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Claim Analyst Jobs in Wisconsin (NOW HIRING)

Network Health

Claims Analyst II

Brookfield, WI · On-site +1

We are seeking a Claims Analyst II to examine and process paper and electronic claims. In this role ... Enters eligible claim data into appropriate WRAP network re-pricing website. Overrides claims ...

New

Network Health, Inc

Claims Analyst II

Brookfield, WI · On-site +1

We are seeking a Claims Analyst II to examine and process paper and electronic claims. In this role ... Enters eligible claim data into appropriate WRAP network re-pricing website. Overrides claims ...

Network Health, Inc

Claims Analyst II

Menasha, WI · On-site +1

We are seeking a Claims Analyst II to examine and process paper and electronic claims. In this role ... Enters eligible claim data into appropriate WRAP network re-pricing website. Overrides claims ...

Network Health

Claims Analyst II

Menasha, WI · On-site +1

We are seeking a Claims Analyst II to examine and process paper and electronic claims. In this role ... Enters eligible claim data into appropriate WRAP network re-pricing website. Overrides claims ...

New

Quartz

Medical Coding Systems Analyst

Madison, WI · Remote

$72K - $90K/yr

Are you a problem-solver that enjoys working with claim edit systems? If so, come join Quartz as a Medical Coding Systems Analyst. The Medical Coding Systems Analyst will be responsible for oversight ...

Unavailable

Medical Coding Systems Analyst

Madison, WI · On-site

$72K - $90K/yr

Are you a problem-solver that enjoys working with claim edit systems? If so, come join Quartz as a Medical Coding Systems Analyst. The Medical Coding Systems Analyst will be responsible for oversight ...

Quartz

Medical Coding Systems Analyst

Madison, WI · On-site

$72K - $90K/yr

Coding Systems Analyst Come Find your Spark at Quartz! Do you have a strong background in medical ... Work with two separate claim edit systems and vendors to help Quartz achieve maximum savings * Work ...

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Claim Analyst information

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$14

$27

$52

How much do claim analyst jobs pay per hour?

As of Aug 8, 2026, the average hourly pay for claim analyst in Wisconsin is $27.65, according to ZipRecruiter salary data. Most workers in this role earn between $20.38 and $31.78 per hour, depending on experience, location, and employer.

What are the key skills and qualifications needed to thrive as a claim analyst?

To thrive as a Claim Analyst, you need strong analytical skills, attention to detail, and a background in finance, insurance, or a related field, often supported by a relevant degree or certificate. Familiarity with claims management software, data entry systems, and sometimes industry-specific regulations or certifications like AIC is typical. Strong communication, problem-solving abilities, and customer service skills help you resolve issues efficiently and build trust with clients. These competencies are crucial for ensuring accurate claim evaluations, minimizing errors, and providing excellent service in a fast-paced environment.

What is a claim analyst?

A claims analyst works for an insurance company, government agency, or medical billing department. As a claims analyst, your responsibilities include reviewing insurance claims filed by policyholders to ensure they are accurate and complete, that the individual understands their benefits, and that the policies cover the claims. Your duties include monitoring each claim throughout the process, determining reimbursement eligibility, negotiating payments to each party, and following up to ensure the parties make their payments. You then provide documentation and report the necessary information to each party. You are the primary contact for groups and members to answer questions and solve any issues. You may work in a variety of medical and insurance subsets in the claims industry, like dental or vision health, disability, and even construction.

How does a claim analyst typically collaborate with other departments during the claims review process?

Claim Analysts frequently work closely with teams such as underwriting, customer service, and legal to ensure accurate and timely resolution of claims. They often need to clarify policy details with underwriters, gather additional information from customer service representatives, and consult with legal advisors on complex or disputed cases. Effective communication and teamwork are essential, as these collaborations help ensure that claims are processed in compliance with company policies and regulatory requirements. This cross-functional interaction also provides valuable learning opportunities and can support career advancement within the insurance industry.

How much do claim analysts make in the US?

Claim analysts in the US typically earn a median annual salary of around $50,000 to $70,000, depending on experience, location, and industry. Entry-level positions may start lower, while experienced analysts or those with specialized skills can earn higher salaries and bonuses.

What does a claim analyst do?

A claim analyst reviews insurance claims to determine their validity and ensure accurate processing. They analyze documentation, assess coverage, and identify discrepancies, often using specialized software and industry knowledge to make informed decisions. Strong attention to detail and understanding of policy terms are essential for this role.

Is being a claim analyst hard?

Claim analysts review insurance claims to determine coverage and payout amounts, which requires attention to detail, analytical skills, and knowledge of insurance policies. The job can involve repetitive tasks and working under deadlines, but it generally depends on the complexity of claims and the individual's experience. Training and familiarity with claims processing software are also important factors in job difficulty.
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What are popular job titles related to Claim Analyst jobs in WI? For Claim Analyst jobs in WI, the most frequently searched job titles are:
Claim Analyst jobs near you
Infographic showing various Claim Analyst job openings in Wisconsin as of August 2026, with employment types broken down into 96% Full Time, and 4% Contract. Highlights an 88% In-person, and 12% Remote job distribution, with an average salary of $57,507 per year, or $27.6 per hour.

Claims Analyst II

Network Health

Brookfield, WI • On-site, Remote

Full-time

Posted yesterday

New

Job description

Network Health’s success is rooted in its mission to create healthy and strong Wisconsin communities. This mission drives the decisions we make, including the people we choose to join our growing team.

We are seeking a Claims Analyst II to examine and process paper and electronic claims. In this role, you will determine whether to return, pend, deny, or pay claims in accordance with established policies and procedures. Key responsibilities of this position include the following:

  • Adjudicate claims by following departmental policies, operating memos, and corporate guidelines.
  • Resolve claims and related issues in compliance with policy provisions.
  • Compare claims applications and provider statements with policy files and other records to ensure completeness and validity.
  • Process payments for claims that are approved.

This position plays a vital role in ensuring accurate and efficient claims processing, contributing to the overall success of Network Health.
Location: Candidates must reside in the state of Wisconsin for consideration. This position is eligible to work at your home office (reliable internet is required), at our office in Brookfield or Menasha, or a combination of both in our hybrid workplace model.
Hours: 1.0 FTE, 40 hours per week between 8am-5pm Monday through Friday.

Check out our 2025 Community Report to learn a little more about the difference our employees make in the communities we live and work in. As an employee, you will have the opportunity to work hard and have fun while getting paid to volunteer in your local neighborhood. You too, can be part of the team and making a difference. Apply to this position to learn more about our team.

Job Responsibilities:

    • Processes Professional and Facility claims for payment in accordance with members Certificate of Coverage, established medical policies and procedures, and plan benefit interpretation while maintaining a high level of confidentiality.
    • Reviews claims to ensure compliance with proper billing standards and completeness of information. 
    • Obtains additional information from appropriate person and/or agency as needed.  
    • Maintains department quality standards.
    • Maintains established department turn-around processing time. Maintain and/or improves individual production rate standards and department quality standards.
    • Identifies potential coordination of benefits (COB), Workers Compensation, and Subrogation issues and adjudicates claims accordingly.
    • Investigates and resolves pending claims in accordance with established time frames.  Identifies claims needing to be pended or suspended. Reviews pending claims timely and denies claims after established time frame is reached without resolution.
    • Monitors computerized system for claims processing errors and make corrections and/or adjustments as needed.
    • Keeps current on group contracts specifics, provider discounts, percentages and per diems, enrollee certificates and agreements, authorizations and other utilization management policies, etc.
    • Reviews home office claims for payment up to $18,000.00.
    • Reviews claims for re-pricing.  Enters eligible claim data into appropriate WRAP network re-pricing website.  Overrides claims allowed amounts to apply internal/external discounts.
    • Appropriately documents attributes and memos for pertinent information related to claims payment.
    • Processes specialty claims (transplant, URN, COB) to determine appropriate pricing according to external contract.
    • Performs other duties and responsibilities as assigned. 

    Job Requirements:

    • High school diploma or equivalent preferred. 
    • 2-4 years claims processing experience required
    • Knowledge of current procedural terminology (CPT) and international classification of diseases (ICD-9 and ICD-10). Medical terminology, COB processing, subrogation.
    • Past experience using QNXT™ Claims Workflow a plus
    • Prior experience with ACA, Medicaid, or similar health plans preferred.
    • Coding experience preferred.

     

    Network Health is an Equal Opportunity Employer.

    Apply