Utilization Review Manager Jobs in Madison, WI (NOW HIRING)

About Acrisure

A global fintech leader, Acrisure empowers millions of ambitious businesses and individuals with the right solutions to grow boldly forward. Bringingcutting-edgetechnology and top-tier human support together, we connect clients with customized solutions across a range of insurance, reinsurance, payroll, benefits, cybersecurity, mortgage services - and more.

In the last twelve years, Acrisure has grown in revenue from $38 million to almost$5 billionand employs over 19,000 colleagues in more than 20 countries. Acrisure was built on entrepreneurial spirit. Prioritizing leadership, accountability, and collaboration, we equip our teams to work at the highest levels possible.

Job Summary

Acrisure is seeking a Claims Assistant to provide administrative and operational support to the workers' compensation claims team by maintaining accurate claim records, processing claim-related updates, and ensuring compliance with internal procedures and regulatory requirements. This role is responsible for organizing and updating digital claim files, completing claim maintenance audits, processing data corrections, handling Medicare and WCAB-related inquiries, supporting medical authorization and utilization review processes, coordinating vendor referrals, and assisting with subpoenas, liens, and claim file management activities.

Responsibilities

• Organizes the digital claim records for uniformity by removing duplicate records and top-lining documents.
• Completes 10-day and 6-month claim maintenance checklists to ensure the highest level of claims statistical data processing in accordance with multiple calls for data. Processes corrections to data error crits as required.
• Completes manual Medicare query of claims at the CMS COB&R site as needed and documents the digital claim record.
• Processes class code corrections that accurately depict the scope of an injured workers' job and payroll.
• Completes claim documents in both ImageRight and Powersuite.
• Completes closure, re-opens, and reassignments of all claim files as submitted by Supervisory personnel.
• Assists with record subpoenas and completes lien reviews organized with a worksheet summary.
• Completes vendor referrals by service specialty and utilization review submissions to Rising.
• Maintains contact with the WCAB for status updates on claims where named as a party to suit in error.
• Complies with Maximus responses following IMR for timely fulfillment.
• Reviews adjuster ImageRight tasks daily for medical authorization requests.
• Provides administrative assistance to claim adjusting team members as needed.
• The Claims Assistant II provides back-up in the entry of manual payments to the Claims Payable Analyst.
• Other duties and projects as assigned.

Requirements

• Professional telephone demeanor, good verbal and written communication skills, good listening skills, along with strong organizational skills.
• Thorough knowledge of workers' compensation claims procedures and policies.
• Possess a strong understanding of human nature and motivation principles.
• Readily control/handle problem issues in times of stress and in a climate of conflict and/or adversity.
• Computer literacy including strong familiarity with Microsoft Office Suite. Ability to type 45 WPM.
• Basic understanding of business technology.
• Responsiveness to changing business needs.
• Ability to work well under pressure and multi-task in a fast paced environment while continually paying attention to detail.
• Ability to adhere to the code of ethical conduct.
• Ability to take direction and make decisions.
• Ability to learn new procedures quickly and adapt to a changing environment.
• Ability to work in a team environment.
• Ability to work with limited supervision.

Education/Experience

• Minimum Education: High School Diploma or equivalent.
• Preferred Education: College degree preferred.
• 1-2 years of relevant claims processing experience preferable in the worker's compensation field or similar experience.
• Desire for career development within the insurance industry.

#LI-DL1

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Pay Details:

Candidates should be comfortable with an on-site presence to support collaboration, team leadership, and cross-functional partnership.

Why Join Us:

At Acrisure, we're building more than a business, we're building a community where people can grow, thrive, and make an impact. Our benefits are designed to support every dimension of your life, from your health and finances to your family and future.

Making a lasting impact on the communities it serves, Acrisure has pledged more than $22 million through its partnerships with Corewell Health Helen DeVos Children's Hospital in Grand Rapids, Michigan, UPMC Children's Hospital in Pittsburgh, Pennsylvania and Blythedale Children's Hospital in Valhalla, New York.

Employee Benefits

We also offer our employees a comprehensive suite of benefits and perks, including:

• Physical Wellness: Comprehensive medical insurance, dental insurance, and vision insurance; life and disability insurance; fertility benefits; wellness resources; and paid sick time.

• Mental Wellness: Generous paid time off and holidays; Employee Assistance Program (EAP); and a complimentary Calm app subscription.

• Financial Wellness: Immediate vesting in a 401(k) plan; Health Savings Account (HSA) and Flexible Spending Account (FSA) options; commuter benefits; and employee discount programs.

• Family Care: Paid maternity leave and paid paternity leave (including for adoptive parents); legal plan options; and pet insurance coverage.

• ... and so much more!

This list is not exhaustive of all available benefits. Eligibility and waiting periods may apply to certain offerings. Benefits may vary based on subsidiary entity and geographic location.

Acrisure is an Equal Opportunity Employer. We consider qualified applicants without regard to race, color, religion, sex, national origin, disability, or protected veteran status. Applicants may request reasonable accommodation by contacting leaves@acrisure.com.

Final candidates will be required to complete post-offer verification processes related to the role and in accordance with applicable laws.

California Residents: Learn more about our privacy practices for applicants by visiting the Acrisure California Applicant Privacy Policy.

Recruitment Fraud: Please visit here to learn more about our Recruitment Fraud Notice.

Welcome, your new opportunity awaits you.