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Insurance Claims Representative Jobs in Wisconsin

Chubb

ESIS Senior Claims Representative, WC

Milwaukee, WI · On-site

$78K - $109K/yr

Join ESIS, a leader in risk management and insurance services, where your skills and talents can ... We are seeking a skilled Senior Claims Representative to enhance our team. Reporting to the Claims ...

Chubb

ESIS Senior Claims Representative, WC

Milwaukee, WI · On-site

$78K - $109K/yr

Join ESIS, a leader in risk management and insurance services, where your skills and talents can ... We are seeking a skilled Senior Claims Representative to enhance our team. Reporting to the Claims ...

American International Group

WI · On-site

$104.60 - $127.60/hr

Grow your career at the forefront of Casualty insurance.In Mass Tort and Complex Casualty Claims, we strive to live AIG's corporate values: Take Ownership, Set the Standard, Win Together, Be an Ally ...

New

Acrisure

Medical Only Adjuster

Stevens Point, WI

In this role, you will gain exposure to claims processes, medical billing review, and insurance operations while working alongside experienced Claims Representatives and Examiners. This role plays a ...

Vizance

Senior Claims Advisor

Hartland, WI · On-site

Coordinate with insurance carrier claims liaisons to support high-quality claim handling and ... achieve optimal outcomes. * Collaborate cross-functionally to ensure strategic participation in ...

Vizance, Inc.

Senior Claims Advisor

Hartland, WI · On-site

Coordinate with insurance carrier claims liaisons to support high-quality claim handling and ... achieve optimal outcomes. * Collaborate cross-functionally to ensure strategic participation in ...

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Insurance Claims Representative information

See Wisconsin salary details

$7

$24

$40

How much do insurance claims representative jobs pay per hour?

As of Aug 7, 2026, the average hourly pay for insurance claims representative in Wisconsin is $24.79, according to ZipRecruiter salary data. Most workers in this role earn between $17.93 and $29.13 per hour, depending on experience, location, and employer.

Is it hard to be an insurance claims representative?

Being an insurance claims representative involves handling complex cases, requiring strong communication, attention to detail, and knowledge of insurance policies. The job can be demanding due to the need to evaluate claims accurately and manage customer interactions, but it is generally manageable with proper training and experience.

What does an insurance claims representative do?

An Insurance Claims Representative is responsible for evaluating insurance claims submitted by policyholders. They investigate the details of each claim, determine the extent of the insurance company's liability, and help ensure that claims are processed accurately and efficiently. They may gather information from claimants, witnesses, and other parties, review documentation, and communicate decisions to customers. Their goal is to provide fair settlements while adhering to company policies and legal guidelines.

What are the key skills and qualifications needed to thrive as an insurance claims representative, and why are they important?

To thrive as an Insurance Claims Representative, you need a solid understanding of insurance policies, claims processes, and investigative techniques, typically supported by a high school diploma or associate degree. Familiarity with claims management software, CRM systems, and occasionally industry certifications such as AIC (Associate in Claims) are commonly required. Strong customer service, analytical thinking, and effective communication skills help you manage claims efficiently and support clients during stressful situations. These abilities are vital for ensuring accurate claims resolution, maintaining customer satisfaction, and upholding the company's reputation.

Do you need a degree to be an insurance claims representative?

Typically, a high school diploma or equivalent is sufficient to become an insurance claims representative. Some employers prefer candidates with post-secondary education or relevant certifications, and strong communication and customer service skills are important for the role.

What does an insurance claims representative do?

An insurance claims representative assesses customer insurance claims. Your duties in this career include visiting accident sites and interviewing witnesses or customers to determine the scope of the claim. You also determine whether or not it is worth negotiating a settlement, and if so, you ensure all settlement claims are handled quickly. In addition to assessing accidents and claims, you update customer policies depending on their history. Qualifications for the career include experience and job skills. You should have excellent customer service, a firm knowledge of all company policies, and computer literacy.

What are some common challenges insurance claims representatives face when handling complex claims?

Insurance Claims Representatives often encounter challenges such as managing high caseloads, interpreting intricate policy details, and handling sensitive conversations with policyholders during stressful situations. They must balance empathy with adherence to company policies and regulations, all while investigating and verifying the validity of claims. Effective communication, time management, and problem-solving skills are essential to navigate these complexities and deliver fair outcomes for both the client and the insurer.

What is the difference between Insurance Claims Representative vs Insurance Adjuster?

AspectInsurance Claims RepresentativeInsurance Adjuster
Required CredentialsHigh school diploma or equivalent; some roles may require licensingLicensing often required; certifications like AIC or CPCU beneficial
Work EnvironmentOffice settings, customer service interactions, claims processingFieldwork, site inspections, or office-based assessments
Employer & Industry UsageInsurance companies, claims departmentsInsurance companies, independent adjusting firms
Common Search & ComparisonOften compared for claims handling rolesMore focused on damage assessment and investigation

The main difference between an Insurance Claims Representative and an Insurance Adjuster lies in their roles. Claims Representatives primarily handle customer interactions and process claims within an office environment, while Adjusters often conduct field inspections and assess damages. Both roles require relevant licensing and are integral to the insurance industry, but they focus on different aspects of claims management.

More about Insurance Claims Representative jobs
What are popular job titles related to Insurance Claims Representative jobs in Wisconsin? For Insurance Claims Representative jobs in Wisconsin, the most frequently searched job titles are:
What job categories do people searching Insurance Claims Representative jobs in Wisconsin look for? The top searched job categories for Insurance Claims Representative jobs in Wisconsin are:
What are popular job titles related to Insurance Claims Representative jobs in WI? For Insurance Claims Representative jobs in WI, the most frequently searched job titles are:
Insurance Claims Representative jobs near you
Infographic showing various Insurance Claims Representative job openings in Wisconsin as of July 2026, with employment types broken down into 1% As Needed, 73% Full Time, 22% Part Time, and 4% Contract. Highlights an 89% Physical, 1% Hybrid, and 10% Remote job distribution, with an average salary of $51,569 per year, or $24.8 per hour.

Claims Submission Rep

Children's Wisconsin

West Allis, WI

Full-time

Re-posted 2 days ago

Children's Wisconsin rating

7.6

Company rating: 7.6 out of 10

Based on 66 frontline employees who took The Breakroom Quiz

256th of 1,055 rated hospitals

Job description

At Children's Wisconsin, we believe kids deserve the best.

Children's Wisconsin is a nationally recognized health system dedicated solely to the health and well-being of children. We provide primary care, specialty care, urgent care, emergency care, community health services, foster and adoption services, child and family counseling, child advocacy services and family resource centers. Our reputation draws patients and families from around the country.

We offer a wide variety of rewarding career opportunities and are seeking individuals dedicated to helping us achieve our vision of the healthiest kids in the country. If you want to work for an organization that makes a difference for children and families, and encourages you to be at your best every day, please apply today.

Please follow this link for a closer look at what it's like to work at Children's Wisconsin:https://www.instagram.com/lifeatcw/

Job Summary:
Responsibility for the submission of all paper and electronic claims. This will include primary, secondary, and specialty claims. Will have assigned work-queues to correct billing, charging, and registration edits.
Essential Functions:

  • Facilitates the daily submission of electronic claims to the clearinghouse. Along with the Lead, participates in the claims reconciliation process.
  • Works assigned work-queues to correct billing, charging, and registration edits.
  • Calculates and applies appropriate contractual discounts at the time of billing.
  • Utilizes payer websites and electronic eligibility clearinghouses to verify the accuracy of patient insurance information.
  • Utilizes payer websites for direct claim entry when necessary.
  • Submits secondary claims to payers according to department policy and procedure and payer guidelines and requirements.


Education:

  • High School graduate or Certificate of General Educational Development (GED) or High School Equivalency Diploma (HSED) required


Experience:

  • 2+ years experience of billing and/or claims follow up , HCFAs and/or UB-04's (preferably in a hospital setting) including insurance reimbursement procedures and comprehension of insurance EOB's required
  • General pediatric and/or pediatric subspecialty experience preferred
  • Prior EPIC, QSI or IDX experience is strongly preferred


Knowledge, Skills and Abilities:

  • Working knowledge of medical terminology, ICD-9, CPT and HCPCS level II codes.
  • Excellent verbal and written communication skills. Bilingual skills a plus.
  • Strong analytical skills and ability to perform noncomplex arithmetic calculations when determining contractual allowances.
  • Ability to work independently with minimal supervision.
  • Proficient in Microsoft Office applications and technology skills required to perform duties.
  • The ability to multi-task and function effectively in a team environment and maintain successful relationships with coworkers, patients, physicians, management, staff, and other customers.


Required for All Jobs:

  • This job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that may be requested in the performance of this job.
  • Employment is at-will. This document does not create an employment contract, implied or otherwise.

Children's Wisconsin is an equal opportunity / affirmative action employer. We are committed to creating a diverse and inclusive environment for all employees. We treat everyone with dignity, respect, and fairness. We do not discriminate against any person on the basis of race, color, religion, sex, gender, gender identity and/or expression, sexual orientation, national origin, age, disability, veteran status, or any other status or condition protected by the law.

Certifications/Licenses:

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