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Insurance Claims Processing Jobs in Wisconsin (NOW HIRING)

WPS

Foreign Claims Processor

Madison, WI · On-site +1

$18.50/hr

Two (2) or more years of prior health insurance experience, i.e., Claims Processor, Customer ... Service Representative, or Billing Representative preferred. Remote Work Requirements * Wired ...

Sedgwick

Claims Representative, Recovery

Milwaukee, WI · On-site

... Insurance Claims Representative, Recovery PRIMARY PURPOSE OF THE ROLE: Analyzes and processes complex claims, works with high exposure claims involving litigation, and ensures ongoing claims within ...

Sedgwick

Claims Representative, Recovery

Wausau, WI · On-site

... Insurance Claims Representative, Recovery PRIMARY PURPOSE OF THE ROLE: Analyzes and processes complex claims, works with high exposure claims involving litigation, and ensures ongoing claims within ...

Sedgwick

Claims Representative, Recovery

Madison, WI · On-site

... Insurance Claims Representative, Recovery PRIMARY PURPOSE OF THE ROLE: Analyzes and processes complex claims, works with high exposure claims involving litigation, and ensures ongoing claims within ...

CSAA

In order for your application to be correctly processed please sign-in before you apply Internal ... Job Title Commercial Insurance Analyst, Claims Insights - Remote Requisition Number R7770 ...

CSAA

In order for your application to be correctly processed please sign-in before you apply Internal ... Job Title Commercial Insurance Analyst, Claims Insights - Remote Requisition Number R7770 ...

CSAA

In order for your application to be correctly processed please sign-in before you apply Internal ... Job Title Commercial Insurance Analyst, Claims Insights - Remote Requisition Number R7770 ...

CSAA

In order for your application to be correctly processed please sign-in before you apply Internal ... Job Title Commercial Insurance Analyst, Claims Insights - Remote Requisition Number R7770 ...

Acrisure

Claims Specialist

Middleton, WI

$50K - $55K/yr

Prior claims or insurance experience is beneficial, but not required. Acrisure is open to training ... claims process * Maintain accurate and timely documentation within the claims management system

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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?

AspectInsurance Claims ProcessingInsurance Adjuster
CredentialsTypically requires a high school diploma or equivalent; certifications like CPCU or AIC are commonRequires a high school diploma; certifications like AIC or state licensing often needed
Work EnvironmentOffice-based, processing claims via computer systemsField and office work, inspecting damages and interviewing claimants
Employer & Industry UsageInsurance companies, third-party administratorsInsurance companies, independent adjusting firms
Primary FocusReviewing and processing insurance claims efficientlyAssessing 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:
Insurance Claims Processing jobs near you
Infographic showing various Insurance Claims Processing job openings in Wisconsin as of June 2026, with employment types broken down into 91% Full Time, 1% Part Time, and 8% Contract. Highlights an 91% Physical, 2% Hybrid, and 7% Remote job distribution.
Foreign Claims Processor

Foreign Claims Processor

WPS

Madison, WI • On-site, Remote

$18.50/hr

Full-time

Medical, Dental, Retirement, PTO

Posted 7 days ago

Job description

Role Snapshot
Process all MVH overseas claims from receipt through resolution in accordance with MVH regulations, guidelines, and quality standards, with expertise in coordination of benefits (COB), DEERS eligibility, and claims development.
Additional Details
  • Start Date: Tuesday August 11
  • Starting Base Salary: starting at $18.50/hour (may fluctuate with experience)
  • Training Schedule: 8:00am-4:35pm CST Monday-Friday (4 weeks)
  • Scheduled Shift: Flexible schedule once metrics have been obtained, 8-hours shifts between 6am-10pm CST
    • During Probationary Period: 8:00-4:35pm CST Mon-Fri

Work Location
We are open to remote work in the following approved states (training will also be remote):
Colorado, Florida, Georgia, Illinois, Indiana, Iowa, Michigan, Minnesota, Missouri, Nebraska, New Jersey, North Carolina, Ohio, South Carolina, Texas, Virginia, Wisconsin
How do I know this opportunity is right for me? If you enjoy the following:
  • Process all MH overseas claim types by determining corrective action to be taken on various types of errors pended by edit system and resolving interactive edits.
  • Translate, research, and verify claims information to determine if all requirements have been met.
  • Review submitted claim information and select correct procedure code and diagnosis code using ICD-9, ICD-10, CPT4, and HCPCS manuals.
  • Obtain development information from external contacts and add successful development information to notepad via PC.
  • Access patient/sponsor files and update information accordingly.

Minimum Qualifications
  • High School Diploma or GED or equivalent experience.
  • U.S. citizenship is required for this position due to Department of Defense restrictions
  • One (1) or more years of experience in a claims processing role.
  • Demonstrated proficiency in data entry with a strong ability to maintain focus and accuracy.
  • Ability to effectively utilize available resources to further research and verify claims.
  • Strong written communication skills.
  • Demonstrates the ability to work independently and take initiative.

Preferred Qualifications
  • Ability to translate a foreign language.
  • Two (2) or more years of prior health insurance experience, i.e., Claims Processor, Customer Service Representative, or Billing Representative preferred.

Remote Work Requirements
  • Wired (ethernet cable) internet connection from your router to your computer.
  • High speed cable or fiber
  • Minimum of 10 Mbps downstream and at least 1 Mbps upstream internet connection (can be checked at https://speedtest.net).
  • Please review Remote Worker FAQs for additional information.

Benefits
  • Remote work available
  • Performance bonus and/or merit increase opportunities
  • 401(k) with a 100% match for the first 3% of your salary and a 50% match for the next 2% of your salary (100% vested immediately)
  • Competitive paid time off
  • Health insurance, dental insurance, and telehealth services start DAY 1
  • Professional and Leadership Development Programs
  • Review additional benefits: (https://www.wpshealthsolutions.com/careers/)

Who We Are
WPS, a health solutions company, is a leading not-for-profit health insurer and federal government contractor headquartered in Madison, Wisconsin. WPS offers health insurance plans for individuals, families, seniors and group health plans for small to large businesses. We process claims and provide customer support for beneficiaries of the Medicare program and manage benefits for millions of active-duty and retired military personnel across the U.S. and abroad. WPS has been making healthcare easier for the people we serve for nearly 80 years. Proud to be military and veteran ready.
Culture Drives Our Success
WPS' culture is where the great work and innovations of our people are seen, fueled and rewarded. We accomplish this by creating an open and empowering employee experience. We recognize the benefits of employee engagement as an investment in our workforce-both current and future-to effectively seek, leverage, and include differing and unique perspectives that fuel agility and innovation on high-performing teams. This results in people bringing their authentic selves to work every day in an organization that successfully adapts to business changes and new opportunities.
We are proud of the recognition we have received from local and national organization regarding our culture and workplace: WPS Newsroom - Awards and Recognition.
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TRICARE (MVH)
This position supports services under U.S. Department of Defense (DoD) Defense Health Agency (DHA) contract(s). As such, the role is subject to all applicable federal regulations, DoD contract requirements, and WPS internal policies, including but not limited to standards for data security, privacy, confidentiality, and program integrity. DoD contractors and their personnel are subject to screening and background investigation prior to being granted access to information systems and/or sensitive data to safeguard government resources that provide critical services.
Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities
This employer is required to notify all applicants of their rights pursuant to federal employment laws.
For further information, please review the Know Your Rights notice from the Department of Labor.

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