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

Mercyhealth

Internal Auditor

Janesville, WI · On-site

$58K - $94K/yr

Evaluate claims processing activities for adherence to industry best practices, federal and state ... MercyCare administers a diverse portfolio of health insurance products, including Medicaid ...

Mercyhealth

Internal Auditor

Janesville, WI · On-site

$58K - $94K/yr

Evaluate claims processing activities for adherence to industry best practices, federal and state ... MercyCare administers a diverse portfolio of health insurance products, including Medicaid ...

Accord Group Inc.

Exterior Inspector/PSR

Madison, WI · On-site

$60K - $175K/yr

Help them navigate the insurance claims process * Facilitate restoration projects that bring their homes back to life * Control your pipeline, your schedule, and your income This isnt cold-call ...

Accord Group Inc.

Exterior Inspector/PSR

Madison, WI · On-site

$60K - $175K/yr

Help them navigate the insurance claims process * Facilitate restoration projects that bring their homes back to life * Control your pipeline, your schedule, and your income This isn't cold-call ...

Tegria Company

Facets Configuration Analyst

Oregon, WI · On-site

$90 - $120/hr

Knowledge of healthcare payer operations and claims processing.* Experience gathering and analyzing ... We offer competitive wages, retirement savings plans, company-paid disability and life insurance ...

New

Compeer Financial

Insurance Client Coordinator

Janesville, WI · On-site

$18 - $24/hr

Assists with facilitating client insurance claims by collaborating with insurance sales team ... Assists Crop Insurance Sales Team with internal processes, procedures, and projects. * Prepares and ...

IANS

Madison, WI - Field Roof Inspector

Madison, WI · On-site

$45 - $75/hr

... with numerous insurance agencies for efficient claims management. At Hancock, we are at the ... Our established process ensures top-tier claims support, ranging from rapid catastrophe response to ...

New

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Insurance Claims Processing information

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How much do insurance claims processing jobs pay per hour?

As of Sep 4, 2026, the average hourly pay for insurance claims processing in Verona, WI is $22.84, according to ZipRecruiter salary data. Most workers in this role earn between $18.70 and $26.06 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 Verona, WI are hiring for Insurance Claims Processing jobs?

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

Insurance Claims Processing jobs near you

Internal Auditor

Mercyhealth

Janesville, WI • On-site

$58K - $94K/yr

Full-time

Medical, Dental, Vision, Life, PTO

Re-posted 3 days ago

Mercy Health rating

6.9

Company rating: 6.9 out of 10

Based on 384 frontline employees who took The Breakroom Quiz

454th of 898 rated healthcare providers

Job description

Conduct comprehensive claims audits to ensure compliance with fee schedules, benefit plans, contractual obligations, service-level agreements, and claim turnaround standards. Evaluate claims processing activities for adherence to industry best practices, federal and state regulatory requirements, organizational policies and procedures, provider contracts, and applicable accreditation standards.
Analyze audit results, identify trends and areas of risk, and prepare detailed written reports summarizing findings, root causes, and recommendations for corrective action and process improvement. Collaborate with internal stakeholders to monitor compliance, improve operational effectiveness, and support regulatory readiness.
MercyCare administers a diverse portfolio of health insurance products, including Medicaid, Exchange, ERISA, and commercial plans, and operates within regulatory frameworks established by the Wisconsin Office of the Commissioner of Insurance (OCI), Illinois Department of Insurance (DOI), and other applicable federal and state agencies. The role requires a strong understanding of health plan operations, claims administration, and regulatory compliance across multiple lines of business.
Essential Duties and Responsibilities
  • Conduct audit interviews with front line staff in all functional areas that fall under claim operations.
  • Test, create flow charts and map operational processes that touch the outcome of claims accuracy.
  • Perform routine and moderately complex audits on claims for payment integrity in alignment with regulatory standards and timelines, business policy, contract, appropriate coding, and system configuration.
  • Research claim processing issues and errors to determine their origin and appropriate resolution. Interacts with Operations management regarding trends in order to improve claims processing accuracy and incorporate into training programs, policies and procedures.
  • Create audit reports to document audit findings, which will result in audit recommendations, reports and claims audit criteria enhancements.
  • Perform special project audits and reviews as requested by other departments.

Education and Experience
  • Bachelor's degree in accounting or business administration preferred with concentration in health care also preferred.
  • Minimum 2 years audit experience in health care industry.

Certification and Licensure
The following certifications are preferred:
  • Certified Internal Auditor (CIA) certification
  • Certified Healthcare Auditor (CHA)
  • Certified Public Accountant (CPA)
  • Registered Health Information Administrator (RHIA)

Skills and Abilities
  • Effective written and oral communication skills.
  • Excellent analytical/interpretive skills.
  • High degree of accuracy.
  • Proficiency in application of computers and software programs such as Excel.

PAY RANGE:
$58,797.66 - $94,076.26
Mercyhealth is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identify, national origin, disability, or protected veteran status.
Mercyhealth offers competitive pay and a comprehensive benefits package including:
  • Medical, Dental, Vision
  • Life & Disability Insurance
  • FSA/HSA Options
  • Generous, accruing paid time off
  • Paid Parental and caregiver leave
  • Career advancement and educational opportunities
  • Tuition and certification reimbursement
  • Certification Reimbursement
  • Well-being Programs
  • Employee Discounts
  • On-Demand Pay
  • Financial Education
  • Annual recognition/awards events
  • Partner appreciation days
  • Family entertainment/attractions discount
  • Community service/improvement opportunities

Click here for more details regarding Mercyhealth Careers Benefit Information.
At Mercyhealth, we don't simply hire people, we empower employee-partners who are passionate about making lives better. As an integrated health system, we deliver exceptional, coordinated across seven hospitals, 85 primary and specialty clinics, and a team of over 7,500 professionals serving northern Illinois and southern Wisconsin.
Mercyhealth has been nationally recognized for our commitment to our people and culture, including:
  • #1 in the nation on AARP's Best Employers for Workers Over 50
  • One of Working Mother magazine's 100 Best Companies for Working Mothers
  • A Top 50 Company and Top 10 Nonprofit for Executive Women

What Mercy Health employees say

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About Mercyhealth

Sourced by ZipRecruiter

At Mercyhealth, we don’t simply hire people – instead, we empower talented, dedicated health care professionals to provide the highest quality patient care possible with a passion for making lives better. As an integrated health care provider, we provide exceptional, coordinated health care. The organization consists of seven hospitals, 85+ clinics, and more than 7,500 employee-partners to serve patients in 15 counties throughout northern Illinois and southern Wisconsin. We hope you’ll consider becoming the newest member of the Mercyhealth family and join our passion for making lives better!

Industry

Hospitals, fitness and sports centers and health care and social assistance

Company size

10,000+ Employees

Headquarters location

Janesville, WI, US

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