Michigan Claim Support Assistant II

Job Type:Full time Exempt/Non Exempt:

Hourly

Job Description:

Location:

Dearborn, Michigan Position Schedule /

Shift: Rotating hybrid schedule Monday – Friday: 8:30 AM EST – 5:00 PM EST. In office reporting will rotate based on role responsibilities. All employees will be notified of in office reporting days as applicable.

Training for this position will be in office for the first initial 90 days of employment. Rotating schedule will begin after training is completed.

Position Summary:

Join our Claims team in a role where your analytical skills, attention to detail, and problem-solving abilities make a direct impact on the customer experience and the financial integrity of our claims operations. As a claims operations professional, you'll take ownership of complex payment and reconciliation processes, resolve challenging issues, and serve as a trusted resource for teammates while helping ensure accurate, timely claim outcomes.

If you enjoy working independently, collaborating across teams, and contributing to continuous operational excellence, this role offers an opportunity to make a meaningful difference every day.

Key Responsibilities:

Provide support to the Claim department by completing functions that require an advanced understanding of concepts, processes, and the organization and workflow for one or more claims lines of business and one or more claims systems

Work independently with limited supervision to complete functions that may require analysis, research, calculations, or the synthesis of information from multiple sources

Receive inbound and make outbound customer phone calls to resolve claims needs

Review claim documents for accuracy and determine the next action within the process

Train less senior staff members in departmental processes and procedures

May be assigned tasks normally handled by the lower-level staff when necessary

Process paperwork for outgoing checks

Investigate stop pay requests for accuracy

Accurately allocate funds to correct coverage in the appropriate Claim system

Review checks and attempt to resolve prior to release of funds to the state for all claim systems, including redeposit funds to claim systems/accounts to avoid improper esheatment

Review and research activity associated with positive pay processes

Research incoming checks for proper allocation and process deposits including balancing accounts and resolving allocation issues

Balance and reconcile all claim deposits

Qualifications:

Required

Education:

High School Diploma or equivalentORThree years of experience in processing, customer service or business administrationA valid driver's license is required if the primary responsibilities of the role involve conducting in-person inspections or frequent in-person meetings with members.

Experience:

Working with P.C. software applications

Maintaining accurate files and records
· Identification, investigation, and resolution of complex problems
· Processing transactions and posting to appropriate accounts
· Organizing and prioritizing multiple tasks
· Communicating effectively (oral and written)
Using automated processing and computer systems

Gathering data and preparing reports

Auditing records, products, and computer files
· Compose routine correspondence including letters and memos

Knowledge of:

Claim processing functions

Claim processing system

Claim processing policy and procedures

Data processing techniques

Techniques used to audit data Skills and Ability to:

Successfully complete General Claims Training Preferred Skills :

The ability to multi-task various assignments at once

Keen attention to details

Excellent communication skills both oral and written2+ years of customer service experience

The ability to work independently

Banking experience preferred

The ability to work within…