Manager, Claims
Marshfield, WI · Remote
The process includes the review and/or testing of claims, benefits and fee schedules to ensure claims process correctly. Accountable as a resource to all employees in the claims department as well as ...
Manager, Claims
Marshfield, WI · Remote
The process includes the review and/or testing of claims, benefits and fee schedules to ensure claims process correctly. Accountable as a resource to all employees in the claims department as well as ...
The manager must empower staff in meeting performance objectives and provide accurate and timely claims processing in accordance with State and Federal regulations. This position reports directly to ...
The manager must empower staff in meeting performance objectives and provide accurate and timely claims processing in accordance with State and Federal regulations. This position reports directly to ...
Insurance Claims Examiner II
Crandon, WI · On-site
Level II Level III 1 Analyzes and processes minimum of 200 claims daily to determine plan liability; reviews payment Purchased Referred Care, medical, dental and vision claims Analyzes and processes ...
Insurance Claims Examiner II
Crandon, WI · On-site
Level II Level III 1 Analyzes and processes minimum of 200 claims daily to determine plan liability; reviews payment Purchased Referred Care, medical, dental and vision claims Analyzes and processes ...
Insurance Claims Examiner II
WI · On-site
Level II Level III 1 Analyzes and processes minimum of 200 claims daily to determine plan liability; reviews payment Purchased Referred Care, medical, dental and vision claims Analyzes and processes ...
Insurance Claims Examiner II
WI · On-site
Level II Level III 1 Analyzes and processes minimum of 200 claims daily to determine plan liability; reviews payment Purchased Referred Care, medical, dental and vision claims Analyzes and processes ...
Director, Claims Operations
Madison, WI · On-site
$113K - $194K/yr
Provide end-to-end oversight of claims processing from intake through adjudication and payment * Own performance management across daily, monthly, and quarterly KPIs, ensuring controls and actions ...
Director, Claims Operations
Madison, WI · On-site
$113K - $194K/yr
Provide end-to-end oversight of claims processing from intake through adjudication and payment * Own performance management across daily, monthly, and quarterly KPIs, ensuring controls and actions ...
Director, Claims Operations
Madison, WI · On-site
$113K - $194K/yr
Provide end-to-end oversight of claims processing from intake through adjudication and payment * Own performance management across daily, monthly, and quarterly KPIs, ensuring controls and actions ...
Director, Claims Operations
Madison, WI · On-site
$113K - $194K/yr
Provide end-to-end oversight of claims processing from intake through adjudication and payment * Own performance management across daily, monthly, and quarterly KPIs, ensuring controls and actions ...
Director, Claims Operations
Madison, WI · On-site
$113K - $194K/yr
Provide end-to-end oversight of claims processing from intake through adjudication and payment * Own performance management across daily, monthly, and quarterly KPIs, ensuring controls and actions ...
Director, Claims Operations
Madison, WI · On-site
$113K - $194K/yr
Provide end-to-end oversight of claims processing from intake through adjudication and payment * Own performance management across daily, monthly, and quarterly KPIs, ensuring controls and actions ...
Claims Specialist (Full Time)
Eau Claire, WI · On-site
$20/hr
Responsibilities * Follow up on unpaid claims, process denials, researching payer trends * Review under and overpayments using clearinghouse to find variances, work claim source rejections, and send ...
Quick apply
Claims Specialist (Full Time)
Eau Claire, WI · On-site
$20/hr
Responsibilities * Follow up on unpaid claims, process denials, researching payer trends * Review under and overpayments using clearinghouse to find variances, work claim source rejections, and send ...
Claims Adjuster
Stevens Point, WI · On-site
Process invoices through cost-containment networks * Maintain clear, timely updates to customers, providers, and partners on claim status * Document thoroughly in the claims system and ensure ...
Claims Adjuster
Stevens Point, WI · On-site
Process invoices through cost-containment networks * Maintain clear, timely updates to customers, providers, and partners on claim status * Document thoroughly in the claims system and ensure ...
Process invoices through cost-containment networks * Maintain clear, timely updates to customers, providers, and partners on claim status * Document thoroughly in the claims system and ensure ...
Process invoices through cost-containment networks * Maintain clear, timely updates to customers, providers, and partners on claim status * Document thoroughly in the claims system and ensure ...
Claims Supervisor
Waukesha, WI · Remote
$73K - $113K/yr
Assists Claims Manager with recruitment, interviewing, and onboarding new staff, ensuring ... process taking into consideration experience, qualifications, and overall fit for the role. The ...
Quick apply
Claims Supervisor
Waukesha, WI · Remote
$73K - $113K/yr
Assists Claims Manager with recruitment, interviewing, and onboarding new staff, ensuring ... process taking into consideration experience, qualifications, and overall fit for the role. The ...
Senior Claims Advisor
Hartland, WI · On-site
This individual is central to both the proactive and reactive claims processes and serves as a trusted advisor and subject matter expert across the organization WHY JOIN VIZANCE? Vizance has nearly ...
Senior Claims Advisor
Hartland, WI · On-site
This individual is central to both the proactive and reactive claims processes and serves as a trusted advisor and subject matter expert across the organization WHY JOIN VIZANCE? Vizance has nearly ...
Be Seen First
Includes a high volume of claims processing, issuance of reimbursements, plan changes, status changes, enrollments, responding to client and participant inquiries, plan set-up in administration ...
Quick apply
Be Seen First
Includes a high volume of claims processing, issuance of reimbursements, plan changes, status changes, enrollments, responding to client and participant inquiries, plan set-up in administration ...
Be Seen First
Claims Account Specialist - Employee Benefits
Waukesha, WI · On-site
$23 - $25/hr
Includes a high volume of claims processing, issuance of reimbursements, plan changes, status changes, enrollments, responding to client and participant inquiries, plan set-up in administration ...
Quick apply
Be Seen First
Claims Account Specialist - Employee Benefits
Waukesha, WI · On-site
$23 - $25/hr
Includes a high volume of claims processing, issuance of reimbursements, plan changes, status changes, enrollments, responding to client and participant inquiries, plan set-up in administration ...
This individual is central to both the proactive and reactive claims processes and serves as a trusted advisor and subject matter expert across the organization WHY JOIN VIZANCE? Vizance has nearly ...
This individual is central to both the proactive and reactive claims processes and serves as a trusted advisor and subject matter expert across the organization WHY JOIN VIZANCE? Vizance has nearly ...
Senior Claims Advisor
Hartland, WI · On-site
This individual is central to both the proactive and reactive claims processes and serves as a trusted advisor and subject matter expert across the organization WHY JOIN VIZANCE? Vizance has nearly ...
Quick apply
Senior Claims Advisor
Hartland, WI · On-site
This individual is central to both the proactive and reactive claims processes and serves as a trusted advisor and subject matter expert across the organization WHY JOIN VIZANCE? Vizance has nearly ...
Be Seen First
Includes a high volume of claims processing, issuance of reimbursements, plan changes, status changes, enrollments, responding to client and participant inquiries, plan set-up in administration ...
Quick apply
Be Seen First
Includes a high volume of claims processing, issuance of reimbursements, plan changes, status changes, enrollments, responding to client and participant inquiries, plan set-up in administration ...
Claims Analyst II
Menasha, WI · On-site +1
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:
Claims Analyst II
Menasha, WI · On-site +1
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:
Claims Analyst II
Menasha, WI · On-site +1
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:
Claims Analyst II
Menasha, WI · On-site +1
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:
Claims Analyst II
Brookfield, WI · On-site +1
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:
Claims Analyst II
Brookfield, WI · On-site +1
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:
Claims Processor information
See Wisconsin salary details
$12.13 - $13.46
2% of jobs
$13.46 - $14.78
6% of jobs
$14.78 - $16.10
9% of jobs
$16.79 is the 25th percentile. Wages below this are outliers.
$16.10 - $17.43
14% of jobs
$17.43 - $18.75
18% of jobs
The median wage is $18.79 / hr.
$18.75 - $20.07
17% of jobs
$20.80 is the 75th percentile. Wages above this are outliers.
$20.07 - $21.40
16% of jobs
$21.40 - $22.72
7% of jobs
$22.72 - $24.04
4% of jobs
$24.04 - $25.37
4% of jobs
$25.37 - $26.69
2% of jobs
$12
$19
$26
How much do claims processor jobs pay per hour?
As of Aug 16, 2026, the average hourly pay for claims processor in Wisconsin is $19.34, according to ZipRecruiter salary data. Most workers in this role earn between $16.49 and $20.87 per hour, depending on experience, location, and employer.
What is a claims processor?
A claims processor reviews insurance claims. Their responsibilities include verifying insurance policy coverage and making sure client information is accurate. After they determine there is a covered loss, a processor documents the information and makes sure all the required paperwork is complete. Other duties include modifying new or existing policies.
What are some common challenges faced by claims processors, and how can they be managed effectively?
Claims Processors often encounter challenges such as managing high volumes of claims, handling complex or incomplete documentation, and meeting strict accuracy and timeliness standards. To navigate these, strong organizational skills, effective communication with colleagues and claimants, and attention to detail are crucial. Utilizing workflow management tools and maintaining open channels with supervisors and other departments can help address issues quickly and ensure claims are processed efficiently. Regular training and staying updated on policy changes also support success in this role.
Is claims processing a stressful job?
Claims processing is often considered a routine administrative role that involves reviewing and verifying insurance claims. While it can involve tight deadlines and attention to detail, the level of stress varies depending on workload, workplace environment, and individual coping skills.
What is the difference between Claims Processor vs Claims Examiner?
| Aspect | Claims Processor | Claims Examiner |
|---|---|---|
| Required Credentials | High school diploma or equivalent; some roles may require certification | High school diploma; certification often preferred |
| Work Environment | Office setting, processing claims efficiently | Office setting, reviewing and approving claims |
| Employer & Industry Usage | Insurance companies, healthcare providers | Insurance companies, government agencies |
| Common Search & Comparison | Claims Processor vs Claims Examiner |
Claims Processors primarily handle the data entry and initial processing of insurance claims, focusing on accuracy and efficiency. Claims Examiners review claims for validity, compliance, and coverage before approval. While both roles work within the insurance industry and require similar credentials, Claims Examiners typically perform more detailed reviews and decision-making tasks. Understanding these differences helps job seekers identify the right role based on their skills and career goals.
What are the key skills and qualifications needed to thrive as a claims processor?
To thrive as a Claims Processor, you need strong analytical abilities, attention to detail, and knowledge of insurance policies, typically supported by a high school diploma or associate degree. Familiarity with claims management software, data entry systems, and sometimes industry certifications like AIC (Associate in Claims) is valuable. Excellent organization, communication, and customer service skills help you efficiently resolve claims and interact with clients. These competencies ensure accuracy, minimize errors, and maintain trust in the claims process.
Do you need a degree to be a claims processor?
A claims processor typically does not need a college degree, but employers often prefer candidates with a high school diploma or equivalent. Relevant skills include attention to detail, communication, and familiarity with claims processing software, and some positions may offer on-the-job training or certification programs.
What does a claims processor do?
A Claims Processor is responsible for reviewing, evaluating, and processing insurance claims submitted by policyholders. They verify the accuracy of the information provided, ensure all required documentation is present, and determine if the claim meets the policy's terms and conditions. Claims Processors work with both customers and insurance adjusters to resolve any discrepancies and help facilitate timely payments. Their role is essential in ensuring that claims are handled efficiently and fairly.
More about Claims Processor jobs
What are the most commonly searched types of Claims Processor jobs in Wisconsin?
The most popular types of Claims Processor jobs in Wisconsin are:
What are popular job titles related to Claims Processor jobs in Wisconsin?
For Claims Processor jobs in Wisconsin, the most frequently searched job titles are:
What job categories do people searching Claims Processor jobs in Wisconsin look for?
The top searched job categories for Claims Processor jobs in Wisconsin are:
What cities in Wisconsin are hiring for Claims Processor jobs?
Cities in Wisconsin with the most Claims Processor job openings:
What are popular job titles related to Claims Processor jobs in WI?
For Claims Processor jobs in WI, the most frequently searched job titles are:
Sanford Health rating
6.8
Based on 549 frontline employees who took The Breakroom Quiz
495th of 887 rated healthcare providers
Job description
Sanford Health, the largest rural health system in the United States, is dedicated to transforming the health care experience and providing access to world-class health care in America's heartland.
Work Shift:
8 Hours - Day Shifts (United States of America)Scheduled Weekly Hours:
40Compensation:
Union Position:
NoDepartment Details
This position allows some work from home options as well as a flexible scheduleSummary
The Claims Manager is under the general supervision of the Sanford Health Plan Director of Claims, in the areas of health insurance claims submitted by providers and patients for processing.Job Description
Responsible for the implementation and day-to-day performance of process activities related to claims research and resolution. The process includes the review and/or testing of claims, benefits and fee schedules to ensure claims process correctly. Accountable as a resource to all employees in the claims department as well as other departments in the organization. Responsible for the interviewing, hiring, discipline of employees and any other personnel issues that arise. Completes performance appraisals. Coordinates claims processing and adjustment activities within the claims department. Manages claims inventory, ensuring accurate and timely processing. Knowledge of various lines of business that the Sanford Health Plan services and how to differentiate services. Understands the details of professional and institutional claim processing which includes how benefits are assigned and pricing is calculated. Works to help develop and maintain claims policies and procedures. Must communicate effectively with a high level of diplomacy. Demonstrates analytical ability and a good awareness of pertinent details. Assimilates large amounts of information to maintain a broad knowledge base. Exercises good judgement in determining the best method for handling a variety of situations. Maintains good working relationships with staff, physicians, and enrollees. Handles pressure effectively. Maintains confidentiality. Other duties as assigned.Qualifications
Bachelor's degree preferred.Three years in a team lead or management role in claims processing or similar environment required.
Sanford is an EEO/AA Employer M/F/Disability/Vet.
If you are an individual with a disability and would like to request an accommodation for help with your online application, please call 1-877-949-5678 or send an email to talent@sanfordhealth.org.
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About Sanford Health
Sourced by ZipRecruiter
Sanford Health is one of the largest and fastest-growing not-for-profit health systems in the United States. We're proud to offer many development and advancement opportunities to our nearly 50,000 members of the Sanford Family who are dedicated to the work of health and healing across our broad footprint.
Industry
Health care and social assistance and hospitals
Company size
10,000+ Employees
Headquarters location
Sioux Falls, SD, US