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Remote Claims Processor Jobs in Wisconsin (NOW HIRING)

Network Health, Inc

Claims Analyst II

Brookfield, WI · On-site +1

Process payments for claims that are approved. This position plays a vital role in ensuring accurate and efficient claims processing, contributing to the overall success of Network Health. Location:

CorVel Corporation

Claims Supervisor

Waukesha, WI · Remote

$73K - $113K/yr

This is a remote position. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: * Supervises WC claims staff in ... process taking into consideration experience, qualifications, and overall fit for the role. The ...

Network Health

Claims Analyst II

Menasha, WI · On-site +1

Process payments for claims that are approved. This position plays a vital role in ensuring accurate and efficient claims processing, contributing to the overall success of Network Health. Location:

New

Network Health, Inc

Claims Analyst II

Menasha, WI · On-site +1

Process payments for claims that are approved. This position plays a vital role in ensuring accurate and efficient claims processing, contributing to the overall success of Network Health. Location:

Network Health

Claims Analyst II

Brookfield, WI · On-site +1

Process payments for claims that are approved. This position plays a vital role in ensuring accurate and efficient claims processing, contributing to the overall success of Network Health. Location:

New

Corvel

Indemnity Claims Specialist

Madison, WI · Remote

$51K - $83K/yr

This is a remote position. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: * Receives claims, confirms ... process taking into consideration experience, qualifications, and overall fit for the role. The ...

CSAA

In order for your application to be correctly processed please sign-in before you apply Internal ... Job Title Sr. Examiner, Homeowner Claims Multi-State - Remote Requisition Number R7899 Sr. Examiner ...

New

CSAA

In order for your application to be correctly processed please sign-in before you apply Internal ... Job Title Sr. Examiner, Homeowner Claims Multi-State - Remote Requisition Number R7899 Sr. Examiner ...

New

CSAA

In order for your application to be correctly processed please sign-in before you apply Internal ... Job Title Sr. Examiner, Homeowner Claims Multi-State - Remote Requisition Number R7899 Sr. Examiner ...

New

CSAA

In order for your application to be correctly processed please sign-in before you apply Internal ... Job Title Sr. Examiner, Homeowner Claims Multi-State - Remote Requisition Number R7899 Sr. Examiner ...

New

Globe Life American Income Division

$15.50 - $21/hr

Remote Client Representative Location: 100% Remote | Schedule: Flexible We have proudly served ... Support policyholders with inquiries, policy updates, and claims processing. * Foster Relationship ...

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All JobsClaims Processor JobsRemote Claims Processor JobsRemote Claims Processor Jobs in Wisconsin

Remote Claims Processor information

See Wisconsin salary details

$12

$19

$26

How much do remote claims processor jobs pay per hour?

As of Aug 7, 2026, the average hourly pay for remote claims processor 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 are some common challenges faced by remote claims processors, and how can they be addressed?

Remote Claims Processors often encounter challenges such as managing high volumes of claims, maintaining accuracy without in-person supervision, and communicating effectively with team members across different locations. To address these, it's essential to develop strong organizational skills, utilize digital tools for tracking and documentation, and participate actively in virtual team meetings. Proactively seeking feedback and staying updated on policy changes can also enhance efficiency and reduce errors in a remote setting.

What does a remote claims processor do?

The job duties of a remote claims processor revolve around working to process insurance claims. You typically work from home or another remote location. Your responsibilities start with assessing the claimant's insurance policy and coverage. You review documents and records related to the claim and decide on approval or denial of the claim. A processor also prepares the paperwork necessary for the insurer to process the case for the client. You also have customer service duties, such as answering patient questions and telling them about the claim status. Processors can work with medical insurance, property insurance, or casualty insurance.

What does a remote claims processor do?

A Remote Claims Processor reviews, evaluates, and processes insurance claims from a remote location, typically working from home. They verify information, assess documentation, and determine the validity of claims for insurance companies or healthcare providers. This role requires attention to detail, knowledge of insurance policies, and the ability to communicate with clients or providers to resolve discrepancies. Remote Claims Processors use specialized software to manage claims efficiently and ensure compliance with industry regulations.

What are the key skills and qualifications needed to thrive as a remote claims processor, and why are they important?

To thrive as a Remote Claims Processor, you need strong attention to detail, analytical skills, and a solid understanding of insurance policies, often supported by a high school diploma or relevant experience. Familiarity with claims management software, Microsoft Office Suite, and sometimes industry certifications like AIC (Associate in Claims) are typically required. Excellent written communication, time management, and problem-solving abilities help you stand out in this role. These skills ensure accurate and efficient claims handling, customer satisfaction, and compliance with regulatory standards in a remote work environment.

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

AspectRemote Claims ProcessorRemote Claims Examiner
Required CredentialsHigh school diploma or equivalent; some roles may require insurance or claims processing certificationsHigh school diploma or equivalent; often requires licensing or certification in insurance claims examination
Work EnvironmentHome-based or remote office; primarily computer and phone workHome-based or remote; involves reviewing and analyzing insurance claims
Industry UsageInsurance, healthcare, government agenciesInsurance companies, healthcare providers, government agencies
Common Search/ComparisonYesYes

Remote Claims Processors and Remote Claims Examiners both work in the insurance industry, often remotely, handling claims. While both roles require similar credentials and work environments, Claims Examiners typically perform more detailed analysis and may require specific licensing. Understanding these differences helps job seekers identify the right position based on their skills and certifications.

More about Remote Claims Processor jobs
What are popular job titles related to Remote Claims Processor jobs in Wisconsin? For Remote Claims Processor jobs in Wisconsin, the most frequently searched job titles are:
What job categories do people searching Remote Claims Processor jobs in Wisconsin look for? The top searched job categories for Remote Claims Processor jobs in Wisconsin are:
What cities in Wisconsin are hiring for Remote Claims Processor jobs? Cities in Wisconsin with the most Remote Claims Processor job openings:
Remote Claims Processor jobs near you
Infographic showing various Remote Claims Processor job openings in Wisconsin as of August 2026, with employment types broken down into 90% Full Time, and 10% Part Time. Highlights an 100% Remote job distribution, with an average salary of $40,236 per year, or $19.3 per hour.

Claims Analyst II

Network Health, Inc

Brookfield, WI • On-site, Remote

Full-time

Re-posted 19 days ago

Job description

Network Health’s success is rooted in its mission to create healthy and strong Wisconsin communities. This mission drives the decisions we make, including the people we choose to join our growing team.

We are seeking a Claims Analyst II to examine and process paper and electronic claims. In this role, you will determine whether to return, pend, deny, or pay claims in accordance with established policies and procedures. Key responsibilities of this position include the following:

  • Adjudicate claims by following departmental policies, operating memos, and corporate guidelines.
  • Resolve claims and related issues in compliance with policy provisions.
  • Compare claims applications and provider statements with policy files and other records to ensure completeness and validity.
  • Process payments for claims that are approved.

This position plays a vital role in ensuring accurate and efficient claims processing, contributing to the overall success of Network Health.
Location: Candidates must reside in the state of Wisconsin for consideration. This position is eligible to work at your home office (reliable internet is required), at our office in Brookfield or Menasha, or a combination of both in our hybrid workplace model.
Hours: 1.0 FTE, 40 hours per week between 8am-5pm Monday through Friday.

Check out our 2025 Community Report to learn a little more about the difference our employees make in the communities we live and work in. As an employee, you will have the opportunity to work hard and have fun while getting paid to volunteer in your local neighborhood. You too, can be part of the team and making a difference. Apply to this position to learn more about our team.

Job Responsibilities:

    • Processes Professional and Facility claims for payment in accordance with members Certificate of Coverage, established medical policies and procedures, and plan benefit interpretation while maintaining a high level of confidentiality.
    • Reviews claims to ensure compliance with proper billing standards and completeness of information.
    • Obtains additional information from appropriate person and/or agency as needed.
    • Maintains department quality standards.
    • Maintains established department turn-around processing time. Maintain and/or improves individual production rate standards and department quality standards.
    • Identifies potential coordination of benefits (COB), Workers Compensation, and Subrogation issues and adjudicates claims accordingly.
    • Investigates and resolves pending claims in accordance with established time frames. Identifies claims needing to be pended or suspended. Reviews pending claims timely and denies claims after established time frame is reached without resolution.
    • Monitors computerized system for claims processing errors and make corrections and/or adjustments as needed.
    • Keeps current on group contracts specifics, provider discounts, percentages and per diems, enrollee certificates and agreements, authorizations and other utilization management policies, etc.
    • Reviews home office claims for payment up to $18,000.00.
    • Reviews claims for re-pricing. Enters eligible claim data into appropriate WRAP network re-pricing website. Overrides claims allowed amounts to apply internal/external discounts.
    • Appropriately documents attributes and memos for pertinent information related to claims payment.
    • Processes specialty claims (transplant, URN, COB) to determine appropriate pricing according to external contract.
    • Performs other duties and responsibilities as assigned.

    Job Requirements:

    • High school diploma or equivalent preferred.
    • 2-4 years claims processing experience required
    • Knowledge of current procedural terminology (CPT) and international classification of diseases (ICD-9 and ICD-10). Medical terminology, COB processing, subrogation.
    • Past experience using QNXT™ Claims Workflow a plus
    • Prior experience with ACA, Medicaid, or similar health plans preferred.
    • Coding experience preferred.

    Network Health is an Equal Opportunity Employer.

    Apply