Claims Analyst jobs in Madison, WI

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

  • Just Posted

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Business Analyst, FFS Medicaid Claims- remote
  • Navitus Health Solutions LLC
  • 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...
  • 9 Days Ago

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Claims - ILSP
  • AssuranceSD
  • Madison, WI FULL_TIME
  • About the Company: AssuranceSD is a mission-driven organization that offers administrative services to empower individuals to take control of their personal care services. Our mission is to help stren...
  • Just Posted

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Claims Adjuster - Auto Casualty
  • Rural Mutual Insurance
  • Madison, WI FULL_TIME
  • We are seeking a skilled and detail-oriented Desk Auto Bodily Injury Adjuster to join our team. As a Desk Auto Bodily Injury Adjuster, you will play a crucial role in the insurance process by evaluati...
  • 2 Months Ago

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Desk Auto Claims Adjuster
  • Rural Mutual Insurance
  • Madison, WI FULL_TIME
  • Remote in WisconsinWe are seeking a skilled and detail-oriented Desk Auto Adjuster to join our team. As a Desk Auto Adjuster, you will play a crucial role in the insurance process by assessing and det...
  • 18 Days Ago

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Managing Claims Attorney
  • Rural Mutual Insurance
  • Madison, WI FULL_TIME
  • Rural Mutual Insurance Company seeks an Attorney with 5-8 years of civil litigation experience for an in-house claims management position. Rural Mutual acts as a Third-Party Administrator for a Wiscon...
  • 19 Days Ago

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0 Claims Analyst jobs found in Madison, WI area

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Insurance Benefits Specialist- 100% Remote
  • Global Elite
  • Madison, WI
  • NOW IS THE BEST TIME TO JOIN FULL-TIME REMOTE COMPLETELY WORK FROM HOME ALL BENEFITS REPRESENTATIVES START AT ENTRY LEVE...
  • 4/25/2024 12:00:00 AM

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Outside Insurance Sales Associate- Wisconsin- Remote
  • Allstate
  • Madison, WI
  • Are you a natural networker? Join Allstates sales organization and you can build a lucrative and rewarding career with t...
  • 4/24/2024 12:00:00 AM

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Logistics Analyst- On-Site (Windsor, WI)
  • WALGREENS
  • Windsor, WI
  • Job Summary: Responsible for daily coordination, dispatching and performs administrative functions that support drivers,...
  • 4/23/2024 12:00:00 AM

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Lead Machine Learning Engineer
  • QBE Insurance Group Limited
  • Sun Prairie, WI
  • Primary Details Time Type: Full time Worker Type: Employee The Opportunity QBE is on the lookout for a Lead Machine Lear...
  • 4/22/2024 12:00:00 AM

A
Casualty Reinsurance Underwriting Manager (Open to Remote)
  • American Family Mutual Insurance Company
  • Madison, WI
  • Responsible for evaluation, market research, due diligence, and providing recommendations for expanding the treaty casua...
  • 4/22/2024 12:00:00 AM

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Regional Financial Analyst-Services
  • Franklin Energy
  • Madison, WI
  • COMPANY Summary As a combined organization, Franklin Energy and AM Conservation Group is undertaking what is perhaps the...
  • 4/21/2024 12:00:00 AM

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Regional Financial Analyst
  • Franklin Energy
  • Madison, WI
  • COMPANY Summary As a combined organization, Franklin Energy and AM Conservation Group is undertaking what is perhaps the...
  • 4/21/2024 12:00:00 AM

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Commercial Property Field Claim Adjuster (Madison/Milwaukee, WI)
  • American Family Insurance
  • Madison, WI
  • Investigate and maintain commercial property claims, focused on residential structures. Determine liability, secure info...
  • 4/10/2024 12:00:00 AM

Madison is located in the center of Dane County in south-central Wisconsin, 77 miles (124 km) west of Milwaukee and 122 miles (196 km) northwest of Chicago. The city completely surrounds the smaller Town of Madison, the City of Monona, and the villages of Maple Bluff and Shorewood Hills. Madison shares borders with its largest suburb, Sun Prairie, and three other suburbs, Middleton, McFarland, and Fitchburg. Other suburbs include the city of Verona and the villages of Cottage Grove, DeForest, and Waunakee as well as Mount Horeb, Oregon, Stoughton, and Cross Plains among others. According to th...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Claims Analyst jobs
$37,905 to $48,608
Madison, Wisconsin area prices
were up 1.3% from a year ago

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