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Remote Insurance Claims Manager Jobs in Wisconsin

CSAA

Job Title Commercial Insurance Analyst, Claims Insights - Remote Requisition Number R7770 ... management, and risk outcomes. You will be responsible for performing complex analyses to inform ...

CSAA

Job Title Commercial Insurance Analyst, Claims Insights - Remote Requisition Number R7770 ... management, and risk outcomes. You will be responsible for performing complex analyses to inform ...

CSAA

Job Title Commercial Insurance Analyst, Claims Insights - Remote Requisition Number R7770 ... management, and risk outcomes. You will be responsible for performing complex analyses to inform ...

CSAA

Job Title Commercial Insurance Analyst, Claims Insights - Remote Requisition Number R7770 ... management, and risk outcomes. You will be responsible for performing complex analyses to inform ...

Corvel

Indemnity Claims Specialist

Madison, WI · Remote

$51K - $83K/yr

This is a remote position. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: * Receives claims, confirms ... Manages non-complex and non-problematic medical only claims and minor lost-time workers ...

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Remote Insurance Claims Manager information

What are the key skills and qualifications needed to thrive as a Remote Insurance Claims Manager, and why are they important?

To thrive as a Remote Insurance Claims Manager, you need in-depth knowledge of insurance policies, claims processes, and regulatory requirements, often supported by a bachelor's degree and relevant industry experience. Familiarity with claims management software, digital documentation tools, and, in some cases, certifications like AIC (Associate in Claims) are typically required. Excellent problem-solving, leadership, and communication skills help manage teams remotely and resolve complex claims efficiently. These skills ensure accurate claims processing, regulatory compliance, and effective team coordination in a virtual environment.

What does a Remote Insurance Claims Manager do?

A Remote Insurance Claims Manager oversees the process of evaluating, processing, and resolving insurance claims, all while working from a remote location. They manage a team of claims adjusters, review claims for accuracy and compliance, and ensure timely settlements for policyholders. This role often involves communicating with clients, liaising with other departments, and leveraging technology to streamline claims handling. The remote aspect allows managers to perform all duties using digital tools, making communication and documentation critical parts of the job.

How does a Remote Insurance Claims Manager typically coordinate with on-site team members and external partners?

As a Remote Insurance Claims Manager, you will frequently collaborate with on-site adjusters, underwriters, and external partners such as legal advisors and service vendors. Most communication is conducted via video conferencing, email, and specialized claims management platforms. You’ll be responsible for ensuring seamless information flow, timely updates, and resolution of claims by coordinating virtual meetings and maintaining clear documentation. Developing strong remote communication and organizational skills is essential for success in this role.

What is the difference between Remote Insurance Claims Manager vs Remote Insurance Adjuster?

AspectRemote Insurance Claims ManagerRemote Insurance Adjuster
CredentialsTypically requires a claims management certification or industry experienceRequires licensing and certifications specific to insurance adjusting
Work EnvironmentOversees claims teams, manages processes remotelyEvaluates individual claims remotely, often in the field or from home
Employer & Industry UsageUsed by insurance companies for claims oversightUsed by insurance companies for claim evaluation and settlement
Search & Comparison IntentPeople compare managerial roles in claims processingPeople compare roles focused on claim assessment and settlement

The main difference is that a Remote Insurance Claims Manager oversees claims teams and manages claims processes remotely, requiring management experience and certifications. In contrast, a Remote Insurance Adjuster evaluates individual claims, often needing specific licensing and adjusting certifications. Both roles are integral to the insurance industry but differ in responsibilities and focus areas.

What are the most commonly searched types of Remote Insurance Claims jobs in Wisconsin? The most popular types of Remote Insurance Claims jobs in Wisconsin are:
What are popular job titles related to Remote Insurance Claims Manager jobs in Wisconsin? For Remote Insurance Claims Manager jobs in Wisconsin, the most frequently searched job titles are:
What job categories do people searching Remote Insurance Claims Manager jobs in Wisconsin look for? The top searched job categories for Remote Insurance Claims Manager jobs in Wisconsin are:
What cities in Wisconsin are hiring for Remote Insurance Claims Manager jobs? Cities in Wisconsin with the most Remote Insurance Claims Manager job openings:
Remote Insurance Claims Manager jobs near you

Claims Manager

OPERATING ENGINEERS LOCAL 139 HEALTH FUND

Pewaukee, WI • Remote

$85K/yr

Full-time

Medical, Dental, Vision, PTO

Posted 24 days ago

Job description

Benefits:
  • Paid Holidays
  • Health Reimbursement Account
  • Pensions
  • Health insurance
  • Paid time off

Summary
The Claims Manager is responsible for supervising, coordinating, and implementing a wide range of departmental projects and programs, as well as overseeing the day-to-day operations of the Claims Department. The Claims Department processes medical, dental, vision, disability, and HRA claims and provides customer service support to participants.
Essential Duties and Responsibilities
Operational Responsibilities
Process and audit all types of claimsincluding medical, dental, vision, HRA, and loss-of-time (short-term disability)for active members and retirees.
Ensure claims are processed accurately and meet quality, timeliness, and production standards.
Research and resolve appealed, questionable, or denied claims to ensure fair and timely outcomes.
Conduct phone monitoring to ensure quality service.
Respond promptly and professionally to phone, written, and walk-in inquiries from participants, trustees, employers, and union representatives.
Draft written correspondence regarding claim inquiries, determinations, and appeals.
Coordinate programming updates and client communications for Plan changes.
Run reports as needed. Analyze report data and notify Administrative Manager of concerns or recommendations for improvement.
Collaborate with consultants, attorneys, and management on benefit interpretations, subrogation, workers compensation, and preparation of plan materials and booklets.
Communicate and collaborate with vendors such as PBM, PPO, UR, Case Management, etc as needed.
Support efforts to improve electronic claims productivity and auto-adjudication rates.
Perform other special projects as assigned.
Supervisory Responsibilities
Ensure employees follow organizational policies and procedures.
Manage scheduling for PTO, assign overtime, and arrange coverage for absent staff.
Regularly assess departmental and employee needs to maintain efficient operations.
Develop individualized training plans to ensure employees have the expertise required for their roles; provide ongoing coaching and guidance.
Prepare agendas for regular staff meetings.
Maintain performance standards for staff roles, provide constructive feedback, and identify opportunities for improvement.
Develop performance improvement plans when necessary, as well as recognize and reward strong performance.
Qualifications
Posthigh school education and/or relevant work experience preferred.
Five or more years of experience in an automated claims processing or benefits administration environment.
At least two years of management or supervisory experience.
Thorough knowledge of claims operations, including claim payment, contract interpretation, and benefit communication.
Ability to read and interpret documents such as Summary Plan Descriptions and Plan rules. Ability to communicate clearly and professionally with participants and internal departments.
Ability to apply common sense understanding to carry out detailed written or oral instructions.
Physical Demands
Ability to sit or stand for long periods of time. The physical demands listed are representative of those required to successfully perform the essential functions of this position. Reasonable accommodations may be provided to enable individuals with disabilities to perform these functions.
Work Environment
In office work environment Monday through Friday. Limited ability to work from home. May require occasional travel for meetings with vendors or participants.
The company is an equal opportunity employer. This description is not intended and should not be construed to be an exhaustive list of all responsibilities, skills, effort, work conditions, and benefits associated with the job.