, and guide customers through the full claims process with professionalism and empathy. As a trusted resource, you may ...
You will conduct thorough investigations, evaluate damage, determine coverage, and guide customers through the full claims process with professionalism and empathy. As a trusted resource, you may ...
Setting expectations for the remainder of the claim process, and initiating documentation in the ... Refer claims to other company units when necessary (e.g., Underwriting, Recovery Units or Claims ...
Setting expectations for the remainder of the claim process, and initiating documentation in the ... Refer claims to other company units when necessary (e.g., Underwriting, Recovery Units or Claims ...
High school diploma or GED Bachelor's degree preferred 3+ years Dental Front Desk or Dental Claims Processing experience Orthodontic claims experience preferred. Prior experience with insurance or ...
High school diploma or GED Bachelor's degree preferred 3+ years Dental Front Desk or Dental Claims Processing experience Orthodontic claims experience preferred. Prior experience with insurance or ...
Setting expectations for the remainder of the claim process, and initiating documentation in the ... Refer claims to other company units when necessary (e.g., Underwriting, Recovery Units or Claims ...
Setting expectations for the remainder of the claim process, and initiating documentation in the ... Refer claims to other company units when necessary (e.g., Underwriting, Recovery Units or Claims ...
Setting expectations for the remainder of the claim process, and initiating documentation in the ... Refer claims to other company units when necessary (e.g., Underwriting, Recovery Units or Claims ...
Setting expectations for the remainder of the claim process, and initiating documentation in the ... Refer claims to other company units when necessary (e.g., Underwriting, Recovery Units or Claims ...
Setting expectations for the remainder of the claim process, and initiating documentation in the ... Refer claims to other company units when necessary (e.g., Underwriting, Recovery Units or Claims ...
Setting expectations for the remainder of the claim process, and initiating documentation in the ... Refer claims to other company units when necessary (e.g., Underwriting, Recovery Units or Claims ...
Setting expectations for the remainder of the claim process, and initiating documentation in the ... Refer claims to other company units when necessary (e.g., Underwriting, Recovery Units or Claims ...
Setting expectations for the remainder of the claim process, and initiating documentation in the ... Refer claims to other company units when necessary (e.g., Underwriting, Recovery Units or Claims ...
Bachelor's degree preferred * 3+ years Dental Front Desk or Dental Claims Processing experience * Orthodontic claims experience preferred. * Prior experience with insurance or accounts receivable ...
Bachelor's degree preferred * 3+ years Dental Front Desk or Dental Claims Processing experience * Orthodontic claims experience preferred. * Prior experience with insurance or accounts receivable ...
You will conduct thorough investigations, evaluate damage, determine coverage, and guide customers through the full claims process with professionalism and empathy. As a trusted resource, you may ...
You will conduct thorough investigations, evaluate damage, determine coverage, and guide customers through the full claims process with professionalism and empathy. As a trusted resource, you may ...
Setting expectations for the remainder of the claim process, and initiating documentation in the ... Refer claims to other company units when necessary (e.g., Underwriting, Recovery Units or Claims ...
Setting expectations for the remainder of the claim process, and initiating documentation in the ... Refer claims to other company units when necessary (e.g., Underwriting, Recovery Units or Claims ...
Setting expectations for the remainder of the claim process, and initiating documentation in the ... Refer claims to other company units when necessary (e.g., Underwriting, Recovery Units or Claims ...
Setting expectations for the remainder of the claim process, and initiating documentation in the ... Refer claims to other company units when necessary (e.g., Underwriting, Recovery Units or Claims ...
Bachelor's degree preferred * 3+ years Dental Front Desk or Dental Claims Processing experience * Orthodontic claims experience preferred. * Prior experience with insurance or accounts receivable ...
Bachelor's degree preferred * 3+ years Dental Front Desk or Dental Claims Processing experience * Orthodontic claims experience preferred. * Prior experience with insurance or accounts receivable ...
Claims Operations Associate II
Wyoming, MI · Remote
$20 - $27/hr
Verify coverage, process claim-related transactions, and support payment and financial processing ... Experience in claims operations, claims processing, claims support, or a related insurance ...
Claims Operations Associate II
Wyoming, MI · Remote
$20 - $27/hr
Verify coverage, process claim-related transactions, and support payment and financial processing ... Experience in claims operations, claims processing, claims support, or a related insurance ...
$20 - $27/hr
Verify coverage, process claim-related transactions, and support payment and financial processing ... Experience in claims operations, claims processing, claims support, or a related insurance ...
$20 - $27/hr
Verify coverage, process claim-related transactions, and support payment and financial processing ... Experience in claims operations, claims processing, claims support, or a related insurance ...
Warranty Claims Specialist
$23 - $24/hr
This role is responsible for reviewing and processing warranty claims, including conducting technical analyses to ensure compliance with established Warranty Policies and Procedures in effect at the ...
Warranty Claims Specialist
$23 - $24/hr
This role is responsible for reviewing and processing warranty claims, including conducting technical analyses to ensure compliance with established Warranty Policies and Procedures in effect at the ...
Negotiate claim settlements with insureds, contractors, and other parties in the claims process within defined authority limits. * Maintain claim files and documents in accordance with company policy ...
Negotiate claim settlements with insureds, contractors, and other parties in the claims process within defined authority limits. * Maintain claim files and documents in accordance with company policy ...
Elevate Claims Solutions is founded on the belief that human experience and claim quality are the essence of profitable growth and retention for our adjuster partners, our clients, and ourselves. Are ...
Elevate Claims Solutions is founded on the belief that human experience and claim quality are the essence of profitable growth and retention for our adjuster partners, our clients, and ourselves. Are ...
Claims Processor information
See Michigan salary details
$10.48 - $11.62
2% of jobs
$11.62 - $12.76
6% of jobs
$12.76 - $13.90
9% of jobs
$14.50 is the 25th percentile. Wages below this are outliers.
$13.90 - $15.05
14% of jobs
$15.05 - $16.19
18% of jobs
The median wage is $16.23 / hr.
$16.19 - $17.33
17% of jobs
$17.96 is the 75th percentile. Wages above this are outliers.
$17.33 - $18.48
16% of jobs
$18.48 - $19.62
7% of jobs
$19.62 - $20.76
4% of jobs
$20.76 - $21.90
4% of jobs
$21.90 - $23.05
2% of jobs
$10
$16
$23
How much do claims processor jobs pay per hour?
As of Aug 16, 2026, the average hourly pay for claims processor in Michigan is $16.70, according to ZipRecruiter salary data. Most workers in this role earn between $14.23 and $18.03 per hour, depending on experience, location, and employer.
What is a claims processor?
A claims processor reviews insurance claims. Their responsibilities include verifying insurance policy coverage and making sure client information is accurate. After they determine there is a covered loss, a processor documents the information and makes sure all the required paperwork is complete. Other duties include modifying new or existing policies.
What are some common challenges faced by claims processors, and how can they be managed effectively?
Claims Processors often encounter challenges such as managing high volumes of claims, handling complex or incomplete documentation, and meeting strict accuracy and timeliness standards. To navigate these, strong organizational skills, effective communication with colleagues and claimants, and attention to detail are crucial. Utilizing workflow management tools and maintaining open channels with supervisors and other departments can help address issues quickly and ensure claims are processed efficiently. Regular training and staying updated on policy changes also support success in this role.
Is claims processing a stressful job?
Claims processing is often considered a routine administrative role that involves reviewing and verifying insurance claims. While it can involve tight deadlines and attention to detail, the level of stress varies depending on workload, workplace environment, and individual coping skills.
What is the difference between Claims Processor vs Claims Examiner?
| Aspect | Claims Processor | Claims Examiner |
|---|---|---|
| Required Credentials | High school diploma or equivalent; some roles may require certification | High school diploma; certification often preferred |
| Work Environment | Office setting, processing claims efficiently | Office setting, reviewing and approving claims |
| Employer & Industry Usage | Insurance companies, healthcare providers | Insurance companies, government agencies |
| Common Search & Comparison | Claims Processor vs Claims Examiner |
Claims Processors primarily handle the data entry and initial processing of insurance claims, focusing on accuracy and efficiency. Claims Examiners review claims for validity, compliance, and coverage before approval. While both roles work within the insurance industry and require similar credentials, Claims Examiners typically perform more detailed reviews and decision-making tasks. Understanding these differences helps job seekers identify the right role based on their skills and career goals.
What are the key skills and qualifications needed to thrive as a claims processor?
To thrive as a Claims Processor, you need strong analytical abilities, attention to detail, and knowledge of insurance policies, typically supported by a high school diploma or associate degree. Familiarity with claims management software, data entry systems, and sometimes industry certifications like AIC (Associate in Claims) is valuable. Excellent organization, communication, and customer service skills help you efficiently resolve claims and interact with clients. These competencies ensure accuracy, minimize errors, and maintain trust in the claims process.
Do you need a degree to be a claims processor?
A claims processor typically does not need a college degree, but employers often prefer candidates with a high school diploma or equivalent. Relevant skills include attention to detail, communication, and familiarity with claims processing software, and some positions may offer on-the-job training or certification programs.
What does a claims processor do?
A Claims Processor is responsible for reviewing, evaluating, and processing insurance claims submitted by policyholders. They verify the accuracy of the information provided, ensure all required documentation is present, and determine if the claim meets the policy's terms and conditions. Claims Processors work with both customers and insurance adjusters to resolve any discrepancies and help facilitate timely payments. Their role is essential in ensuring that claims are handled efficiently and fairly.
More about Claims Processor jobs
What are popular job titles related to Claims Processor jobs in Michigan?
For Claims Processor jobs in Michigan, the most frequently searched job titles are:
What job categories do people searching Claims Processor jobs in Michigan look for?
The top searched job categories for Claims Processor jobs in Michigan are:
What cities in Michigan are hiring for Claims Processor jobs?
Cities in Michigan with the most Claims Processor job openings:
What are popular job titles related to Claims Processor jobs in MI?
For Claims Processor jobs in MI, the most frequently searched job titles are:
Full-time
Medical, Dental, Vision, Retirement, PTO
Posted 3 days ago
New
BeneSys rating
7.8
Based on 11 frontline employees who took The Breakroom Quiz
150th of 492 rated business services
Job description
Claims Analyst (Troy, MI)
Summary – The Claims Analyst will be responsible for medical, dental, and vision claims processing of claims submitted electronically or on hard copy. Each Analyst will specialize in a particular group but is expected to handle claims processing for multiple groups.
Applicants for this remote role will only be considered if they live in these locations: Arizona, California, Colorado, Washington DC, Iowa, Illinois, Indiana, Kentucky, Massachusetts, Maryland, Michigan, Missouri, Nevada, Ohio, Oregon, Pennsylvania, Texas, Utah, Washington, Wisconsin.
Essential Duties and Responsibilities include but not limited to
- Review claims for benefit determination based on exception reports of electronic claim submission or hard copy submissions.
- Make corrections when necessary to incorrect participant or provider data.
- Assist Client Services Representatives with difficult claim adjustments/corrections.
- Analyst must be able to determine benefits for multiple groups and process claims accurately according to the corresponding Plan Documents.
- Primary responsibilities will not include telephone or personal interaction with participants or providers unless; it is determined by a supervisor or manager that assistance is needed in this area.
- Regular and predictable attendance is an essential function of this job.
Claim Analyst Levels
- Level I – Previous claims processing experience necessary. Must have working knowledge of medical terminology, CPT, ICD9/10, and HCPCS codes as well as CMS1500 and CMS1450 claim forms. Must be detail-oriented, work well independently and part of a team, self-motivated, possess analytical skills and ability to make benefit determinations utilizing plan documents. Must meet established productivity and quality expectations of 98% procedural and 99% payment/financial accuracy. Ability to process specialty claims such as flexible spending and HRAs.
- Level II – Must be proficient at all Level I skills. Complete understanding of claims processing system and assigned funds. Demonstrated ability to process all claim types and resolve complex claims including but not limited to Coalition and Hospitalist claims. Sound understanding of all aspects of the adjustment process. Ability to assist with system testing and claims auditing. Demonstrates initiative, sound judgment, and independent decision-making ability.
- Level III – Must be proficient at all Level I and II skills. Solid understanding of all claim types and the ability to assist on all funds. Ability to identify inconsistencies and escalate findings appropriately. Excellent communication skills. Ability to train and assist new hires as well as provide support for Analyst I and II’s. Conduct audits, report findings, provide detailed analysis of claims, and recommend changes for process improvement.
- Unit Lead - Must be proficient at all Level I - III skills. Must possess leadership ability and excellent communication skills both verbally and in writing. Demonstrates the ability to understand and facilitate the resolution of all complex claims issues including adjustments and appeals. Provide training to new hires and existing staff. Complete reporting for inventory, department, and individual analysts’ performance stats. Monitors inventory to ensure turn-around-times are maintained and department goals are achieved. Identifies error trends for training needs and works with the supervisor for implementation of processes to improve overall performance. Must demonstrate initiative, ability to multi-task and prioritize, and excellent organizational skills. Ability to represent the department on workgroups and new system implementation.
Qualifications - Individual must have previous medical claims processing experience and knowledgeable of medical terminology (i.e., CPT codes, ICD-9 codes, HCPCS, ADA codes). Analyst must be methodical and possess the skills to determine approval for benefit payment, versus pending or denying. Analyst will be accountable for benefit determinations. Excellent customer service skills are a must.
Applicants for this remote role will only be considered if they live in these locations: Arizona, California, Colorado, Washington DC, Iowa, Illinois, Indiana, Kentucky, Massachusetts, Maryland, Michigan, Missouri, Nevada, Ohio, Oregon, Pennsylvania, Texas, Utah, Washington, Wisconsin.
Education and/or Experience - High School diploma or GED equivalent and two years related experience.
Language Skills - Ability to read and interpret documents such as Summary Plan Descriptions of Plan rules. Ability to communicate professionally and clearly with other departments of BeneSys.
Mathematical Skills - Ability to apply concepts of basic addition, subtraction, multiplication and division.
Reasoning Ability - Ability to apply common sense to carry out detailed written or oral instructions.
Work Schedule - Full-time. Monday – Friday, 7:30am - 4:00pm. Permanent Remote position (No in-office days).
Competitive Benefits and Compensation Package
- 15 days Paid Time Off (PTO) during first full calendar-year of service
- 12 paid holidays
- 3 days paid bereavement
- Up to 20 days paid jury leave
- Medical, dental, and vision insurance, with option for dependent coverage
- Company-paid basic life, short-term disability, long-term disability, and AD amp;D insurance
- 401k with employer match
- Tuition reimbursement program
- Career development opportunities
- Referral bonus for all successful full-time referrals
- Annual opportunities for increases
Pay - Hourly rate ranges from $25.00 - $27.00. Actual rate dependent on location, skills, education, experience and other business factors.
Our Culture
BeneSys wants to be a great service provider to the members we serve, and we recognize we can only do that if we are also a great employer with successful employees. In short, our success is driven by our employees’ successes. We want to be a place where people want to work, feel proud of what they do and feel fulfilled both professionally and personally. We want to create a place where employees can find long-term growth and potential.
Our culture focuses on three core values:
- Collaboration: working together across 31 locations to achieve the best for the company and our clients
- Dedication: striving to create an environment where all employees work toward a common goal while committing to providing the best customer service to our members and our colleagues
- Integrity: doing what we say we will do. Upholding strong ethical and moral principles
ADA amp; EEO
Reasonable accommodations will be made so that qualified individuals with disabilities are able to complete the application process and, if hired, fulfill the essential functions of their job.
About BeneSys
Sourced by ZipRecruiter
Industry
Insurance and employee benefit funds
Company size
501 - 1,000 Employees
Headquarters location
Troy, MI, US
Year founded
1979