Claims Examiner jobs in Wisconsin

Claims Examiner reviews, evaluates, and processes insurance claims and makes recommendations for resolution. Examines and authorizes insurance claims investigated by insurance adjusters. Being a Claims Examiner studies reports prepared by adjusters and similar claims to determine the extent of insurance coverage and validity of the claim. Communicates with agents, claimants, and policy holders. Additionally, Claims Examiner determines settlement according to organization practices and procedures. May require a bachelor's degree. Typically reports to a supervisor or manager. The Claims Examiner work is closely managed. Works on projects/matters of limited complexity in a support role. To be a Claims Examiner typically requires 0-2 years of related experience. (Copyright 2024 Salary.com)

A
Claims Examiner
  • Auxiant
  • Madison, WI FULL_TIME
  • Be part of a growing and prospering company as a Claims Examiner for our Madison, WI office. Auxiant is a third party administrator of self-funded employee benefit plans with offices in Cedar Rapids, IA, Madison and Milwaukee, WI. Auxiant is a fast-growing,progressive company offering an excellent wage and benefit package.

    Auxiant’s Mission Statement and Core Values

    Mission:
    An Independent TPA investing in People and Innovation to deliver expert-driven experiences with REAL Results.

    Core Values: Independent Solutions. REAL Results
    Respect
    Empowerment
    Agility
    Leadership

    Job Summary: Responsible for processing medical claims and correspondence and handling customer service calls from members, providers, and clients.

    Essential Functions:

    • Process claims in a timely manner with acceptable accuracy
    • Handle correspondence and phone calls from member and providers in a timely manner
    • Analyze self-funded health plans and use plan language to correspond to necessary inquiries, both verbally and written
    • Interpret plan design and language to analyze claim edits
    • Point of contact for clients and members
    • Work Customer Service Tickets

    Nonessential Functions:

    • Other duties as assigned or appropriate

    Education/Qualifications:

    • Familiarity with ICD-10 and CPT coding
    • Understanding of medical claims processing guidelines
    • Proficient PC skills including email, record keeping, routine database activity, word processing, spreadsheet and 10-key
    • QicLink experience
    • Medical Terminology
    • High school diploma and 1-2 years related experience; or equivalent combination of education and experience

    *Full benefits including: Medical, Dental, Vision, Flexible Spending, Gym Membership Reimbursement, Life Insurance, LTD, STD, 401K, 3 weeks vacation, 9 paid holidays, casual dress code and more

    Job Type: Full-time

    Benefits:

    • 401(k)
    • 401(k) matching
    • Dental insurance
    • Employee assistance program
    • Flexible spending account
    • Health insurance
    • Life insurance
    • Paid time off
    • Professional development assistance
    • Referral program
    • Retirement plan
    • Vision insurance

    Schedule:

    • 8 hour shift
    • Day shift
    • Monday to Friday

    Work setting:

    • In-person
    • Office

    Work Location: In person

  • 8 Days Ago

A
Claims Examiner
  • Auxiant
  • Madison, WI FULL_TIME
  • Be part of a growing and prospering company as a Claims Examiner for our Madison, WI office. Auxiant is a third party administrator of self-funded employee benefit plans with offices in Cedar Rapids, ...
  • 8 Days Ago

B
Claims Examiner (Milwaukee, WI)
  • BeneSys, Inc.
  • Milwaukee, WI FULL_TIME
  • Claims Examiner (Milwaukee, WI) Summary - Processes routine medical, dental, vision and HRA claims and provide customer service, including providing information to hospitals, physicians and participan...
  • 29 Days Ago

M
Claims Examiner, MercyCare Insurance
  • Mercyhealth
  • Janesville, WI FULL_TIME
  • Overview Claims Adjudicator Examiner, MercyCare Insurance, Days, 80 Hrs/ 2 wks Location: MercyCare Building; Janesville, WI Analyzes claims to determine extent of insurance carrier's liability in acco...
  • 7 Days Ago

B
Claims Examiner (Waukesha, WI)
  • BeneSys, Inc.
  • Waukesha, WI FULL_TIME
  • Claims Examiner (Waukesha, WI) Summary The Claims Examiner processes health claims to completion in both paper and electronic form, responds to telephone inquiries from participants and providers, and...
  • 12 Days Ago

R
1099 CAT Claims Examiner (Remote)
  • RYZE Claim Solutions
  • Milwaukee, WI CONTRACTOR
  • 1099 CAT Claims Examiner (Remote) Contractor - 1099 Nationwide, Remote, Remote, US Overview: Our Independent Catastrophe Claims Examiners are (1099) contractors that will ensure a quality product is d...
  • 25 Days Ago

P
Claim Examiner
  • Pyramid Consulting, Inc
  • Garden City, NY
  • Immediate need for a talented Claim Examiner. This is a 06+ Months contract opportunity with long-term potential and is ...
  • 5/6/2024 12:00:00 AM

B
Claims Examiner
  • Berkley
  • Jersey City, NJ
  • Company Details: W. R. Berkley Corporation, founded in 1967, is one of the nations premier commercial lines property cas...
  • 5/6/2024 12:00:00 AM

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Claims Examiner
  • Erie Insurance
  • Erie, PA
  • Division or Field Office: Claims Division Department of Position: Corporate Claims Department Work from: ERIE's Footprin...
  • 5/4/2024 12:00:00 AM

Q
Claims Examiner
  • Quality Distribution, Inc.
  • Tampa, FL
  • Quality Carriers, Inc. is the nation's #1 tank trucking company. We transport a broad range of chemical products and pro...
  • 5/4/2024 12:00:00 AM

E
Claims Examiner
  • E-Solutions
  • Whittier, CA
  • POSITION SUMMARY: The claims examiner reports directly to the claims manager. They are primarily responsible for the pro...
  • 5/4/2024 12:00:00 AM

I
Claims Examiner
  • Innovative Management Systems Incorporated
  • Whittier, CA
  • Description: The Position. We are looking for a detail-oriented individual that can accurately review, research, and ana...
  • 5/4/2024 12:00:00 AM

C
Claims Examiner
  • Centers Plan for Healthy Living
  • Staten Island, NY
  • Claims Examiner 75 Vanderbilt Ave, Staten Island, NY 10304, USA Req #816 Monday, April 29, 2024 Centers Plan for Healthy...
  • 5/4/2024 12:00:00 AM

F
Claims Examiner
  • Fortuna BMC
  • Folsom, CA
  • As a Medical Claims Examiner Processor at Fortuna, you will play a vital role in ensuring the smooth adjudication and pr...
  • 5/2/2024 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 Examiner jobs
$47,407 to $62,864