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Claims Reviewer Jobs in Michigan (NOW HIRING)

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 ...

Claims Processor

Warren, MI ยท 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 ...

Claims Assistant

Wolverine, MI ยท 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 ...

Review, process, and maintain claims documentation while ensuring information is complete, accurate, and properly recorded * Serve as a primary point of contact for clients throughout the claims ...

Review, process, and maintain claims documentation while ensuring information is complete, accurate, and properly recorded * Serve as a primary point of contact for clients throughout the claims ...

Claims Assistant

Wolverine, MI ยท 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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Showing results 1-20

Claims Reviewer information

See Michigan salary details

$26.6K

$56.3K

$78.4K

How much do claims reviewer jobs pay per year?

As of Sep 2, 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.
Infographic showing various Claims Reviewer job openings in Michigan as of August 2026, with employment types broken down into 86% Full Time, 10% Part Time, 3% Contract, and 1% Nights. Highlights an 85% Physical, 4% Hybrid, and 11% Remote job distribution, with an average salary of $56,313 per year, or $27.1 per hour.

Auto PIP - Manager Casualty Claims

thg

Itasca, IL โ€ข Hybrid

Full-time

Posted 15 days ago


Job description

Our Claims team is currently seeking a Manager Casualty Claims.ย 

This is a full-time, exempt role with a hybrid work schedule at one of our Hanover offices:ย 

  • Itasca, IL
  • Worcester, MA
  • Richmond, VA
  • Syracuse, NY
  • Southfield, MI
  • Howell, MI

POSITION OVERVIEW:ย 

The Mgr Casualty Claims is responsible for the daily oversight of the claims handling team, leading employees to foster a highly engaged, high-performing workforce aligned with the organizationโ€™s strategic goals. This role ensures effective front-line claims handling while demonstrating expertise in performance management, communication, decision-making, relationship building, and customer service. The manager proactively assesses current and future resource needs, providing mentorship and guidance to support continuous development and operational excellence.

IN THIS ROLE, YOU WILL:ย 

  • Oversee the day-to-day operations of a claims handling team including the investigation and evaluation of claims.
  • Monitor and assess employee performance through spot checks (e.g., phone listening, file reviews) and data tools (e.g., Power BI, flight decks, trend analysis); provide feedback and implement improvement plans to ensure thorough and efficient investigations.
  • Develop and implement continuous improvement initiatives to enhance the quality and consistency of the investigative process.
  • 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 support employees in their investigations and evaluations. Direct day-to-day operations including tracking measures, analyzing reports, and reinforcing goals.
  • Handle escalated complaints or disputes, working to resolve issues amicably and maintain positive relationships with clients.
  • May utilize technology and talent management to increase efficiency and scalability in claims handling; analyze claims data to identify trends, areas for improvement, and opportunities for cost savings.
  • Evaluate and approve reserve and settlements outside of individual authorities.
  • Monitor and control expenses related to claim handling activities; review and approve settlement proposals prepared by claims handlers to ensure they are reasonable and justifiable.
  • Support and mentor others and demonstrate proficiency in contractual indemnification.
  • Oversee, manage, and direct litigated claims; mentor others on approach.
  • Collaborate with legal teams to ensure proper handling of litigation cases; analyze claims to identify strengths, weaknesses, and potential risks associated with litigation.
  • Manage and report on litigation outcomes to identify trends and areas for improvement.
  • Monitor and manage litigation costs to ensure they remain within budget and evaluating the financial impact of litigation on the company.
  • Ensure accurate documentation and compliance with legal requirements in litigated claims.
  • Provide guidance on the development of policies and procedures and training and development programs for claims handlers on litigation support.
  • Lead negotiation in contested claims, employing advanced negotiation strategies for optimal outcomes for claims within scope of unit, balancing indemnity and customer satisfaction.
  • Ensure compliance with all claims handling guidelines and policies.
  • Provide regular updates and reports to senior management and other departments; adapt communication styles to audience (e.g., director versus peer).

WHAT YOU NEED TO APPLY:ย 

  • Bachelorโ€™s degree; Generally, 5-7 years related claims experience; supervisory experience preferred but not required
  • Skilled in Microsoft Office Suite (Word, Excel), claims management systems, and data analysis tools for documentation, reporting, and process optimization.
  • Ability to cultivate a high-performing team through mentoring, coaching, and fostering a positive work environment.
  • Skilled in leading negotiations with stakeholders to achieve fair outcomes while maintaining policy and financial integrity.
  • Capable of resolving complex or sensitive disputes with empathy and adherence to organizational guidelines.
  • Effective verbal and written communicator across diverse audiences and situations; able to draft factual, objective work products.
  • Proficient in developing othersโ€™ negotiation, communication, and organizational skills.
  • Highly organized with the ability to manage complex projects and develop scalable organizational strategies.
  • Expert in developing empathetic customer service strategies and delivering exceptional service.
  • Recognized authority in insurance principles, policy coverage, legal liability, and jurisdictional requirements.
  • Expert in managing legal and reputational risks; ensures compliance with regulatory standards.
  • Makes informed, independent decisions within authority, evaluating risks and financial implications.
  • Understands how to align team performance with broader business goals and resource planning.

Core Capabilities:

  • Analytical Reasoning: The ability to identify problems, understand your impact, gather input and data, and develop an effective solution.
  • Customer Centricity: Makes customers/clients and their needs a primary focus of oneโ€™s actions; shows interest in and understanding of the needs and expectations of internal and external customers; gains customer trust and respect; meets or exceeds customer expectations.
  • Digital Fluency: Effectively uses digital tools and technology appropriately to find, evaluate, create, and communicate information understands how to navigate digital platforms, use software applications, and leverage technology for productivity and communication purposes.
  • Persuasion and Influence: Uses appropriate interpersonal skills and techniques to gain acceptance for ideas or solutions; uses influencing strategies to gain genuine agreements; seeks to persuade rather than force solutions or impose decisions or regulations.
  • Professional Insurance Acumen: Demonstrates a deepening understanding of the insurance industry and the ability to apply specialized technical skills to address complex challenges, adapt to industry trends, and drive value for the organization.
  • Planning and Execution: Plans, prioritizes and manages resources and time effectively to achieve specific goals or deadlines.