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Medicaid Claims Processing Jobs in Wisconsin (NOW HIRING)

Mercyhealth

$18.25 - $23.50/hr

Processes claims on a daily basis by demonstrating in-depth knowledge of billing procedures by ... and Medicaid are correct and that issues resulting in inaccurate claims are brought to the ...

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All JobsMedicaid Claims Processing JobsMedicaid Claims Processing Jobs in Wisconsin

Medicaid Claims Processing information

See Wisconsin salary details

$12

$19

$26

How much do medicaid claims processing jobs pay per hour?

As of Sep 7, 2026, the average hourly pay for medicaid claims processing in Wisconsin is $19.34, according to ZipRecruiter salary data. Most workers in this role earn between $16.49 and $20.87 per hour, depending on experience, location, and employer.

What is a Medicaid claims processing job?

A Medicaid Claims Processing job involves reviewing, verifying, and processing healthcare claims submitted by providers seeking reimbursement for services rendered to Medicaid beneficiaries. Workers in this role ensure claims comply with state and federal regulations, identify errors or discrepancies, and communicate with healthcare providers to resolve issues. They may also use specialized software to input and track claims, process denials or appeals, and ensure timely and accurate payments. Strong attention to detail, knowledge of Medicaid policies, and proficiency with healthcare billing codes are essential for success in this role.

What are the key skills and qualifications needed to thrive in Medicaid claims processing?

Success in Medicaid Claims Processing requires excellent attention to detail, a thorough understanding of healthcare billing procedures, and familiarity with Medicaid regulations and insurance guidelines. Proficiency in medical billing software, claims management systems, and sometimes industry certifications such as Certified Professional Coder (CPC) is beneficial. Strong organizational skills, problem-solving abilities, and effective written and verbal communication help individuals excel in this role. These skills and qualifications are crucial for ensuring accurate, timely claims processing and compliance with ever-evolving Medicaid requirements.

What are some typical challenges faced in Medicaid claims processing, and how can I prepare for them?

One of the main challenges in Medicaid Claims Processing is staying up-to-date with frequently changing policies, billing codes, and compliance requirements, which can vary by state and program. Professionals in this role must pay close attention to detail to avoid errors and denials, often working with tight deadlines and large volumes of claims. To prepare, it's helpful to become familiar with Medicaid guidelines, maintain strong organizational habits, and proactively seek out updates in regulations or coding standards. Collaborating with other team members, such as care coordinators and billing specialists, is essential to ensure claims are accurate and properly documented. Ongoing learning and adaptability are key for long-term success in this dynamic environment.

How to get a job as a Medicaid Claims Processing specialist?

To become a Medicaid Claims Processing specialist, candidates typically need a high school diploma or equivalent, with some roles requiring postsecondary education or certifications in healthcare administration or related fields. Relevant skills include knowledge of healthcare billing, claims processing software, and federal Medicaid policies; experience in healthcare or insurance is often preferred. Applying through healthcare organizations, government agencies, or insurance companies and demonstrating attention to detail and familiarity with claims systems can improve job prospects.

Is a Medicaid claims processing job in demand?

Medicaid claims processing jobs are in steady demand due to ongoing healthcare coverage needs and the complexity of processing claims. These roles often require knowledge of healthcare regulations and claims management software, making them essential in healthcare administration and insurance companies.

What are the most commonly searched types of Medicaid Claims Processing jobs in Wisconsin?

The most popular types of Medicaid Claims Processing jobs in Wisconsin are:

What are popular job titles related to Medicaid Claims Processing jobs in Wisconsin?

For Medicaid Claims Processing jobs in Wisconsin, the most frequently searched job titles are:

What job categories do people searching Medicaid Claims Processing jobs in Wisconsin look for?

The top searched job categories for Medicaid Claims Processing jobs in Wisconsin are:

Medicaid Claims Processing jobs near you
Infographic showing various Medicaid Claims Processing job openings in Wisconsin as of August 2026, with employment types broken down into 87% Full Time, 9% Part Time, and 4% Contract. Highlights an 74% In-person, 4% Hybrid, and 22% Remote job distribution, with an average salary of $40,236 per year, or $19.3 per hour.

Associate Director, Consumer Service Operations- WI Market

Humana

Milwaukee, WI • On-site, Remote

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

This job post has expired today. Applications are no longer accepted.

Humana rating

8.0

Company rating: 8.0 out of 10

Based on 267 frontline employees who took The Breakroom Quiz

173rd of 315 rated insurance

Job description

Become a part of our caring community
Join Humana as a Associate Director of Consumer Operations where you will be responsible for ensuring the day to day operation metrics are being met for the WI Medicaid Market. Reporting to the Director of Consumer Service Operations, you will lead customer service, enrollment, and vendor operations that support members, providers, insurance partners. You will oversee call center operations, enrollment and work closely with operational teams that support claims inquiry resolution, configuration activities, provider and member service teams. You will drive operational performance, cost efficiency, process improvement, and implementation of new programs and contribute to overall strategy.

Main Responsibilities

  • Perform and ensure installation, implementation, client support, client services, client administration, customer service, enrollment and eligibility, claims processing, and call center operations. Investigate and settle claims and customer service issues.
  • Decision-making related to resolving complex technical and operational problems within department(s) leading multiple managers or specialized professional associates.
  • Drive continuous improvement of operational processes to support achievement of daily performance metrics and evolving goals.
  • Support coordination with enterprise and market business areas to align priorities, strengthen communication, and ensure collective progress toward shared goals.
  • Ensure the team is positioned for success by providing clear direction, appropriate support, and the resources needed.
  • Model leadership through accountability, partnership, and a commitment to the Humana Way Principles
  • Monitor and recommend improvements to increase operational productivity by providing advice and assistance to other team members.

Use your skills to make an impact

Required Qualifications

  • Bachelor's Degree
  • 3 or more years of progressive operational or service experience
  • 2 or more years of formal leadership/people management experience
  • Reside within the State of WI
  • 2 or more years of experience with project management, process improvement or process design
  • Comprehensive knowledge of all Microsoft Office applications, including Word, Excel, PowerPoint and Visio

Preferred Qualifications

  • Prior Experience in healthcare or insurance setting
  • Experience with Human Resource principles
  • Six Sigma or Lean experience

Additional Information

  • Workstyle: remote, work from home
  • Typical Workdays/hours: Monday - Friday, between 8:00 am - 5:00 pm CST
Work at Home Requirements: To ensure Home or Hybrid Home/Office employees' ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following criteria: At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is required; wireless, wired cable or DSL connection is suggested. In certain roles, the minimum recommended internet speed required by Humana may not be sufficient for business needs. Humana reserves the right to require associates to upgrade their internet service if necessary. Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information.Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.

Scheduled Weekly Hours

40

Pay Range

The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc.


$104,000 - $143,000 per year


This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance.

Description of Benefits

Humana, Inc. and its affiliated subsidiaries (collectively, "Humana") offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.
About us
About Humana: Humana Inc. (NYSE: HUM) is a leading U.S. healthcare company. Through our Humana insurance services and our CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health - delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare and Medicaid, families, individuals, military service personnel, and communities at large. Learn more about what we offer atHumana.comand atCenterWell.com.


Equal Opportunity Employer

It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.

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About Humana

Sourced by ZipRecruiter

Humana Inc., headquartered in Louisville, KY., is a leading health care company that offers a wide range of insurance products and health and wellness services that incorporate an integrated approach to lifelong well-being. By leveraging the strengths of its core businesses, Humana believes it can better explore opportunities for existing and emerging adjacencies in health care that can further enhance wellness opportunities for the millions of people across the nation with whom the company has relationships.

Industry

Health care and social assistance

Company size

10,000+ Employees

Headquarters location

Louisville, KY, US

Year founded

1961

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