ZipRecruiter

Log In

1

Home Based Subrogation Analyst Jobs in Wisconsin

Network Health

Claims Analyst II

Menasha, WI · On-site +1

This position is eligible to work at your home office (reliable internet is required), at our ... Identifies potential coordination of benefits (COB), Workers Compensation, and Subrogation issues ...

Network Health, Inc

Claims Analyst II

Menasha, WI · On-site +1

This position is eligible to work at your home office (reliable internet is required), at our ... Identifies potential coordination of benefits (COB), Workers Compensation, and Subrogation issues ...

Network Health, Inc

Claims Analyst II

Brookfield, WI · On-site +1

This position is eligible to work at your home office (reliable internet is required), at our ... Identifies potential coordination of benefits (COB), Workers Compensation, and Subrogation issues ...

Network Health

Claims Analyst II

Brookfield, WI · On-site +1

This position is eligible to work at your home office (reliable internet is required), at our ... Identifies potential coordination of benefits (COB), Workers Compensation, and Subrogation issues ...

Network Health WI

Claims Analyst II

Menasha, WI · On-site

This position is eligible to work at your home office (reliable internet is required), at our ... Identifies potential coordination of benefits (COB), Workers Compensation, and Subrogation issues ...

TEKsystems

Claims Analyst

Brookfield, WI · Remote

$19.25/hr

Determine whether claims should be approved, denied, returned, suspended, or pended based on policy ... Subrogation-related claims. * Monitor claims processing systems for errors and make necessary ...

TEKsystems

Claims Analyst

Menasha, WI · Remote

$19.25/hr

Determine whether claims should be approved, denied, returned, suspended, or pended based on policy ... Subrogation-related claims. * Monitor claims processing systems for errors and make necessary ...

thg

Sr Field Adjuster

Milwaukee, WI · On-site

$64K - $85K/yr

Identify and assign subrogation potential appropriately; set up files to support successful ... Makes informed decisions based on thorough analysis of complex issues. Evaluates risks and outcomes ...

thg

Sr Field Adjuster

Madison, WI · On-site

$65K - $87K/yr

Identify and assign subrogation potential appropriately; set up files to support successful ... Makes informed decisions based on thorough analysis of complex issues. Evaluates risks and outcomes ...

next page

Showing results 1-20

All JobsHome Based Subrogation Analyst JobsHome Based Subrogation Analyst Jobs in Wisconsin

Home Based Subrogation Analyst information

What is the difference between Home Based Subrogation Analyst vs Home Based Claims Adjuster?

AspectHome Based Subrogation AnalystHome Based Claims Adjuster
Required CredentialsInsurance license, claims or subrogation certificationInsurance license, claims adjusting certification
Work EnvironmentRemote, office-based, independent investigationRemote, field visits, client communication
Employer & Industry UsageInsurance companies, third-party administratorsInsurance companies, public adjusting firms
Common Search & ComparisonYesYes

The main difference is that a Home Based Subrogation Analyst focuses on recovering funds from third parties after a claim, while a Home Based Claims Adjuster handles the initial assessment and settlement of claims. Both roles require insurance credentials and are often remote, but their responsibilities differ in scope and focus.

What are popular job titles related to Home Based Subrogation Analyst jobs in Wisconsin?

For Home Based Subrogation Analyst jobs in Wisconsin, the most frequently searched job titles are:

What job categories do people searching Home Based Subrogation Analyst jobs in Wisconsin look for?

The top searched job categories for Home Based Subrogation Analyst jobs in Wisconsin are:

What cities in Wisconsin are hiring for Home Based Subrogation Analyst jobs?

Cities in Wisconsin with the most Home Based Subrogation Analyst job openings:

Home Based Subrogation Analyst jobs near you
Infographic showing various Home Based Subrogation Analyst job openings in Wisconsin as of August 2026, with employment types broken down into 1% As Needed, 78% Full Time, 16% Part Time, and 5% Contract. Highlights an 87% Physical, 3% Hybrid, and 10% Remote job distribution.

Claims Analyst II

Network Health

Menasha, WI • On-site, Remote

Full-time

Posted 26 days ago

Network Health rating

7.9

Company rating: 7.9 out of 10

Based on 5 frontline employees who took The Breakroom Quiz

187th of 315 rated insurance

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.

    What Network Health employees say

    Pay

    Hours and flexibility

    Workplace

    Get the full story on Breakroom

    Apply