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)

M
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

  • 2 Months Ago

Z
Freight Audit and Claims Analyst
  • Zurn Water LLC
  • Milwaukee, WI FULL_TIME
  • Freight Audit and Claims Analyst The Company Zurn Elkay Water Solutions Corporation is a thriving, values-driven company focused on doing the right things. We’re a fast growing, publicly traded compan...
  • 4 Days Ago

N
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...
  • 28 Days Ago

N
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 ...
  • Just Posted

N
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...
  • 3 Days Ago

T
Commercial GL Adjuster
  • TheBest Claims Solutions
  • Wisconsin, WI FULL_TIME
  • The Claims Adjuster is responsible for adjusting claims from franchisee and Corporate (Auto, Fleet, GL/PL and Property/Inventory) losses. Additionally, individual will review, respond, and negotiate t...
  • 2 Days Ago

G
Scheduler/Claims Analyst
  • Ghirardelli Associates
  • Oakland, CA
  • At Ghirardelli Associates we take pride in the accomplishments of our Associates and the environment that we foster. As ...
  • 4/19/2024 12:00:00 AM

E
Claims Analyst
  • ERISA Recovery
  • Dallas, TX
  • Job Description: Are you a high-performing collections analyst and underpaid? Join a team where compensation and opportu...
  • 4/18/2024 12:00:00 AM

B
Claims Analyst
  • Bernard Nickels & Associates
  • Mason, OH
  • Type: Contract Start Date: ASAP End Date: 6/30/2024 (w/ potential for extension) Location: Mason, OH (HYBRID position; i...
  • 4/18/2024 12:00:00 AM

F
Claims Analyst - Remote
  • First American Financial Corporation
  • West Hills, CA
  • Who We Are Join a team that puts its People First! As a member of First American's family of companies, First American H...
  • 4/18/2024 12:00:00 AM

F
Claims Analyst
  • Fresno PACE by Innovative Integrated Health
  • Fresno, CA
  • Who We Are Are you interested in working for an organization whose mission it is to enable frail, underserved, and multi...
  • 4/17/2024 12:00:00 AM

F
Claims Analyst
  • Fresno Pace By Innovative Integrated Health
  • Fresno, CA
  • Who We Are Are you interested in working for an organization whose mission it is to enable frail, underserved, and multi...
  • 4/17/2024 12:00:00 AM

P
Medial Claims Analyst
  • PrideStaff
  • Mesa, AZ
  • We are currently looking for a Medical Claims and Correspondence Processing Agent to join our team! MUST HAVE RELIABLE T...
  • 4/17/2024 12:00:00 AM

C
Reinsurance Claims Analyst
  • C. Winchell Agency, Inc.
  • New York, NY
  • Reinsurance Claims Analyst New York City - Remote Opportunity Property and Casualty Insurance Industry Come join the glo...
  • 4/15/2024 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
$38,020 to $48,756

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