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Remote Claims Representative Jobs in Madison, WI

State of Wisconsin

Disability Claims Reviewer

Madison, WI · On-site +1

$72K/yr

Remote work flexibility will be discussed in more detail during the interview process. * DHS does ... claims of the Social Security Act and Amendments. * Experience independently resolving complex ...

Rural Mutual Insurance

Desk Auto Claims Adjuster

Madison, WI · On-site +1

$49K - $65K/yr

You'll enjoy the flexibility of remote work while serving customers across Wisconsin. Candidates ... Ready to put your claims expertise to work with a trusted Wisconsin company? Join a supportive team ...

Rural Mutual Insurance

Desk Auto Claims Adjuster

Madison, WI · On-site +1

$65K - $75K/yr

You'll enjoy the flexibility of remote work while serving customers across Wisconsin. Candidates ... Ready to put your claims expertise to work with a trusted Wisconsin company? Join a supportive team ...

Auxiant

Claims Examiner

Madison, WI · On-site +1

Responsible for processing medical claims and correspondence and handling customer service calls from members, providers, and clients. Essential Functions: * Process claims in a timely manner with ...

Afni, Inc.

Remote Customer Service Representative

Madison, WI · Remote

$16.25 - $22/hr

What You Need to Thrive in Our Remote Environment: * Cable or Fiber Internet Service only (no dial-up, DSL, satellite or cellular) * 25Mbps Download/10Mbps Upload * Ping Rate - Less than 100 ms * A ...

Getaway

Customer Representative

Mcfarland, WI · Remote

$30K - $50K/yr

Position Description As a Customer Representative, you will play a key role in supporting clients ... Perks * 100% remote work with flexible scheduling. * Opportunities for growth within the agency.

Getaway

Customer Representative

Mcfarland, WI · Remote

$30K - $50K/yr

Position Description As a Customer Representative, you will play a key role in supporting clients ... Perks * 100% remote work with flexible scheduling. * Opportunities for growth within the agency.

All JobsClaims Representative JobsRemote Claims Representative JobsRemote Claims Representative Jobs in Madison, WI

Remote Claims Representative information

See Madison, WI salary details

$11

$24

$42

How much do remote claims representative jobs pay per hour?

As of Sep 2, 2026, the average hourly pay for remote claims representative in Madison, WI is $24.31, according to ZipRecruiter salary data. Most workers in this role earn between $18.41 and $27.60 per hour, depending on experience, location, and employer.

What is a remote claims representative?

A Remote Claims Representative is responsible for reviewing, processing, and resolving insurance claims while working from a remote location. They assess claim details, verify coverage, and communicate with policyholders, medical providers, or other relevant parties to ensure accurate and timely claim settlements. Strong analytical skills, attention to detail, and knowledge of insurance policies are essential for this role. The job often involves using digital tools to document claims and provide customer support.

What are the key skills and qualifications needed to thrive as a remote claims representative?

To thrive as a Remote Claims Representative, you need strong analytical abilities, attention to detail, and a solid understanding of insurance policies and claim processes, often supported by a relevant associate's or bachelor's degree. Familiarity with claims management software, CRM systems, and occasionally industry certifications like AIC (Associate in Claims) is highly beneficial. Excellent communication, problem-solving skills, and the ability to work independently are important soft skills for success in this remote role. These competencies ensure accurate evaluation and efficient resolution of claims while maintaining high customer satisfaction and adherence to regulatory standards.

What are some common challenges faced by remote claims representatives, and how can they be managed?

Remote Claims Representatives often encounter challenges such as managing high caseloads, communicating complex decisions effectively with clients, and staying organized without direct in-person supervision. Successfully navigating these challenges typically involves developing strong time management, self-motivation, and clear digital communication skills. Many companies provide robust training, digital collaboration tools, and regular virtual meetings to support remote staff and maintain team cohesion. Proactively seeking feedback and utilizing available resources can help you stay on track and excel in this dynamic remote environment.

Do you need a license to be a remote claims representative?

In most cases, remote claims representatives do not need a specific license to perform their duties, but licensing requirements can vary depending on the industry and state regulations. Some roles may require a general insurance license or certification, especially if handling sensitive claims or working directly with insurance policies. It is important to check the specific employer's requirements and local regulations for the role.

What are the most commonly searched types of Claims Representative jobs in Madison, WI?

The most popular types of Claims Representative jobs in Madison, WI are:

What are popular job titles related to Remote Claims Representative jobs in Madison, WI?

For Remote Claims Representative jobs in Madison, WI, the most frequently searched job titles are:

What job categories do people searching Remote Claims Representative jobs in Madison, WI look for?

The top searched job categories for Remote Claims Representative jobs in Madison, WI are:

What cities near Madison, WI are hiring for Remote Claims Representative jobs?

Cities near Madison, WI with the most Remote Claims Representative job openings:

Remote Claims Representative jobs near you
Infographic showing various Remote Claims Representative job openings in Madison, WI as of August 2026, with employment types broken down into 84% Full Time, 9% Part Time, and 7% Contract. Highlights an 100% Remote job distribution, with an average salary of $50,562 per year, or $24.3 per hour.

Disability Claims Reviewer

State of Wisconsin

Madison, WI • On-site, Remote

$72K/yr

Full-time

Medical, Retirement, PTO

Posted 6 days ago

State Of Wisconsin rating

7.9

Company rating: 7.9 out of 10

Based on 130 frontline employees who took The Breakroom Quiz

17th of 50 rated states

Job description

Introduction
The Department of Health Services (DHS), Division of Medicaid Services is recruiting for multiple full-time and 2 part-time (32 hours per week) Disability Claims Reviewer in the Disability Determination Bureau.
The DDB consists of approximately 200 employees, including some contractors. The DDB operates on a yearly budget of approximately $30 million funded by the Social Security Administration (SSA) to do medical determinations for SSA disability claims. The DDB also processes a small number of State Medicaid disability claims funded by DHS. The DDB must follow all SSA policies and regulations for safety, security and hiring as well as State of Wisconsin policies and regulations.
As an employee of the State of Wisconsin, you'll have access to an amazing benefits package . Note: Benefits and leave time will be prorated based on the number of hours worked.
  • 3.5 weeks of vacation, 9 paid holidays and ample sick time ; limitations may apply for leave time usage in the first six months.
  • Top rated health plan options starting at $47/month for single plans and $117/month for family plans, after 2 months of state service.
  • Exceptional pension plan with a 7.2% employer match in 2026 with lifetime retirement payment. Plus, a tax advantaged supplemental retirement savings plan which allows you to save money directly from your paycheck for retirement. Use this Total Rewards Calculator to see the total value of our competitive benefits package!
  • Several flex spending accounts: medical, dependent care, commuter, parking and High-Deductible Health Savings.
  • Well Wisconsin Wellness Program.
  • A free and confidential employee assistance program that offers employees and their immediate family dependents a variety of tools, resources, and professional consultation services to support their health, goals, and overall well-being.
  • Public Service Loan Forgiveness Program employer.

These positions offer the option to work remotely up to 4 days per week after the completion of 3 months of training and is headquartered at 1400 E. Washington Avenue office in downtown Madison and offers free on-site parking. This schedule may vary based on training or operational need.
Position Summary
These positions decide and document disability entitlement under the Social Security Disability Act, Amendments, and Regulations in both paper and electronic formats. This requires:
  • Extensive reading of records.
  • Working with electronic medical, vocational, and other records pertaining to disability.
  • Effective caseload management in an electronic environment.
  • High case production and decisional accuracy which requires timeliness of decisions.
Based on Agency workload needs and guided by the Social Security Administration, the Disability Claims Reviewers evaluate a mix of Adult, Child and Continuing Disability Review claims at both the initial and appellate levels under Title II, Title XVI, and Title XIX of the Social Security Act. Workloads may vary over time and by section or work unit. The Disability Claims Reviewers will maintain the capability and flexibility to efficiently process a variety of disability claim types.
Salary Information
The starting pay is between $35.00 and $37.68 per hour (approximately between $72,800 and 78,300 per year), depending on qualifications, plus excellent benefits. A 12-month probationary period is required.
Pay for current or former state employees will be set based on the rules that apply to compensation for the applicable transaction The position is classified as Disability Claims Reviewer and is in pay schedule and range 12/64.
Job Details
  • All applicants who may be appointed to these positions will be required to go through a complete federal background investigation. A suitability determination by the Social Security Administration is necessary prior to hire to determine whether an employee can be issued credentials in order to have access to Social Security disability data, records, and systems.
  • For positions that allow remote working flexibility, working outside of Wisconsin or in bordering cities will not be allowed except in extremely limited circumstances due to the need to report to an office location in Wisconsin on short notice.
  • Employees must have access to both a private workspace and secure high-speed internet for remote work option. Mileage reimbursement to the employee's headquarter location is not provided. Remote work flexibility will be discussed in more detail during the interview process.
  • DHS does not sponsor work visas for these positions, thus, in compliance with federal law, selected candidates will be required to verify eligibility to work in the United States by completing the require d I-9 form upon hire. DHS is not an E-Verify employer nor a STEM-OPT eligible employer.

Qualifications
Minimally qualified applicants will have all of the following:
  • Experience evaluating and adjudicating and making medical determinations on Social Security and Medicaid disability claims using knowledge of initial T-2, T-16 and T-19 disability claims of the Social Security Act and Amendments.
  • Experience independently resolving complex policy questions using a variety of resources including policy resources, business process documents, training manuals or in-house consultants.
  • Experience using medical terminology in a work setting.
  • Experience providing technical assistance to internal and external customers in a professional setting (e.g., answering questions, explaining requirements to customers, etc.)
Well-qualified applicants will also have one or more of the following:
  • 18 or more months of experience adjudicating disability claims in a state disability office.
  • Experience adjudicating Reconsideration or Quick Disability Determination/Compassionate Allowance claims.
Your letter of qualifications is limited to 1 page and your resume is limited to 2 pages. For a guide on developing your resume and letter of qualifications and what should be included in these materials, click here .
How To Apply
Applying is easy! Click "Apply for Job" to start your application process. Sign into your account or create an account before applying for the job. Follow the steps outlined in the application process to submit your application.
Helpful Information:
  • Once your application is submitted, no changes are allowed. Click "Save" to allow changes to your application as needed before submitting by the deadline.
  • You may want to save a copy of the job posting for referencing after the deadline.
  • Submitted materials will be evaluated by a panel of job experts according to the qualifications above.
  • Please monitor your email for communications related to this position.
  • Current or former permanent, classified, state employees must complete the online application process to be considered.
  • If viewing through an external site, please apply directly at Wisc.Jobs .
  • For technical assistance and general information, please see Frequently Asked Questions . For questions about the position, to request a copy of the full position description, or for other employment inquiries, please contact DDB Human Resources at DHSBHRDDB@dhs.wisconsin.gov
DHS is an Equal Opportunity and Affirmative Action employer. Veterans are encouraged to apply. For complete information on Veterans' hiring programs with the WI Department of Veteran's Affairs, click here .
Deadline to Apply
The deadline to apply is September 1, 2026 by 11:59 pm.
Applicants are strongly encouraged to allow ample time to finalize their applications keeping in mind that technical assistance is only available Monday through Friday 7:45 am - 4:30 pm. Late or incomplete applications will not be accepted.

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