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Medical Claims Associate Jobs in Michigan (NOW HIRING)

BeneSys, Inc.

Specialty Claims Analyst (Troy, MI)

Troy, MI · Remote

$21 - $24/hr

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

Support Plan Manager/Associates as needed. * Regular and predictable attendance is an essential function of this job. Qualifications - Individual must be skilled in medical claims processing and ...

thg

Consultant Casualty Claims

Howell, MI · Hybrid

Independently manage indemnity, medical, and basic arbitration or mediation components of claims ... Associate degree required; bachelor's degree preferred or combination of education and experience.

Hanover Insurance Group, Inc.

Consultant Casualty Claims

Howell, MI · On-site

$65 - $95/hr

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

Independently manage indemnity, medical, and basic arbitration or mediation components of claims ... Associate degree required; bachelor's degree preferred or combination of education and experience.

New

thg

Consultant Casualty Claims

Howell, MI · Hybrid

Independently manage indemnity, medical, and basic arbitration or mediation components of claims ... Associate degree required; bachelor's degree preferred or combination of education and experience.

MEDLOGIX, LLC

Field Case Manager - RN

Southfield, MI · On-site

$80K/yr

Northville, Michigan Medlogix, LLC delivers innovative medical claims solutions through a seamless ... Associates Degree or BSN preferred * Please reply with resume and salary requirements. Medlogix ...

Yeo & Yeo

Medical Coder

Saginaw, MI · On-site

$17.50 - $23.25/hr

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

Associates Degree, Business Administration or equivalent; or the combination of education and work ... Customer service skills for interacting with patients regarding medical claims and payments ...

Yeo & Yeo

Medical Coder

Saginaw, MI

$17.50 - $23.25/hr

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

Associates Degree, Business Administration or equivalent; or the combination of education and work ... Customer service skills for interacting with patients regarding medical claims and payments ...

Yeo & Yeo

Medical Coder

Saginaw, MI · On-site

$17.50 - $23.25/hr

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

Associates Degree, Business Administration or equivalent; or the combination of education and work ... Customer service skills for interacting with patients regarding medical claims and payments ...

Healthrise

Coding Denials Resolution Specialist

Farmington, MI · On-site

$18.50 - $23.50/hr

... claims or other coding reasons, and processing charge corrections based on medical record reviews ... High school diploma or Associate degree in Accounting, Business Administration, or related field ...

Summit

$69K - $92K/yr

  • Medical

  • Dental

  • Vision

  • Retirement

  • PTO

Completion of or continuing progress toward a professional designation preferred, such as Associate ... Full-time employees have access to medical, dental, and vision coverage, wellness plans, parental ...

Great American Insurance Group

$69K - $92K/yr

  • Medical

  • Dental

  • Vision

  • Retirement

  • PTO

Completion of or continuing progress toward a professional designation preferred, such as Associate ... Full-time employees have access to medical, dental, and vision coverage, wellness plans, parental ...

Auto-Owners Insurance

PIP Claims Representative

Lansing, MI · On-site

  • Retirement

  • PTO

Our group of caring associates create financial security by helping individuals and businesses make ... Review medical bills, authorize payments and ensure payments are issued in a timely and accurate ...

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Showing results 21-40

All JobsMedical Claims Associate JobsMedical Claims Associate Jobs in Michigan

Medical Claims Associate information

What does a medical claims associate do?

A Medical Claims Associate is responsible for reviewing, processing, and adjudicating medical insurance claims submitted by healthcare providers or policyholders. They verify the accuracy of claims, ensure compliance with insurance policies, and determine the appropriate payment or denial based on guidelines. The role involves communication with healthcare providers, patients, and insurance companies to resolve discrepancies or gather additional information. Medical Claims Associates play a crucial part in ensuring that claims are handled efficiently and accurately, contributing to the smooth operation of healthcare reimbursement processes.

What are the key skills and qualifications needed to thrive as a medical claims associate, and why are they important?

To thrive as a Medical Claims Associate, you need strong knowledge of medical terminology, health insurance policies, and claims processing, often supported by a high school diploma or associate degree. Familiarity with claims management software, coding systems like ICD-10 or CPT, and basic office applications is essential. Attention to detail, problem-solving, and effective communication are vital soft skills for accuracy and client interactions. These skills ensure timely, accurate claims processing and help prevent errors or fraud, supporting efficient healthcare operations.

What are some common challenges faced by medical claims associates, and how can they be effectively managed?

Medical Claims Associates often encounter challenges such as managing high volumes of claims, navigating complex insurance policies, and ensuring accuracy under tight deadlines. To address these, it's important to develop strong organizational skills, keep up-to-date with the latest policy changes, and utilize available claims processing software efficiently. Additionally, collaborating closely with healthcare providers and insurance representatives can help clarify discrepancies and resolve issues more quickly, making teamwork and communication key assets in this role.

What is the difference between Medical Claims Associate vs Medical Billing Specialist?

AspectMedical Claims AssociateMedical Billing Specialist
CredentialsHigh school diploma; certification often preferredHigh school diploma; certification often preferred
Work EnvironmentHealthcare offices, insurance companiesHealthcare offices, billing companies
Primary ResponsibilitiesReview and process insurance claims, ensure accuracyGenerate bills, submit claims, follow up on payments
Industry UsageInsurance companies, healthcare providersHealthcare providers, billing services

While both roles involve working with healthcare payments, a Medical Claims Associate primarily reviews and processes insurance claims to ensure accuracy and compliance. In contrast, a Medical Billing Specialist focuses on generating bills, submitting claims, and managing payment collections. Both roles require similar credentials and often work in healthcare or insurance settings, but their core functions differ in the claims review versus billing process.

Is claims processing a stressful job?

Claims processing as a Medical Claims Associate can be stressful due to the need for accuracy, attention to detail, and meeting deadlines. The role often involves handling complex information and working under time constraints, which can contribute to job-related stress. However, workload and stress levels vary depending on the employer and individual workload management skills.

What are the most commonly searched types of Medical Claims jobs in Michigan?

The most popular types of Medical Claims jobs in Michigan are:

What cities in Michigan are hiring for Medical Claims Associate jobs?

Cities in Michigan with the most Medical Claims Associate job openings:

Medical Claims Associate jobs near you
Infographic showing various Medical Claims Associate job openings in Michigan as of August 2026, with employment types broken down into 1% As Needed, 77% Full Time, 15% Part Time, 1% Temporary, and 6% Contract. Highlights an 95% Physical, 1% Hybrid, and 4% Remote job distribution.

Specialty Claims Analyst (Troy, MI)

BeneSys, Inc.

Troy, MI • Remote

$21 - $24/hr

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Posted 13 days ago

BeneSys rating

7.8

Company rating: 7.8 out of 10

Based on 11 frontline employees who took The Breakroom Quiz

150th of 494 rated business services

Job description

Specialty Claims Analyst (Troy, MI)
Summary - The Specialty Claims Analyst will process Disability, SUB, Flex, and Death claims. Provide support for WEX health card users and receive documentation from members through e-mail, fax or by hard copy mail to correctly process submitted claims. Assists with customer service.
Applicants for this remote role will only be considered if they live in these locations: Illinois, Indiana, Iowa, Kentucky, Michigan, Missouri, Ohio, Oregon, Pennsylvania, Wisconsin.
Essential Duties and Responsibilities include but not limited to
  • Process Flex claims in the appropriate amount of time to ensure that member receives payment in a timely manner according to the rules of the plan.
  • Coordinate with Eligibility by informing them of payouts of SUB and Disability benefits to update disability credit hours.
  • Work with the Local Halls to determine benefits for weekly SUB payments.
  • Prepare and send Disability and SUB Reports to the Local Halls on a weekly basis.
  • Determine benefits for multiple groups to process claims correctly, and retrieve documentation required by each group for payments to go out; outcome is either the issuing of a check or sending letters of rejection with proper appeal procedures.
  • Work with Pension to coordinate retirement dates, to avoid overlapping payments of both Pension and Disability simultaneously.
  • Document Disability and SUB dates to avoid overpayments; request refunds from members when overpayments are made.
  • Run checks on assigned days weekly, for SUB, Disability, Flex and Death Benefits, advise Operations of these check runs, and coordinate with accounting on the release of checks.
  • Process stops payments, voids and refunds for all benefit types.
  • Provide back-up for Customer Service and Eligibility; take calls in assigned queue for SUB, Disability, Flex and Death Claims.
  • Research payments according to plan rules to respond to members requests for payment of claim; call back members with result. Ensure the member that claim was processed correctly, and the maximum benefit was received.
  • Process death applications and gather information needed for different life insurance carriers for processing of death benefits.
  • Maintain claims processing quality standards of at least 98%.
  • Maintain claims turnaround times as defined by Specialty Claims Management based on type of claim assigned (claim TAT varies based on SUB, MRA, disability or death)
  • Support Plan Manager/Associates as needed.
  • Regular and predictable attendance is an essential function of this job.
Qualifications - Individual must be skilled in medical claims processing and knowledge of medical terminology. Have two (2) years of experience in a related field, required. Good reasoning and phone skills. Proficient in Microsoft office.
Applicants for this remote role will only be considered if they live in these locations: Illinois, Indiana, Iowa, Kentucky, Michigan, Missouri, Ohio, Oregon, Pennsylvania, Wisconsin.
Education and/or Experience - High School diploma or GED equivalent. Prior claims experience preferred.
Language Skills - Ability to read and interpret the plan rules as outlined in the SPD (Summary Plan Description), user manuals and department rules amp; procedures. Ability to communicate with members, union officials and co-workers the plan rules and procedures to process amp; issue Disability and SUB payments.
Mathematical Skills - Ability to calculate hours and SUB Credits to properly process claims for payment. Ability to determine tax amounts on payments.
Reasoning Ability - Ability to calculate and determine eligibility amp; benefits available according to multiple plan rules to process claims for payment.
Work Schedule - Full time. Monday - Friday, 7:30am - 4:00 pm. Permanent Remote position (No in-office days).
Competitive Benefits and Compensation Package
  • 12 paid holidays
  • Paid Time Off (PTO)
    • Pro-rated during first year of employment
    • 15 days of PTO provided in the next calendar year!
  • 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
The pay range for this position is $21.00 - $24.00 an hour. Actual salary is dependent on skills, experience, education, 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.

What BeneSys employees say

Pay

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Hours and flexibility

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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

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