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Insurance Claims Examiner Jobs in Michigan (NOW HIRING)

Company Name Withheld

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Medical Claims Examiner-Entry Level

Kalamazoo, MI · On-site

Medical Claims Examiner - Entry Level We are seeking a detail-oriented individual to join our team ... offices, patient accounts, insurance verification or similar healthcare administration.

Raphael and Associates

Property Desk Adjuster

Howell, MI · On-site

We are currently growing and are looking for a TPA Property Claims Examiner with a minimum of three years of experience in this discipline of the insurance claims industry. The optimal candidate will ...

Raphael and Associates

Property Desk Adjuster

Howell, MI · On-site

We are currently growing and are looking for a TPA Property Claims Examiner with a minimum of three years of experience in this discipline of the insurance claims industry. The optimal candidate will ...

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All JobsInsurance Claims Examiner JobsInsurance Claims Examiner Jobs in Michigan

Insurance Claims Examiner information

See Michigan salary details

$34.9K

$53.7K

$80.2K

How much do insurance claims examiner jobs pay per year?

As of Sep 1, 2026, the average yearly pay for insurance claims examiner in Michigan is $53,690.00, according to ZipRecruiter salary data. Most workers in this role earn between $47,100.00 and $57,100.00 per year, depending on experience, location, and employer.

What does an insurance claims examiner do?

An Insurance Claims Examiner is responsible for reviewing insurance claims to determine their validity and ensure that payouts are made according to policy guidelines. They investigate the details of claims, verify information, and may consult with medical or legal experts. The examiner determines if claims are covered, recommends approval or denial, and helps prevent fraudulent or excessive claims. Their work ensures that policyholders receive fair treatment while protecting the insurance company's financial interests.

What are some common challenges insurance claims examiners face in their daily work?

Insurance Claims Examiners often encounter the challenge of balancing thorough investigation with timely claims processing. Reviewing complex documentation, communicating with claimants and other stakeholders, and detecting potential fraud can be demanding, especially when managing a high-volume caseload. Examiners must stay updated on changing regulations and policy guidelines while maintaining objectivity and empathy in sometimes stressful situations. Developing strong organizational and communication skills is key to overcoming these challenges and delivering fair, accurate outcomes.

What are the key skills and qualifications needed to thrive as an insurance claims examiner, and why are they important?

To thrive as an Insurance Claims Examiner, you need a solid understanding of insurance policies, claim procedures, and investigative techniques, typically supported by a bachelor's degree in a related field. Familiarity with claims management software, regulatory compliance tools, and sometimes certifications like AIC (Associate in Claims) are commonly required. Attention to detail, analytical thinking, and effective communication are crucial soft skills for evaluating claims and interacting with claimants and stakeholders. These skills ensure accurate claim assessments, minimize fraudulent payouts, and maintain trust with clients and insurers.

What is the difference between Insurance Claims Examiner vs Insurance Adjuster?

AspectInsurance Claims ExaminerInsurance Adjuster
CredentialsTypically requires a high school diploma or equivalent; some roles prefer certifications like CPCU or AICRequires similar credentials; certifications like AIC or CPCU are common
Work EnvironmentOffice-based, reviewing claims and documentationField or office-based, inspecting damages and interviewing claimants
Employer & IndustryInsurance companies, government agenciesInsurance companies, independent adjusting firms
Search & Comparison IntentOften compared for claims processing rolesRelated to claims evaluation and damage assessment

Both Insurance Claims Examiners and Insurance Adjusters work within the insurance industry, handling claims and requiring similar certifications. While Claims Examiners primarily review documentation in office settings, Adjusters often inspect damages in the field. Understanding these differences helps job seekers identify the right role based on work environment and responsibilities.

How much do insurance claims examiners make in the US?

Insurance claims examiners in the US earn a median annual salary of around $45,000 to $70,000, depending on experience, location, and employer. Those with specialized skills or certifications can earn higher wages, and the role often involves reviewing claims, assessing damages, and ensuring compliance with policies.

How to become an insurance claims examiner?

To become an insurance claims examiner, candidates typically need a high school diploma or equivalent, with some roles preferring postsecondary education or relevant experience. Many employers require knowledge of insurance policies, strong analytical skills, and attention to detail; professional certifications such as the Chartered Property Casualty Underwriter (CPCU) can enhance prospects. On-the-job training is common, and familiarity with claims processing software is beneficial.

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

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

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

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

What are popular job titles related to Insurance Claims Examiner jobs in MI?

For Insurance Claims Examiner jobs in MI, the most frequently searched job titles are:

Insurance Claims Examiner jobs near you
Infographic showing various Insurance Claims Examiner job openings in Michigan as of August 2026, with employment types broken down into 1% As Needed, 72% Full Time, 21% Part Time, 5% Contract, and 1% Nights. Highlights an 91% Physical, 1% Hybrid, and 8% Remote job distribution, with an average salary of $53,690 per year, or $25.8 per hour.

Medical Claims Examiner-Entry Level

Company Name Withheld

Kalamazoo, MI • On-site

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Posted 13 days ago

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Job description

Medical Claims Examiner – Entry Level

We are seeking a detail-oriented individual to join our team as a Medical Claims Examiner.

Prior medical claims processing experience is not required. We provide extensive training and are interested in candidates with experience in medical billing, medical offices, patient accounts, insurance verification or similar healthcare administration.


Responsibilities

·         Review and process medical claims

·         Research claim, benefit, eligibility, and payment questions

·         Communicate with medical providers and plan members by phone

·         Review EOBs, medical bills, claim forms, and supporting documentation

·         Learn and apply health plan benefits, deductibles, copays, coinsurance.

·         Document claim activity and telephone conversations accurately

·         Work with other staff to resolve claim issues


Qualifications

·         Strong attention to detail and accuracy

·         Good telephone and communication skills

·         Comfortable working with numbers and computer systems

·         Able to research problems and follow them through to resolution

·         Able to learn and consistently apply detailed rules and procedures

·         Professional when dealing with providers and plan members


Helpful experience includes medical billing, healthcare customer service, patient accounts, insurance verification, EOBs, medical terminology, or other detail-oriented healthcare administration.