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Claims Reviewer Jobs in Michigan (NOW HIRING)

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Auto PIP - Manager Casualty Claims

Richmond, VA · Hybrid

Create and enforce protocols to detect and prevent fraudulent claims; review claims with potential fraud. * Apply technical knowledge (e.g., comparative negligence laws across all 50 states), to ...

Northwood, Inc.

Claims Processor

Warren, MI · On-site

$15/hr

Responsible for processing claims in a timely manner, verifying insurance coverage for date of service/diagnosis and reviewing all paperwork for proper documentation and payment of claims. Comply ...

MSX International

Claims Specialist

Dearborn, MI · On-site

The Claims Specialist provides program claim review, claim entry assistance to both dealers and field personnel as needed. The Claims Specialist at times may act as a liaison between program ...

Cherokee Insurance Company

Claims Assistant

Wolverine, MI · On-site

$17.75 - $22.75/hr

Print off Review Works and distribute to adjusters. * Pull daily mail and distribute. * Assign new claims in BX. * Monitor and distribute claims emails. * Scan and send field adjusters' mail. Skills ...

Cherokee Insurance Company

Claims Assistant

Wolverine, MI · On-site

$17.75 - $22.75/hr

Print off Review Works and distribute to adjusters. * Pull daily mail and distribute. * Assign new claims in BX. * Monitor and distribute claims emails. * Scan and send field adjusters' mail. Skills ...

Cherokee Insurance Company

Claims Assistant

Wolverine, MI · On-site

$17.75 - $22.75/hr

Print off Review Works and distribute to adjusters. * Pull daily mail and distribute. * Assign new claims in BX. * Monitor and distribute claims emails. * Scan and send field adjusters' mail. Skills ...

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All JobsClaims Reviewer JobsClaims Reviewer Jobs in Michigan

Claims Reviewer information

See Michigan salary details

$26.6K

$56.3K

$78.4K

How much do claims reviewer jobs pay per year?

As of Aug 27, 2026, the average yearly pay for claims reviewer in Michigan is $56,313.00, according to ZipRecruiter salary data. Most workers in this role earn between $44,500.00 and $65,800.00 per year, depending on experience, location, and employer.

What is a claims reviewer?

A Claims Reviewer evaluates insurance claims to determine their validity and ensures they comply with company policies and regulations. They analyze documentation, verify details, and may consult with medical or industry experts. Their role helps prevent fraud, control costs, and ensure fair compensation for policyholders. Strong attention to detail and knowledge of insurance policies are essential for this role.

What are the daily responsibilities of a claims reviewer?

As a Claims Reviewer, your typical day involves evaluating insurance claims to determine their validity, reviewing supporting documents, and making recommendations for approval or denial based on policy guidelines. You will often collaborate with team members, adjusters, and occasionally interact with clients or healthcare providers to obtain additional information or clarification. The role frequently requires balancing multiple cases simultaneously while adhering to strict deadlines and maintaining high accuracy. Most Claims Reviewers work in an office setting, but some companies also offer remote or hybrid options, making the work environment flexible. This position offers the opportunity to develop expertise in insurance practices and can lead to advancement into supervisory or specialized claims roles.

What skills and qualifications are needed to be a claims reviewer?

To thrive as a Claims Reviewer, you need a solid understanding of insurance policies, claim evaluation procedures, and strong analytical skills, often supported by a degree in a related field or equivalent experience. Familiarity with claims management software, electronic documentation systems, and knowledge of relevant regulations or coding (such as ICD or CPT) is typically required. Attention to detail, critical thinking, and effective written and verbal communication are essential soft skills in this position. These skills are vital for accurately assessing claims, ensuring compliance, and maintaining efficiency in a detail-oriented, deadline-driven environment.

Is claims processing a stressful job?

Claims reviewers often work in a fast-paced environment where accuracy and attention to detail are essential, which can lead to stress, especially during high workloads or complex cases. The job requires strong organizational skills and knowledge of insurance policies, and some individuals may find the workload demanding at times.

What does a claims reviewer do?

A claims reviewer evaluates insurance claims to determine their validity and ensure they comply with policy terms. They analyze documentation, verify information, and make decisions on claim approval or denial, often using specialized software and following company guidelines. Strong attention to detail and knowledge of insurance policies are essential for this role.

What are popular job titles related to Claims Reviewer jobs in Michigan?

For Claims Reviewer jobs in Michigan, the most frequently searched job titles are:

What job categories do people searching Claims Reviewer jobs in Michigan look for?

The top searched job categories for Claims Reviewer jobs in Michigan are:

Claims Reviewer jobs near you
Infographic showing various Claims Reviewer job openings in Michigan as of August 2026, with employment types broken down into 100% Full Time. Highlights an 100% In-person job distribution, with an average salary of $56,313 per year, or $27.1 per hour.

Healthcare Claims Processor Bakinaw

Mount Pleasant, MI • On-site

Saginaw Chippewa Indian Tribe Fire Department
See more jobs at Saginaw Chippewa Indian Tribe Fire Departmentexternal

$15.75 - $19.75/hr

Other

Posted 23 days ago

Job description

Bakinaw Federal Contacting is a 100% tribally owned company of Migizi Economic Development Company.
As a tribally owned enterprise, we are proud to create career opportunities that support both our employees and the long-term economic success of the Saginaw Chippewa Indian Tribe.
Job Type
Full-time
Description
Join the new Bakinaw-Karna Joint Venture Team as a Temporary, Full-Time Medical Claims Processor. Become an integral part of a team dedicated to servicing the World Trade Center Health Program. In this role, you will leverage your meticulous attention to detail and commitment to accuracy in processing complex medical claims. If you're eager to make a positive impact in our community through your administrative skills, we encourage you to apply!
*Minimum of 5 years' experience in medical claims processing, including professional and facility claims as well as complex and high-dollar claims* Candidates must be located in one of the following states: FL, GA MD, MI, TX
Job Responsibilities:
  • Claims Review and Processing: Analyze and process a variety of complex medical claims in accordance with program policies and procedures, ensuring accuracy and compliance.
  • Critical Analysis: Analyze claims and adjudicate them according to program guidelines, employing critical thinking to navigate complex scenarios.
  • Timely Processing: Ensure claims are processed promptly to meet client standards and regulatory requirements, employing effective problem-solving skills to address any barriers.
  • Issue Resolution: Proactively resolve claim discrepancies and issues by collaborating with other departments, utilizing analytical skills to identify root causes and implement solutions.
  • Confidentiality Maintenance: Uphold the confidentiality of patient records and company information as per HIPAA regulations.
  • Detailed Record Keeping: Maintain thorough records of claims processed, denied, or requiring further investigation, ensuring transparency and traceability.
  • Trend Monitoring: Analyze and report on trends in claim issues or irregularities to management, contributing to process improvement initiatives; Assists Team Leads with reporting.
  • Audit Participation: Engage in audits and compliance reviews to ensure adherence to internal and external regulations, using critical thinking to evaluate processes.
  • Mentoring: Mentors and trains new claims processors as needed.
Requirements
  • High school diploma or equivalent.
  • Minimum of 5 years' experience in processing medical professional and facility claims as well as complex and high-dollar claims.
  • Familiarity with ICD-10, CPT, and HCPCS coding systems.
  • Must have experience working with modifiers and bill types.
  • Understanding of medical terminology, healthcare services, and insurance procedures (worker's compensation experience is a plus).
  • Strong attention to detail and accuracy.
  • Ability to interpret and apply insurance program policies and government regulations effectively.
  • Excellent written and verbal communication skills.
  • Proficient in Microsoft Office Suite (Word, Excel, Outlook).
  • Capacity to work independently as well as collaboratively within a team.
  • Commitment to ongoing education and training in industry standards and technology advancements.
  • Experience with claim denial resolution and the appeals process.
  • Ability to efficiently manage a high volume of claims.
  • Customer service-oriented with strong problem-solving capabilities. Must be flexible and have the ability to adjust to the needs of the client and changes in the program.

Apply at the link below:
https://recruiting.paylocity.com/recruiting/jobs/Details/4201120/KARNA-LLC/Experienced-Healthcare-Claims-Processor
Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities
This employer is required to notify all applicants of their rights pursuant to federal employment laws. For further information, please review the Know Your Rights notice from the Department of Labor.

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