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Claim Jobs in Wisconsin (NOW HIRING)

Network Health

Claims Analyst II

Brookfield, WI · On-site +1

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 ...

Network Health, Inc

Claims Analyst II

Menasha, WI · On-site +1

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 ...

Network Health

Claims Analyst II

Menasha, WI · On-site +1

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 ...

Network Health WI

Claims Analyst II

Menasha, WI · On-site

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 ...

Horace Mann

Group Claims Support Specialist

Madison, WI

$21.44 - $29.16/hr

Support Group Claims Examiners by gathering, verifying, and entering claim information into the claims management system. * Prepare, organize, and maintain complete and accurate electronic claim ...

Horace Mann

Group Claims Support Specialist

Madison, WI · On-site

$21.44 - $29.16/hr

Route claim documentation to the appropriate Claims Examiner. * Set up and maintain disability claim records within the paperless claims management system. * Update policy and employer information ...

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Showing results 21-40

All JobsClaim JobsClaim Jobs in Wisconsin

Claim information

See Wisconsin salary details

$14

$21

$28

How much do claim jobs pay per hour?

As of Aug 18, 2026, the average hourly pay for claim in Wisconsin is $21.25, according to ZipRecruiter salary data. Most workers in this role earn between $18.17 and $23.03 per hour, depending on experience, location, and employer.

What is a claim?

Claims are formal requests made by policyholders to an insurance company for coverage or compensation for a covered loss or policy event. When an insured event occurs, such as an accident or damage, the policyholder submits a claim to the insurer, who then evaluates it to determine if the loss is covered under the policy and the amount to be paid. The claims process involves documentation, assessment, and often interaction with claims adjusters. The goal is to help the insured recover from their loss as outlined in the insurance agreement.

What are the key skills and qualifications needed to thrive as a claims adjuster, and why are they important?

To thrive as a Claims Adjuster, you need analytical skills, attention to detail, and knowledge of insurance policies, typically supported by a bachelor's degree or relevant experience. Familiarity with claims management software, estimating tools, and sometimes industry certifications like AIC (Associate in Claims) is important. Strong negotiation, communication, and customer service skills help manage claimants' expectations and resolve disputes effectively. These abilities ensure accurate claim assessments, regulatory compliance, and a positive customer experience.

What are some common challenges faced by claims professionals and how can they be effectively managed?

Claims professionals often encounter challenges such as interpreting complex policy language, managing high caseloads, and addressing customer concerns during stressful situations. Staying organized, maintaining clear communication with all parties, and leveraging technology for tracking claims can help manage these challenges. Additionally, collaborating closely with underwriters, legal teams, and customers ensures accuracy and efficiency throughout the claims process.

What is the difference between Claim vs Adjuster?

AspectClaimAdjuster
CredentialsMay require basic insurance knowledge, certifications varyOften requires licensing and specific insurance adjuster certifications
Work EnvironmentTypically involves submitting claims, customer service, administrative tasksInvolves investigating, evaluating, and settling insurance claims
Industry UsageUsed across insurance sectors for filing claimsUsed for assessing and settling claims in insurance companies
Search/Comparison IntentPeople compare Claim roles to understand filing processesPeople compare Adjuster roles to understand claim evaluation

In summary, a Claim generally refers to the process of submitting an insurance request, while an Adjuster is responsible for investigating and evaluating those claims to determine coverage and settlement. Both roles are integral to the insurance industry but focus on different stages of the claims process.

What is a job in claims?

A job in claims involves reviewing, investigating, and processing insurance claims to determine coverage and payout eligibility. Claims professionals often analyze documentation, communicate with clients and providers, and use specialized software to ensure accurate and efficient claim handling.

What are the most commonly searched types of Claim jobs in Wisconsin?

The most popular types of Claim jobs in Wisconsin are:

What are popular job titles related to Claim jobs in Wisconsin?

For Claim jobs in Wisconsin, the most frequently searched job titles are:

What job categories do people searching Claim jobs in Wisconsin look for?

The top searched job categories for Claim jobs in Wisconsin are:

What cities in Wisconsin are hiring for Claim jobs?

Cities in Wisconsin with the most Claim job openings:

Claim jobs near you
Infographic showing various Claim job openings in Wisconsin as of August 2026, with employment types broken down into 81% Full Time, 17% Part Time, and 2% Contract. Highlights an 81% Physical, 6% Hybrid, and 13% Remote job distribution, with an average salary of $44,193 per year, or $21.2 per hour.

Claims Analyst II

Network Health

Brookfield, WI • On-site, Remote

Full-time

Posted 11 days ago

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.

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