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Remote Claim Processor Jobs in Wisconsin (NOW HIRING)

CSAA

In order for your application to be correctly processed please sign-in before you apply Internal ... Monitor claim funding accounts and reconciliation practices. * Analyze indemnity and expense trends ...

CSAA

In order for your application to be correctly processed please sign-in before you apply Internal ... Monitor claim funding accounts and reconciliation practices. * Analyze indemnity and expense trends ...

CSAA

In order for your application to be correctly processed please sign-in before you apply Internal ... Monitor claim funding accounts and reconciliation practices. * Analyze indemnity and expense trends ...

CSAA

In order for your application to be correctly processed please sign-in before you apply Internal ... Monitor claim funding accounts and reconciliation practices. * Analyze indemnity and expense trends ...

Corvel

Indemnity Claims Specialist

Madison, WI · Remote

$51K - $83K/yr

This is a remote position. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: * Receives claims, confirms ... Communicates claim status with the customer, claimant and client * Adheres to client and carrier ...

Harris

This role is not just about managing processes; it's about leading and inspiring a diverse team of ... competitors who claim to have a more complete product. * Be an effective liaison between the ...

Harris

This role is not just about managing processes; it's about leading and inspiring a diverse team of ... competitors who claim to have a more complete product. * Be an effective liaison between the ...

Harris

This role is not just about managing processes; it's about leading and inspiring a diverse team of ... competitors who claim to have a more complete product. * Be an effective liaison between the ...

Cayenta

This role is not just about managing processes; it's about leading and inspiring a diverse team of ... competitors who claim to have a more complete product. * Be an effective liaison between the ...

Harris

This role is not just about managing processes; it's about leading and inspiring a diverse team of ... competitors who claim to have a more complete product. * Be an effective liaison between the ...

Cayenta

This role is not just about managing processes; it's about leading and inspiring a diverse team of ... competitors who claim to have a more complete product. * Be an effective liaison between the ...

Manulife

$105K - $124K/yr

This is a remote role open to any location in continental US Manulife is a leading international ... May process all aspects of auditing, formal appeal reviews and contestable claim review. * Audit ...

Manulife

$98K - $115K/yr

This is a remote role open to any location in continental US Manulife is a leading international ... May process all aspects of auditing, formal appeal reviews and contestable claim review. * Audit ...

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All JobsRemote Claim Processor JobsRemote Claim Processor Jobs in Wisconsin

Remote Claim Processor information

What is the difference between Remote Claim Processor vs Remote Claims Examiner?

AspectRemote Claim ProcessorRemote Claims Examiner
Required CredentialsHigh school diploma or equivalent; some roles may require insurance or healthcare certificationsHigh school diploma or equivalent; often requires insurance or healthcare-related certifications
Work EnvironmentHome-based, independent work settingHome-based, independent work setting
Industry UsageInsurance, healthcare, government agenciesInsurance, healthcare, government agencies
Job FocusProcessing insurance claims, data entry, verifying informationReviewing and adjudicating insurance claims, ensuring compliance

Both roles are remote positions within the insurance and healthcare industries, requiring similar credentials and work environments. The main difference lies in their focus: Remote Claim Processors handle initial claim processing and data entry, while Remote Claims Examiners review and make decisions on claims to ensure accuracy and compliance.

What is a Remote Claim Processor?

A Remote Claim Processor is a professional who reviews, evaluates, and processes insurance claims from a remote location, often from home. They verify the accuracy of submitted information, ensure policy guidelines are met, and decide whether claims should be approved, denied, or require further investigation. This role typically involves working with health, auto, or property insurance claims and requires strong attention to detail, analytical skills, and familiarity with relevant software systems. Working remotely allows claim processors to handle their duties outside of a traditional office environment while maintaining communication with their team and clients through digital platforms.

What are the key skills and qualifications needed to thrive as a Remote Claim Processor, and why are they important?

To thrive as a Remote Claim Processor, you need strong analytical skills, attention to detail, and a background in insurance or healthcare administration, typically supported by a high school diploma or relevant certification. Familiarity with claims management software, electronic health record (EHR) systems, and Microsoft Office is crucial for daily tasks. Excellent communication, problem-solving abilities, and self-motivation help remote claim processors efficiently resolve issues and work independently. These skills ensure accurate claims processing, timely resolution, and high customer satisfaction in a remote environment.

What are some common challenges faced by remote claim processors, and how can they be managed effectively?

Remote claim processors often encounter challenges such as maintaining effective communication with team members and staying up-to-date with changing insurance policies and procedures. To manage these challenges, it's important to leverage collaboration tools like instant messaging and video conferencing, and to participate actively in virtual training sessions. Additionally, setting up a dedicated workspace and following a structured daily routine can help ensure productivity and accuracy when processing claims remotely.
What are popular job titles related to Remote Claim Processor jobs in Wisconsin? For Remote Claim Processor jobs in Wisconsin, the most frequently searched job titles are:
What job categories do people searching Remote Claim Processor jobs in Wisconsin look for? The top searched job categories for Remote Claim Processor jobs in Wisconsin are:
Remote Claim Processor jobs near you
Workers Compensation Sr. Claims Examiner

Workers Compensation Sr. Claims Examiner

Berkley

Appleton, WI • On-site, Remote

$75K - $88K/yr

Other

Medical, Dental, Vision, Life, Retirement, PTO

Posted 27 days ago

Job description

Company Details

We're a member company of W. R. Berkley Corporation, an A. M. Best A+ rated Fortune 500 holding company. Berkley is comprised of individual operating units that serve a defined insurance market segment. Berkley Risk is focused on providing self-insured entities program administration services and insurance operations which can include taking or sharing risk using Berkley paper. This capability allows us to customize both an insurance company option and a purely administrative option for our customers.

Responsibilities

Responsible for managing a caseload consisting of incoming and more complex workers' compensation cases including extended disability cases, litigation, employer's liability claims, and assigned claims.  Responsible for all technical aspects of claim management for assigned files including compliance with all established performance guidelines.

  • Investigate claims and make appropriate decisions regarding claim compensability and general claims management for assigned files.
  • Document claim handling activities; create and document action plans.
  • Establish appropriate case reserves.
  • Actively manage medical treatment and disability while assisting the injured worker to return to work.
  • Comply with all performance guidelines.
  • Identify loss trends and communicate to supervisor and/or clients.
  • Use automated diary system to issue indemnity payments and for claims management
  • Investigate and manage claim subrogation and negotiate settlements.
  • Manage coverage B or conflict of interest cases as assigned.
  • Address customer complaints and inquiries in an exemplary and professional manner.
  • Participate in client claim reviews when scheduled or requested

May perform other functions as assigned

For highly qualified candidates who reside more than 50 miles from Minneapolis, remote work may be considered, provided the candidate is willing to travel to Minneapolis as required.Qualifications
  • Demonstrated working knowledge of workers' compensation administration rules/laws in at least one of the following states: MN, IL or WI.
  • Excellent communication and presentation skills.
  • Must be able to interface with clients, legal counsel, health care professionals, etc.
  • Good math and analytical ability.
  • Excellent customer service skills.
  • Basic PC skills and a working knowledge of Windows environment. Experience with a client/server based claims processing system.

Education 

  • BA/BS degree with three years' experience. Experience must include litigation, subrogation and complex medical/legal issues or two years post-high school education and five years' experience in workers compensation claims management.
Additional Company Detailshttps://www.berkleyrisk.com/ The Company is an equal employment opportunity employer. We do not accept unsolicited resumes from third party recruiting agencies or firms. The company offers a competitive compensation plan and robust benefits package for full time regular employees including: Base Salary Range: $75k - $88k Benefits include Health, dental, vision, dental, life, disability, wellness, paid time off, 401(k) and profit-sharing plans The actual salary for this position will be determined by a number of factors, including the scope, complexity and location of the role; the skills, education, training, credentials and experience of the candidate; and other conditions of employment.Additional RequirementsTravel: Occasional travelEmployment Type: OTHER

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