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Insurance Claims Processing Jobs in Gresham, WI (NOW HIRING)

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Insurance Claims Processing information

See Gresham, WI salary details

$11

$20

$31

How much do insurance claims processing jobs pay per hour?

As of Aug 21, 2026, the average hourly pay for insurance claims processing in Gresham, WI is $20.93, according to ZipRecruiter salary data. Most workers in this role earn between $17.12 and $23.89 per hour, depending on experience, location, and employer.

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 the key skills and qualifications needed to thrive in insurance claims processing?

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 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.

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.

How to get a job as an insurance claims processor?

To become an insurance claims processor, candidates typically need a high school diploma or equivalent, with some roles preferring postsecondary training or certifications in insurance or claims processing. Relevant skills include attention to detail, communication, and familiarity with claims management software. Gaining experience through internships or entry-level positions can improve job prospects, and some employers may require background checks or specific licensing depending on the state or company policies.

Is insurance claims processing a stressful job?

Insurance claims processing can be a stressful job due to tight deadlines, high workload, and the need for accuracy in evaluating claims. It often requires strong attention to detail, communication skills, and the ability to handle difficult customer interactions, which can contribute to job-related stress.

What does an insurance claims processing 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 claims management software. Attention to detail and knowledge of insurance policies are essential for this role.

What cities near Gresham, WI are hiring for Insurance Claims Processing jobs?

Cities near Gresham, WI with the most Insurance Claims Processing job openings:

Insurance Claims Processing jobs near you
Infographic showing various Insurance Claims Processing job openings in Gresham, WI as of August 2026, with employment types broken down into 1% As Needed, 74% Full Time, 21% Part Time, and 4% Contract. Highlights an 91% Physical, 1% Hybrid, and 8% Remote job distribution, with an average salary of $43,543 per year, or $20.9 per hour.

Patient Accounts Specialist

Midline Vision Group LLC

Wausau, WI • On-site

$19 - $21/hr

Full-time

Medical, Dental, Vision, Retirement, PTO

Re-posted 12 days ago

Job description

Patient Accounts SpecialistAre you self-motivated, accountable, and great at managing detailed processes? Consider working with us at Midline Vision! Our practice group owns and operates multiple optometry offices throughout Wisconsin, and we're seeking a Patient Accounts Specialist to help us maximize our revenue flow. The best candidate will be excited about finding efficiencies, following and improving best-practice processes for a centralized billing department, and helping the business grow.GENERAL FUNCTION:Within our Central Billing Department, a Patient Accounts Specialist is responsible for insurance verification, claims editing, payment posting, credit review, and managing denials and no-responses. The person in this role will answer inquiries by phone, email, and paper mail from patients, and then take appropriate actions to resolve their questions and concerns.This position works closely with patients, our Central Billing Manager, and with staff in each of our locations to provide an excellent eye care experience through accurate, professional, and timely communication about patients' insurance eligibility and payment status.MAJOR DUTIES & RESPONSIBILITIES:Support in-store staff through the proper verification of insurance and billing of patients and insurance companies.Patient billing responsibilities include sending statements, payment posting, and credit review.Adds insurance carrier and plan information to patient charts with accurate information needed for processing of claims.Reviews claims for errors prior to sending to the insurance companies. Edits claims as needed to ensure proper pricing and coding.Adheres to timely filing requirements.Investigates credit balances on insurance and/or patient accounts and resolves discrepancies.Researches claims that have been denied by the insurance companies and takes action to resolve for correct processing.Files appeals and corrected claims as needed.Follow the workflow of patient billing and insurance claims posting and reconciliation.File all types of insurance claims and post payments.Manage the accounts receivables list and follow up on unpaid claims.Perform provider insurance credentialing to the appropriate carriers.Develop working relationships with insurance companies, research issues as needed, staying informed of and communicating to the team about any changes with carrier rules.KNOWLEDGE & SKILLS:Understanding of vision and medical terminology.Ability to provide enthusiastic and concise communication to meet/exceed patient and coworker expectations.Develops and maintains positive working relationships with other employees and doctors.Ability to manage priorities through adaptability and flexibility.Willingness to take calculated risks.Proficiency with using computers and willingness to learn new software are required.Ability to work in a fast-paced optometric facility while adhering to HIPAA compliance regulations.Demonstrates knowledge of proper, safe, efficient usage of office equipment, computers, and software; working knowledge of Microsoft Office.Attention to detail and a focus on accuracy are needed for success in this position.A proactive approach to problem-solving and a positive, professional attitude are required.BENEFITS:We offer paid time off, professional development assistance, a retirement plan with employer match, as well as employee discounts on vision care, glasses, and contact lenses. We do not currently offer health or dental insurance.EDUCATION:High school diploma or equivalent, and experience typically achieved with a minimum of 1-2 years in a retail or healthcare environment. Post-secondary training in finance, business administration, or healthcare management is preferred.WORK REQUIREMENTS:Ability to effectively communicate at all levels within the organization through written and two-way verbal communication.Able to sit or stand for extended periods of time.Ability to lift 10 to 20 pounds.Ability to see (Near, Distance, Color, and Depth Perception). Good eye and hand coordination.Manual and finger dexterity, as well as hand/arm steadiness. Ability to grip and hold items.Able to operate a cash register, various optical equipment, office equipment, and tools.Able to work normal and/or extended (evenings, nights, and weekends) office hours to meet established deadlines.Able to travel independently to support Company objectives and personal development.About the TeamMidline Vision is a family-owned company that owns and operates several optometry practice locations in communities throughout Wisconsin, including northcentral Wisconsin, the Madison area, and greater Milwaukee. Our owners and 25+ team members are committed to serving our local markets, and our practice group has a national support network with Pearle Vision and Target Optical. We are fast-paced, friendly, and always looking for new ways to improve patient satisfaction. Learn more at www.midlinevision.com/careers.