Claims Processor (Dearborn, MI)

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Elevance Health (anthem) · Dearborn, 15350 Commerce Dr N, Ste 202 & 210, MI

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About the role

Elevance Health is a health company dedicated to improving lives and communities - and making healthcare simpler. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve. How We Work At Elevance Health, we are creating a culture that is designed to advance our strategy but will also lead to personal and professional growth for our associates. Our values and behaviors are the root of our culture. They are how we achieve our strategy, power our business outcomes and drive our shared success - for our consumers, our associates, our communities and our business. We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few. Elevance Health operates in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager, associates are required to work at an Elevance Health location at least once per week, and potentially several times per week. Specific requirements and expectations for time onsite will be discussed as part of the hiring process. The health of our associates and communities is a top priority for Elevance Health. We require all new candidates in certain patient/member-facing roles to become vaccinated against COVID-19 and Influenza. If you are not vaccinated, your offer will be rescinded unless you provide an acceptable explanation. Elevance Health will also follow all relevant federal,

Additional Information

Anticipated End Date: 2026-06-19 Position Title: Claims Processor (Dearborn, MI) Job Description: Claims Processor (Dearborn, MI) Exemption Status: Non-Exempt Reports to: Manager, Claims Processors Job Code: Salary Grade: Union - Grade 4 Virtual: This role enables associates to work virtually full-time, with the exception of required in-person training sessions, providing maximum flexibility and autonomy. This approach promotes productivity, supports work-life integration, and ensures essential face-to-face onboarding and skill development. Alternate locations may be considered if candidates reside within a commuting distance from an office. Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law. *Shift hours: 8am EST - 4:30pm EST Monday - Friday. The Claims Processor is responsible for reviewing, verifying, and processing insurance or healthcare claims to ensure they are accurate and meet company or policy guidelines. How you will make an impact: Verify the accuracy of claims data entered by a data entry clerk and accurately complete the data entry of additional claims data necessary to adjudicate the claim. Research claims for additional or missing information. Utilize pre-established screening guidelines and templates to review claims information to determine member eligibility, level of benefits and if claims should be paid. Route claims information to appropriate departments for action, if necessary. Review open claims' reports on a daily basis to ensure that claims are processed quickly and accurately while meeting Departmental accuracy, productivity and performance standards Process mailbacks and submit for audit. Complete daily production logs and turn them in daily to the Claims Department Manager by the end of shift or before leaving for the day. Ensure that any data required for reporting purposes is entered as instructed by auditor or directed by management. Promptly raise any issues delaying resolution of the claim to management. Contribute to overall success of the claims department in meeting performance guarantees to customers and maintaining customer standards. Minimum Requirements High school diploma or a GED equivalent. 1 year of claims processing or medical billing experience required Preferred Skills, Capabilities and Experiences Claims processing experience preferred. Claims/Billing certification from an accredited business institution preferred Knowledge and experience using management information systems and software CAS or other computerized claims processing system preferred. Word processing and excel experience preferred. Job Level: Non-Management Non-Exempt Workshift: 1st Shift (United States of America) Job Family: UNN > Union 061 Please be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with Elevance Health. Any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health.

Claims Processor (Dearborn, MI)

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