Manager, Claims
Marshfield, WI · Remote
... health insurance claims submitted by providers and patients for processing. Responsible for the implementation and day-to-day performance of process activities related to claims research and ...
Manager, Claims
Marshfield, WI · Remote
... health insurance claims submitted by providers and patients for processing. Responsible for the implementation and day-to-day performance of process activities related to claims research and ...
Insurance Claims Specialist
Middleton, WI · On-site
$50K - $60K/yr
... the claims process * Review claim documentation, medical records, and supporting materials to ... Comprehensive medical insurance, dental insurance, and vision insurance; life and disability ...
Insurance Claims Specialist
Middleton, WI · On-site
$50K - $60K/yr
... the claims process * Review claim documentation, medical records, and supporting materials to ... Comprehensive medical insurance, dental insurance, and vision insurance; life and disability ...
Insurance Claims Specialist
Middleton, WI · On-site
$50K - $60K/yr
... the claims process * Review claim documentation, medical records, and supporting materials to ... Comprehensive medical insurance, dental insurance, and vision insurance; life and disability ...
Insurance Claims Specialist
Middleton, WI · On-site
$50K - $60K/yr
... the claims process * Review claim documentation, medical records, and supporting materials to ... Comprehensive medical insurance, dental insurance, and vision insurance; life and disability ...
Level II Level III 1 Analyzes and processes minimum of 200 claims daily to determine plan liability ... Life insurance * 401k with match
Level II Level III 1 Analyzes and processes minimum of 200 claims daily to determine plan liability ... Life insurance * 401k with match
Insurance Claims Examiner II
WI · On-site
Level II Level III 1 Analyzes and processes minimum of 200 claims daily to determine plan liability ... Insurance Marketplace CAC Provides training and guidance through expert knowledge of claims ...
Insurance Claims Examiner II
WI · On-site
Level II Level III 1 Analyzes and processes minimum of 200 claims daily to determine plan liability ... Insurance Marketplace CAC Provides training and guidance through expert knowledge of claims ...
Claims Analyst
Pewaukee, WI · On-site
$21.83/hr
Vision insurance Claims Analyst The Claims Analyst is responsible for the accurate and timely processing of medical, dental, and vision claims in accordance with plan provisions, policies, and ...
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Claims Analyst
Pewaukee, WI · On-site
$21.83/hr
Vision insurance Claims Analyst The Claims Analyst is responsible for the accurate and timely processing of medical, dental, and vision claims in accordance with plan provisions, policies, and ...
For too long, travel insurance has centered on the company and not the traveler. We're changing ... Process invoices through cost-containment networks * Maintain clear, timely updates to customers ...
For too long, travel insurance has centered on the company and not the traveler. We're changing ... Process invoices through cost-containment networks * Maintain clear, timely updates to customers ...
Claims Adjuster
Stevens Point, WI · On-site
For too long, travel insurance has centered on the company and not the traveler. We're changing ... Process invoices through cost-containment networks * Maintain clear, timely updates to customers ...
Claims Adjuster
Stevens Point, WI · On-site
For too long, travel insurance has centered on the company and not the traveler. We're changing ... Process invoices through cost-containment networks * Maintain clear, timely updates to customers ...
Claims Coordinator
New Holstein, WI · On-site
$19 - $22/hr
A Claims Coordinator manages the insurance claims process from start to finish. They submit claims, track progress with adjusters, keep accurate records, and update clients. They act as the main ...
Claims Coordinator
New Holstein, WI · On-site
$19 - $22/hr
A Claims Coordinator manages the insurance claims process from start to finish. They submit claims, track progress with adjusters, keep accurate records, and update clients. They act as the main ...
Claims Coordinator
Merrill, WI · On-site
$19 - $22/hr
A Claims Coordinator manages the insurance claims process from start to finish. They submit claims, track progress with adjusters, keep accurate records, and update clients. They act as the main ...
Claims Coordinator
Merrill, WI · On-site
$19 - $22/hr
A Claims Coordinator manages the insurance claims process from start to finish. They submit claims, track progress with adjusters, keep accurate records, and update clients. They act as the main ...
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Claims Specialist - Employee Benefits
Hartland, WI · On-site
$23 - $25/hr
Previous experience in claims processing, payroll, banking or insurance environment is required. * Minimum of two years of experience in a professional work environment working directly with ...
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Claims Specialist - Employee Benefits
Hartland, WI · On-site
$23 - $25/hr
Previous experience in claims processing, payroll, banking or insurance environment is required. * Minimum of two years of experience in a professional work environment working directly with ...
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Claims Specialist - Employee Benefits
Waukesha, WI · On-site
$23 - $25/hr
Previous experience in claims processing, payroll, banking or insurance environment is required. * Minimum of two years of experience in a professional work environment working directly with ...
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Claims Specialist - Employee Benefits
Waukesha, WI · On-site
$23 - $25/hr
Previous experience in claims processing, payroll, banking or insurance environment is required. * Minimum of two years of experience in a professional work environment working directly with ...
ManhattanLife is seeking an Insurance Claims Supervisor for our Voluntary Benefits Division. As a ... Provide insights and recommendations for enhancements to claim processes, training procedures ...
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ManhattanLife is seeking an Insurance Claims Supervisor for our Voluntary Benefits Division. As a ... Provide insights and recommendations for enhancements to claim processes, training procedures ...
ManhattanLife is seeking an Insurance Claims Supervisor for our Voluntary Benefits Division. As a ... Provide insights and recommendations for enhancements to claim processes, training procedures ...
Quick apply
ManhattanLife is seeking an Insurance Claims Supervisor for our Voluntary Benefits Division. As a ... Provide insights and recommendations for enhancements to claim processes, training procedures ...
... insurance, managed care programs, claims processing (preferably Medicaid and Medicare claims), and knowledge of billing codes (CPT, ICD-9, HCPCS, RUGS, CMS and DRG pricing). A combination of ...
... insurance, managed care programs, claims processing (preferably Medicaid and Medicare claims), and knowledge of billing codes (CPT, ICD-9, HCPCS, RUGS, CMS and DRG pricing). A combination of ...
Claims Account Specialist
Hartland, WI · On-site
$23 - $25/hr
Insurance claims processing * TPA or carrier environments If you're accustomed to handling financial transactions, reviewing documentation for accuracy, meeting processing deadlines, and maintaining ...
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Claims Account Specialist
Hartland, WI · On-site
$23 - $25/hr
Insurance claims processing * TPA or carrier environments If you're accustomed to handling financial transactions, reviewing documentation for accuracy, meeting processing deadlines, and maintaining ...
Claims Account Specialist
Hartland, WI · On-site
$23 - $25/hr
Insurance claims processing * TPA or carrier environments If you're accustomed to handling financial transactions, reviewing documentation for accuracy, meeting processing deadlines, and maintaining ...
Claims Account Specialist
Hartland, WI · On-site
$23 - $25/hr
Insurance claims processing * TPA or carrier environments If you're accustomed to handling financial transactions, reviewing documentation for accuracy, meeting processing deadlines, and maintaining ...
Customer Claims Specialist
Madison, WI · On-site
$25/hr
Your job isn't just about processing claims - it's about protecting our reputation, living out our ... Experience in the moving industry , insurance claims, or household goods logistics * Familiarity ...
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Customer Claims Specialist
Madison, WI · On-site
$25/hr
Your job isn't just about processing claims - it's about protecting our reputation, living out our ... Experience in the moving industry , insurance claims, or household goods logistics * Familiarity ...
Claims Specialist
De Pere, WI · On-site
Process insurance claims with adherence to company policies and contract provisions in full accordance with the law. * Make decisions and ensure the successful resolution of inquiries and complaints ...
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Claims Specialist
De Pere, WI · On-site
Process insurance claims with adherence to company policies and contract provisions in full accordance with the law. * Make decisions and ensure the successful resolution of inquiries and complaints ...
Customer Claims Specialist
Madison, WI · On-site
$25/hr
Your job isn't just about processing claims - it's about protecting our reputation, living out our ... Experience in the moving industry , insurance claims, or household goods logistics * Familiarity ...
Quick apply
Customer Claims Specialist
Madison, WI · On-site
$25/hr
Your job isn't just about processing claims - it's about protecting our reputation, living out our ... Experience in the moving industry , insurance claims, or household goods logistics * Familiarity ...
Insurance Claims Processing information
Is claims processing a stressful job?
Insurance claims processing can be stressful due to tight deadlines, high workload, and the need for accuracy in evaluating claims. The role often requires strong attention to detail, communication skills, and the ability to handle difficult or emotional situations with claimants. However, workload and stress levels can vary depending on the employer and specific job environment.
What is insurance claims processing?
Insurance claims processing is the procedure by which insurance companies review, investigate, and settle claims made by policyholders. This process involves verifying the details of a claim, ensuring it meets the terms of the policy, and determining the appropriate payout or action. Claims processors handle documentation, communicate with claimants, and may work with other parties like adjusters or healthcare providers. The goal is to ensure claims are resolved efficiently, accurately, and fairly according to policy guidelines.
What are some common challenges faced in insurance claims processing, and how can new team members effectively manage them?
In insurance claims processing, new team members often encounter challenges such as handling high volumes of claims, interpreting complex policy language, and communicating effectively with policyholders and other stakeholders. To manage these challenges, it's important to develop strong organizational skills, stay detail-oriented, and proactively seek clarification when unsure about policy terms or procedures. Collaborating with experienced colleagues and taking advantage of ongoing training opportunities can also help new processors build confidence and efficiency in their daily tasks.
How to get a job as a claims adjuster with no experience?
To become a claims adjuster with no experience, focus on obtaining relevant certifications such as the Property and Casualty (P&C) license, which is often required. Gaining entry-level positions or internships in insurance companies can also help build industry knowledge and skills like communication and attention to detail, increasing your chances of starting a claims adjusting career.
What is the difference between Insurance Claims Processing vs Insurance Adjuster?
| Aspect | Insurance Claims Processing | Insurance Adjuster |
|---|---|---|
| Credentials | Typically requires a high school diploma or equivalent; certifications like CPCU or AIC are common | Requires a high school diploma; certifications like AIC or state licensing often needed |
| Work Environment | Office-based, processing claims via computer systems | Field and office work, inspecting damages and interviewing claimants |
| Employer & Industry Usage | Insurance companies, third-party administrators | Insurance companies, independent adjusting firms |
| Primary Focus | Reviewing and processing insurance claims efficiently | Assessing damages and determining claim validity and payout |
While both roles are essential in the insurance industry, Insurance Claims Processing focuses on handling and managing claims paperwork, whereas Insurance Adjusters evaluate damages and determine claim settlements. Understanding these differences helps job seekers identify the right career path within the insurance sector.
What are the key skills and qualifications needed to thrive in Insurance Claims Processing, and why are they important?
To excel in Insurance Claims Processing, you need strong attention to detail, analytical abilities, and a foundational understanding of insurance policies or claims procedures, often supported by a high school diploma or associate degree. Familiarity with claims management software, databases, and sometimes industry certifications like AIC (Associate in Claims) is common. Effective communication, problem-solving skills, and the ability to manage stressful situations make someone stand out in this role. These competencies are critical for ensuring claims are processed accurately, efficiently, and in compliance with regulatory standards.
What does an insurance claims processor do?
An insurance claims processor reviews and evaluates insurance claims to determine coverage and payout amounts. They verify policy details, gather necessary documentation, and ensure claims are processed accurately and efficiently, often using specialized software. Strong attention to detail and knowledge of insurance policies are essential for this role.
What are popular job titles related to Insurance Claims Processing jobs in Wisconsin? For Insurance Claims Processing jobs in Wisconsin, the most frequently searched job titles are:
What job categories do people searching Insurance Claims Processing jobs in Wisconsin look for? The top searched job categories for Insurance Claims Processing jobs in Wisconsin are:
What cities in Wisconsin are hiring for Insurance Claims Processing jobs? Cities in Wisconsin with the most Insurance Claims Processing job openings:
Sanford Health rating
6.8
Based on 529 frontline employees who took The Breakroom Quiz
483rd of 877 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