Claims Analyst jobs in Wisconsin

Claims Analyst analyzes and reviews insurance claims for accuracy, completeness, and eligibility. Reviews claims for eligibility to be reimbursed. Being a Claims Analyst maintains updated records and prepares required documentation. Assists in controlling the cost of processing claims. Additionally, Claims Analyst contacts policyholders about claims and may provide information regarding the amount of benefits. May require a bachelor's degree or its equivalent. Typically reports to a supervisor or manager. The Claims Analyst gains exposure to some of the complex tasks within the job function. Occasionally directed in several aspects of the work. To be a Claims Analyst typically requires 2 to 4 years of related experience. (Copyright 2024 Salary.com)

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Claims Analyst
  • Midwest Insurance Company
  • Middleton, WI FULL_TIME
  • Requirements:

    • Bachelor’s degree and/or 2-5 years relevant claims adjusting experience in the workers’ compensation field is preferred but not required.
    • Relevant state licensing where required.
    • Computer literacy; familiarity with Microsoft Office a plus
    • This individual will adhere to the code of ethical conduct and is required to engage in fair claims settlement practice.

    Job Summary:

    • Independently adjudicates California or multi-state workers’ compensation indemnity claim files that are non-catastrophic in nature, claim exposures up to $100,000 incurred reserves within branch authority, and some catastrophic claim handling, in accordance with jurisdictional requirements, and Midwest Claims Practices.
    • Conduct timely investigations, including obtaining telephonic/recorded statements, in person interviews, contact with insured, employee, physician, attorney, witness.
    • Handle and review coverage issues, determine compensability, schedule appropriate exposure, and address timely benefit delivery.
    • Recognition of 3rd party liability, and subrogation handling through recovery.
    • Identify and review the need for medical case/vocational management to a specific loss, and direct/manage activity relative to managed care.
    • Interface and manage handling with defense attorneys and investigative vendors when presence is required. Litigation experience is required, and control to the extent we can no longer act in the presence of counsel. Direct settlement resolution with the injured worker and/or with opposing counsel will be expected. Litigation management from initial Arbitration to the Supreme Court level is required. Attendance may be required at hearings, on cases of larger exposure, and/or when testimony is required. Client visits will be required depending on special handling parameters as defined in our best practices, account special handling instructions, or at the discretion of the Unit Manager. Status report completion is required on claims greater than or equal to $50,000.

    Skill and Ability Profile:

    This individual will possess the following skills:

    • Good listening; and good written and communication skills
    • Ability to work independently and stronghold the understanding of human nature and motivation principles.
    • Readily control/handle problem issues in times of stress, and/or in a climate of conflict or adversity.
    • Ability to document claim file activities is required.
    • Responsiveness to changing business or customer needs.

    Working at Midwest:

    • Competitive Pay
    • Competitive paid time off package
    • Excellent benefits package including:
    • Health insurance
    • Dental Insurance
    • Vision Insurance
    • Employer paid Life/AD&D, Short Term Disability, and Long Term Disability
    • 401k with up to 4% company match

    Job Type: Full-time

    Pay: From $48,500.00 per year

    Benefits:

    • 401(k)
    • 401(k) matching
    • Dental insurance
    • Employee assistance program
    • Health insurance
    • Life insurance
    • Paid time off
    • Referral program
    • Vision insurance

    Schedule:

    • Monday to Friday

    Work setting:

    • In-person
    • Office

    Education:

    • Associate (Preferred)

    Experience:

    • Microsoft Office: 1 year (Preferred)
    • Customer Service: 1 year (Preferred)

    Work Location: In person

  • 1 Month Ago

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Analyst, EDI Claims-Remote
  • Navitus Health Solutions LLC
  • Appleton, WI FULL_TIME
  • Putting People First in Pharmacy- Navitus was founded as an alternative to traditional pharmacy benefit manager (PBM) models. We are committed to removing cost from the drug supply chain to make medic...
  • 7 Days Ago

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Business Analyst, FFS Medicaid Claims
  • Navitus Health Solutions / Lumicera Health...
  • Appleton, WI FULL_TIME
  • Pharmacy Benefits Reinvented- As the industry’s alternative pharmacy benefit manager (PBM), we’re committed to making prescriptions more affordable for you and your members. Here at Navitus, our team ...
  • 7 Days Ago

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Senior Claims Analyst - Workers Compensation
  • Crum & Forster
  • BROOKFIELD, WI FULL_TIME
  • Crum & Forster Company Overview Crum & Forster (C&F) with a proud history dating to 1822, provides specialty and standard commercial lines insurance products through our admitted and surplus lines ins...
  • 1 Month Ago

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Claims Customer Care Center Representative (Remote)
  • AFICS American Family Insurance Claims Services, Inc.
  • EC-WI Offsite Wisconsin, WI FULL_TIME
  • Provide customer experience by managing phone and digital interactions on our claims and assisting with immediate needs. Compensation Minimum: Compensation Maximum: Compensation may vary based on the ...
  • 1 Month Ago

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Business Analyst, FFS Medicaid Claims- remote
  • Navitus Health Solutions
  • Madison, WI FULL_TIME
  • Putting People First in Pharmacy- Navitus was founded as an alternative to traditional pharmacy benefit manager (PBM) models. We are committed to removing cost from the drug supply chain to make medic...
  • 23 Days Ago

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Scheduling & Claims Analyst
  • Marathon TS
  • Bethesda, MD
  • Senior Construction Scheduling and Claims Consultant Summary/Objective The Senior Scheduling and Claims Consultant will ...
  • 3/28/2024 12:00:00 AM

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DI Claims Analyst
  • Ameritas
  • Cincinnati, OH
  • This is a hybrid role working partially in-office and partially from home. The DI Claims Analyst provides support to the...
  • 3/26/2024 12:00:00 AM

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Mechanical Claims Analyst (Remote/Hybrid)
  • JM Family Enterprises
  • Deerfield Beach, FL
  • Who We Are Looking For? Fidelity Warranty Services, Inc. (FWS), a subsidiary of JM&A, is looking for Mechanical Claims A...
  • 3/26/2024 12:00:00 AM

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Epic PB Claims Analyst - FTE and REMOTE!!
  • HCTec
  • Houston, TX
  • Positions: Epic PB Claims Analyst (W-2, no 3rd party, no C2C) Start: ASAP Salary Range: $95,000-$110,000 (Analyst IV max...
  • 3/25/2024 12:00:00 AM

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Epic PB Claims Analyst - FTE and REMOTE!!
  • HCTec
  • Nashville, TN
  • Positions: Epic PB Claims Analyst (W-2, no 3rd party, no C2C) Start: ASAP Salary Range: $95,000-$110,000 (Analyst IV max...
  • 3/25/2024 12:00:00 AM

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Epic PB Claims Analyst - FTE and REMOTE!!
  • HCTec
  • San Diego, CA
  • Positions: Epic PB Claims Analyst (W-2, no 3rd party, no C2C) Start: ASAP Salary Range: $95,000-$110,000 (Analyst IV max...
  • 3/25/2024 12:00:00 AM

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Claims Analyst
  • Kuvare Holdings
  • The Complex Claims Analyst is responsible for handling all Life claims including Living Benefits (disability, waiver of ...
  • 3/24/2024 12:00:00 AM

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Claims Analyst
  • MagMutual LLC
  • Atlanta, GA
  • OVERALL RESPONSIBILITIES: Investigate and manage with minimal supervision primarily litigation and selected high-exposur...
  • 3/24/2024 12:00:00 AM

Wisconsin is bordered by the Montreal River; Lake Superior and Michigan to the north; by Lake Michigan to the east; by Illinois to the south; and by Iowa to the southwest and Minnesota to the northwest. A border dispute with Michigan was settled by two cases, both Wisconsin v. Michigan, in 1934 and 1935. The state's boundaries include the Mississippi River and St. Croix River in the west, and the Menominee River in the northeast. With its location between the Great Lakes and the Mississippi River, Wisconsin is home to a wide variety of geographical features. The state is divided into five dist...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Claims Analyst jobs
$37,905 to $48,608

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