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Subrogation Investigative Claim Representative II
The Auto Club Group 4.2
Claim processor job in Milwaukee, WI
Subrogation Investigative Claim Representative II - The Auto Club Group Reports to: Claim Manager as appropriate What you will do:Work under normal supervision with an intermediate-level approval authority to handle moderately complex claims within Claim Handling Standards. Take statements and establish clear evaluation and resolution plans for claims. Assist with subrogation investigations. This may include insurance verification, obtaining proofs, taking recorded statements, and hiring experts. Claim handling responsibilities will include the following: reviewing assigned claims, contacting the insured and other affected parties, setting expectations for the remainder of the claim, and initiating documentation in the claim handling system. Complete an investigation of the facts and determine possible recovery potential. Conduct thorough reviews of damages and determine the applicability of state law and other factors related to the claim. Evaluate the financial value of the loss. Approve payments for the appropriate parties accordingly. Refer claims to other company units when necessary (e.g., Underwriting, Recovery Units or Claims Special Investigation Unit). Thoroughly document and/or code the claim file and complete all claim closure and related activities in the assigned claims management system. Utilize strong negotiating skills. Supervisory Responsibilities:None How you will benefit: A competitive annual salary between $57,500.00 - $85,000.00 ACG offers excellent and comprehensive benefits packages, including: Medical, dental and vision benefits 401k Match Paid parental leave and adoption assistance Paid Time Off (PTO), company paid holidays, CEO days, and floating holidays Paid volunteer day annually Tuition assistance program, professional certification reimbursement program and other professional development opportunities AAA Membership Discounts, perks, and rewards and much more We're looking for candidates who: Education: Complete ACG Claim Representative Training Program or demonstrate equivalent knowledge or experience In states where an Adjuster's license is required, the candidate must be eligible to acquire a State Adjuster's license within 90 days of hire and maintain as specified for appropriate states Experience:One year of experience with: Negotiating claim settlements Securing and evaluating evidence Preparing manual and electronic estimates Subrogation claims Resolving coverage questions Taking statements Establishing clear evaluation and resolution plans for claims Knowledge and Skills: Essential Insurance Act (Michigan) Fair Trade Practices Act as it relates to claims Subrogation procedures and processes Intercompany arbitration Technical knowledge of: Negligence Law No-Fault Law Collision repair shop Ability to: Handle claims to the line Claim Handling Standards Follow and apply ACG and Meemic Claim policies, procedures and guidelines Work within assigned Meemic Claim systems including basic PC software Perform basic claim file review and investigations Demonstrate effective communication skills (verbal and written) Demonstrate customer service skills by building and maintaining relationships with insureds/claimants while exhibiting understanding of their problems and responding to questions and concerns Analyze and solve problems while demonstrating sound decision making skills Prioritize claim related functions Process time sensitive data and information from multiple sources Manage time, organize and plan workload and responsibilities Research analyze and interpret subrogation laws in various states Strong negotiating skills Work Environment This position is currently able to work remotely from a home office location for day-to-day operations unless occasional travel for meetings, collaborative activities, or team building activities is specified by leadership. This is subject to change based on amendments and/or modifications to the ACG Flex Work policy. Who We Are Become a part of something bigger. The Auto Club Group (ACG) provides membership, travel, insurance, and financial service offerings to approximately 14+ million members and customers across 14 states and 2 U.S. territories through AAA, Meemic, and Fremont brands. ACG belongs to the national AAA federation and is the second largest AAA club in North America. By continuing to invest in more advanced technology, pursuing innovative products, and hiring a highly skilled workforce, AAA continues to build upon its heritage of providing quality service and helping our members enjoy life's journey through insurance, travel, financial services, and roadside assistance. And when you join our team, one of the first things you'll notice is that same, whole-hearted, enthusiastic advocacy for each other. We have positions available for every walk of life! AAA prides itself on creating an inclusive and welcoming environment of diverse backgrounds, experiences, and viewpoints, realizing our differences make us stronger. To learn more about AAA The Auto Club Group visit *********** Important Note: ACG's Compensation philosophy is to provide a market-competitive structure of fair, equitable and performance-based pay to attract and retain excellent talent that will enable ACG to meet its short and long-term goals. ACG utilizes a geographic pay differential as part of the base salary compensation program. Pay ranges outlined in this posting are based on the various ranges within the geographic areas which ACG operates. Salary at time of offer is determined based on these and other factors as associated with the job and job level. The above statements describe the principal and essential functions, but not all functions that may be inherent in the job. This job requires the ability to perform duties contained in the job description for this position, including, but not limited to, the above requirements. Reasonable accommodations will be made for otherwise qualified applicants, as needed, to enable them to fulfill these requirements. The Auto Club Group, and all its affiliated companies, is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, gender identity, sexual orientation, national origin, disability or protected veteran status. Regular and reliable attendance is essential for the function of this job. AAA The Auto Club Group is committed to providing a safe workplace. Every applicant offered employment within The Auto Club Group will be required to consent to a background and drug screen based on the requirements of the position.
$27k-32k yearly est. 3d ago

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Claims Representative - Workers Compensation
West Bend Mutual Insurance 4.8
Claim processor job in Appleton, WI
Recognized as a Milwaukee Journal Sentinel Top Workplace for 14 consecutive years, including three years of being honored as number one! Join us at West Bend, where we believe that our associates are our greatest asset. We hire talented individuals who are conscientious, dedicated, customer focused, and able to build lasting relationships. We create and maintain an environment where you feel a sense of belonging and appreciation. Your diversity of thought, experience, and knowledge are valued. We're committed to fostering a welcoming culture, offering you opportunities for meaningful work and professional growth. More than a workplace, we celebrate our successes and take pride in serving our communities. Job Summary When employees are injured on the job, they need someone who can guide them through the process with care and expertise. As a Workers' Compensation Claims Representative at West Bend, you'll guide injured employees through the recovery process, ensure fair and timely claim resolution, and help businesses stay compliant. If you thrive on problem-solving, negotiation, and making a real impact, this is your opportunity to lead with confidence. Work Location This position offers a hybrid schedule with three in-office collaboration days for team meetings and other events. In certain cases, highly qualified candidates with strong jurisdictional experience may be considered for a remote arrangement. External applications will be accepted on a rolling basis while the position remains open. Responsibilities & Qualifications As a Claims Representative, you will manage claims of varying complexity using current claim technology and best practices. You will conduct thorough investigations to determine coverage, evaluate damages/benefits, and assess liability/compensability. You will negotiate settlements with insureds, claimants, and attorneys while maintaining proactive file management, accurate reserving, and adherence to audit and regulatory standards. This role collaborates closely with internal partners and external stakeholders, with the scope of responsibility (including field work and regional liaison duties) increasing with experience level. Key Responsibilities * Investigate and resolve claims within assigned authority * Determine coverage, damages, and liability * Negotiate settlements with insureds, claimants, and attorneys * Maintain accurate documentation and reserving * Communicate promptly and professionally with all stakeholders * Collaborate with internal teams and external partners * Adhere to audit and compliance standards * Participate in training and team initiatives Preferred Experience and Skills * Prior experience managing claims at the appropriate level of complexity (from low/moderate to high-exposure/complex) * Proficiency with computers and current claim technology * Interpersonal, oral, and written communication skills with customer-focused professionalism * Negotiation, problem-solving, and conflict resolution skills * Time management and organizational discipline with proactive file handling * Independent decision-making ability (higher levels) and results orientation * Technical expertise in coverage analysis, compensability, and damages evaluation (higher levels) * Prior experience managing claims across multiple jurisdictions (higher levels) with preferred jurisdictions of Illinois, Wisconsin, and North Carolina Preferred Education and Training * Bachelor's degree in Business, Insurance or related field * Associate in General Insurance (AINS) designation * Associate in Claims (AIC) designation * CPCU coursework or other continuing education * Licensure in jurisdictions where required #LI-LW1 Salary Statement The salary range for this position is $67,000 - $100,000. The actual base pay offered to the successful candidate will be based on multiple factors, including but not limited to job-related knowledge/skills, experience, business needs, geographical location, and internal equity. Compensation decisions are made by West Bend and are dependent upon the facts and circumstances of each position and candidate. Benefits West Bend offers a comprehensive benefit plan including but not limited to: * Medical & Prescription Insurance * Health Savings Account * Dental Insurance * Vision Insurance * Short and Long Term Disability * Flexible Spending Accounts * Life and Accidental Death & Disability * Accident and Critical Illness Insurance * Employee Assistance Program * 401(k) Plan with Company Match * Pet Insurance * Paid Time Off. Standard first year PTO is 17 days, pro-rated based on month of hire. Enhanced PTO may be available for experienced candidates * Bonus eligible based on performance * West Bend will comply with any applicable state and local laws regarding employee leave benefits, including, but not limited to providing time off pursuant to the Colorado Healthy Families and Workplaces Act for Colorado employees, in accordance with its plans and policies. EEO West Bend provides equal employment opportunities to all associates and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws. This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, and promotion.
$33k-42k yearly est. Auto-Apply 28d ago
Claims Examiner
Auxiant 3.1
Claim processor job in Madison, WI
Full-time Description ************************ Auxiant's Mission Statement and Core Values Mission: An Independent TPA investing in People and Innovation to deliver expert-driven experiences with REAL Results. Core Values: Independent Solutions. REAL Results Respect Empowerment Agility Leadership Be part of a growing and prospering company as a Claims Examiner. Auxiant is a third party administrator of self-funded employee benefit plans with offices in Cedar Rapids, IA, Madison and Milwaukee, WI. Auxiant is a fast-growing,progressive company offering an excellent wage and benefit package. Job Summary: 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 acceptable accuracy Answer inbound phone calls from members and providers. Handle correspondence from members and providers in a timely manner. Analyze self-funded health plans and use plan language to correspond to necessary inquiries, both verbally and written. Interpret plan design and language to analyze claim edits. Point of contact for clients and members. Work Customer Service Tickets. Nonessential Functions: Other duties as assigned or appropriate Education/Qualifications: Familiarity with ICD-10 and CPT coding Understanding of medical claims processing guidelines Proficient PC skills including email, record keeping, routine database activity, word processing, spreadsheet and 10-key QicLink experience Medical Terminology High school diploma and 1-2 years related experience; or equivalent combination of education and experience *Full benefits including: Medical, Dental, Vision, Flexible Spending, Gym Membership Reimbursement, Life Insurance, LTD, STD, 401K, 3 weeks vacation, 9 paid holidays, casual dress code and more Job Type: Full-time Schedule: 8 hour shift Day shift Monday to Friday Work Location: In person
$38k-54k yearly est. 20d ago
Claims Examiner
Harriscomputer
Claim processor job in Wisconsin
Responsibilities & Duties:Claims Processing and Assessment: Evaluate incoming claims to determine eligibility, coverage, and validity. Conduct thorough investigations, including reviewing medical records and other relevant documentation. Analyze policy provisions and contractual agreements to assess claim validity. Utilize claims management systems to document findings and process claims efficiently. Communication and Customer Service: Communicate effectively with policyholders, beneficiaries, and healthcare providers regarding claim status and requirements. Provide timely responses to inquiries and maintain professional and empathetic communication throughout the claims process. Address customer concerns and escalate complex issues to senior claims personnel or management as needed. Compliance and Documentation: Ensure compliance with company policies, procedures, and regulatory requirements. Maintain accurate records and documentation related to claims activities. Follow established guidelines for claims adjudication and payment authorization. Quality Assurance and Improvement: Identify opportunities for process improvement and efficiency within the claims department. Participate in quality assurance initiatives to uphold service standards and improve claim handling practices. Collaborate with team members and management to implement best practices and enhance overall departmental performance. Reporting and Analysis: Generate reports and provide data analysis on claims trends, processing times, and outcomes. Contribute to the development of management reports and presentations regarding claims operations.
$29k-47k yearly est. Auto-Apply 32d ago
Billing and Claims Specialist
Behavioral Health Clinic 4.3
Claim processor job in Wausau, WI
Job Title:Billing and Claims Specialist Reports to:Director of Operations Description:The Billing and Claims Specialist will work with clinicians, administrative staff, patients, and insurance companies to submit and process insurance claims for mental health services at Behavioral Health Clinic (BHC). Duties and Responsibilities: Oversee coding of services using ICD-10 and DSM-5 Coding Submit claims using the Electronic Health Record and claims processing software Enter Payments (ERA, EFT, & Other Payments) Prepare Billing Statements Research and Resolve billing issues by working with insurance companies Run Billing Cycle Reports Research Coding Rules and Regulations with Contracted Payers to help guide best business practice Patient Collection Duties (collecting copays and patient allowed amounts, creating refunds, managing collections process etc.) Other duties as assigned Qualifications: Compassionate and Confidential Efficient with computer software systems (with training) Working knowledge of Microsoft Office and Google products (Documents, Sheets, etc.) Ability to work effectively both independently and as part of a team Willingness to learn and adapt Strong organization and time management skills Skilled in verbal and written communication including good phone skills Experience in medical coding and billing preferred but not required; 3-5 years of work experience (preferred) Willingness to work occasional overtime Benefits: Starting pay $22.00 - $26.00 per hour Healthcare Benefit Package - Including Dental, Vision, STD, LTD, and Retirement Plan Options Supportive and collaborate team environment & Opportunities for advancement and leadership Paid Time Off (PTO) and Holidays *In accordance with legal requirements and company policies, successful candidates for this position will be required to complete the form I-9, Employment Eligibility Verification and Background Check, as part of the onboarding process*
$22-26 hourly 19d ago
Claims Specialist
Jewelers Mutual 3.8
Claim processor job in Neenah, WI
Responsible for adjudicating PL, CL, Shipping, and CarePlan claims as assigned. The claims specialist also assists with administrative duties for the department, helping the team effectively negotiate and resolve claims in a timely manner and in accordance with established good faith handling procedures. A secondary responsibility within this role is to provide support to the Jewelry Recovery Specialist with salvage-related documentation including salvage-related invoices, payments, and recoveries. Why Jewelers Mutual: Since 1913 we've been committed to supporting the Jewelry industry and putting customers at the center of everything we do. With over a century of trusted expertise, we're financially strong, forward-thinking, and driven by curiosity. Guided by our core values of Agility, Accountability, and Relevancy, we lead through innovation. As a technology focused organization, we embrace cutting-edge tools and data-driven insights to continuously improve our products, services, and customer experience. Our mission is to be the industry's most trusted advisor by investing in our people, adopting new technologies, and striving for excellence. We're dedicated to fostering growth through collaboration, powered by bold thinking, teamwork, and the passion of our people. Here, you'll: Move fast and embrace change Always look for better ways Grow, thrive, and help shape what's next Join us and be part of a culture where you can make an impact while building your future. What You'll Do: Investigates, evaluates, and resolves multi-line claims in accordance with established procedures, good faith practices, and in accordance with the policy. Examines claim adjustors' reports or similar claims/precedents to determine extent of coverage and liability. Pays claimant/insured amount due according to our contractual obligation and in alignment with our company procedures. Identifies and refers questionable claims to the special investigation unit in accordance with established fraud reporting procedures. Maintains excellent written and verbal correspondence with all parties involved on the claim. Evaluates and obtains damage documentation to accurately set reserves and effectively resolve claims. Maintains current status on claims and reviews claims on diary system. May be required to provide testimony under oath on claims in litigation. Provides quality customer service along with accurate and timely claim investigations and payments. To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. What You'll Bring: Property/casualty insurance adjusting experience is desired. Jewelry expertise, including experience working in the jewelry trade, is desired. Proficient in Microsoft suite applications including Word, Excel, Outlook, and PowerPoint. Proficiency in Guidewire software desired. CERTIFICATES, LICENSES, REGISTRATIONS None PHYSICAL REQUIREMENTS Prolonged periods sitting at a desk and working on a computer. Occasionally required to stand; walk; use hands to finger, handle, or touch objects or controls; and talk or hear. What We Offer You: Competitive Compensation & Benefits: Includes performance bonuses, generous paid time off, and a top-tier retirement program with 401(k) matching and additional company contributions. Collaborative Culture: Work alongside talented, passionate peers who value ownership and continuous learning. Community & Giving: Benefit from 50% charitable gift matching and paid volunteer time to support nonprofit causes Great Place to Work Certified: Join a team recognized for an environment of innovation and growth. Accessibility and Accommodations We are committed to providing an inclusive and accessible recruitment process. If you require accommodation at any stage of the application or interview process, please let us know by contacting *************************.
$52k-69k yearly est. 26d ago
Stop Loss & Health Claim Analyst
Sun Life Financial 4.6
Claim processor job in Milwaukee, WI
Sun Life U.S. is one of the largest providers of employee and government benefits, helping approximately 50 million Americans access the care and coverage they need. Through employers, industry partners and government programs, Sun Life U.S. offers a portfolio of benefits and services, including dental, vision, disability, absence management, life, supplemental health, medical stop-loss insurance, and healthcare navigation. We have more than 6,400 employees and associates in our partner dental practices and operate nationwide. Visit our website to discover how Sun Life is making life brighter for our customers, partners and communities. Job Description: The Opportunity: This position is responsible for reviewing claims, interpreting and comparing contracts, dispersing reimbursement, and ensuring that all claims contain the required documentation to support the Stop Loss claim determination. They are responsible for customer service, and the financial risk associated with an assigned block of Stop Loss claims. This requires applying the appropriate contractual provisions; plan specifications of the underlying plan document; professional case management resources; and claims practices, procedures and protocols to the medical facts of each claim to decide on reimbursement or denial of a claim. The incumbent is accountable for developing, coordinating and implementing a plan of action for each claim accepted to ensure it is managed effectively and all cost containment initiatives are implemented in conjunction with the clinical resources. How you will contribute: * Determine, on a timely basis, the eligibility of assigned claim by applying the appropriate contractual provisions to the medical facts and specifications of the claim * The ability to apply the appropriate contractual provisions (both from the underlying plan of the policyholder as well as the Sun Life contract) especially with regard to eligibility and exclusions * Maintain claim block and meet departmental production and quality metrics * An awareness of industry claim practices * Prepare written rationale of claim decision based on review of the contractual provisions and plan specifications and the analysis of medical records * Knowledge of legal risk and regulatory/statutory guidelines HIPPA, privacy, Affordable Health Care Act, etc. * Understand where, when and how professional resources both internal and external, e.g. medical, investigative and legal can add value to the process * Establish cooperative and productive relationships with professional resources What you will bring with you: * Bachelor's degree preferred * A minimum of three to five years' experience processing first dollar medical claims or stop loss claim processing * Demonstrated ability to work as part of a cohesive team * Strong written and verbal communication skills * Knowledge of Stop Loss Claims and Stop Loss industry preferred * Demonstrated success in negotiation, persuasion, and solutions-based underwriting * Ability to work in a fast-paced environment; flexibility to handle multiple priorities while maintaining a high level of professionalism * Overall knowledge of health care industry * Proficiency using the Microsoft Office suite of products * Ability to travel Salary Range: $54,900 - $82,400 At our company, we are committed to pay transparency and equity. The salary range for this role is competitive nationwide, and we strive to ensure that compensation is fair and equitable. Your actual base salary will be determined based on your unique skills, qualifications, experience, education, and geographic location. In addition to your base salary, this position is eligible for a discretionary annual incentive award based on your individual performance as well as the overall performance of the business. We are dedicated to creating a work environment where everyone is rewarded for their contributions. Not ready to apply yet but want to stay in touch? Join our talent community to stay connected until the time is right for you! We are committed to fostering an inclusive environment where all employees feel they belong, are supported and empowered to thrive. We are dedicated to building teams with varied experiences, backgrounds, perspectives and ideas that benefit our colleagues, clients, and the communities where we operate. We encourage applications from qualified individuals from all backgrounds. Life is brighter when you work at Sun Life At Sun Life, we prioritize your well-being with comprehensive benefits, including generous vacation and sick time, market-leading paid family, parental and adoption leave, medical coverage, company paid life and AD&D insurance, disability programs and a partially paid sabbatical program. Plan for your future with our 401(k) employer match, stock purchase options and an employer-funded retirement account. Enjoy a flexible, inclusive and collaborative work environment that supports career growth. We're proud to be recognized in our communities as a top employer. Proudly Great Place to Work Certified in Canada and the U.S., we've also been recognized as a "Top 10" employer by the Boston Globe's "Top Places to Work" for two years in a row. Visit our website to learn more about our benefits and recognition within our communities. We will make reasonable accommodations to the known physical or mental limitations of otherwise-qualified individuals with disabilities or special disabled veterans, unless the accommodation would impose an undue hardship on the operation of our business. Please email ************************* to request an accommodation. For applicants residing in California, please read our employee California Privacy Policy and Notice. We do not require or administer lie detector tests as a condition of employment or continued employment. Sun Life will consider for employment all qualified applicants, including those with criminal histories, in a manner consistent with the requirements of applicable state and local laws, including applicable fair chance ordinances. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran. Job Category: Claims - Life & Disability Posting End Date: 30/01/2026
$54.9k-82.4k yearly Auto-Apply 9d ago
Associate Claims Examiner - Equine
Markel Corporation 4.8
Claim processor job in Milwaukee, WI
What part will you play? If you're looking for a place where you can make a meaningful difference, you've found it. The work we do at Markel gives people the confidence to move forward and seize opportunities, and you'll find your fit amongst our global community of optimists and problem-solvers. We're always pushing each other to go further because we believe that when we realize our potential, we can help others reach theirs. Join us and play your part in something special! This position will be responsible for the resolution of low complexity and low exposure claims and provide support to other team members as directed. This position will work closely with their manager to train and develop fundamental claims handling skills. Job Responsibilities * Confirms coverage of claims by reviewing policies and documents submitted in support of claims. * Conducts, coordinates and directs investigation into loss facts and extent of damages. * Evaluates information on coverage, liability, and damages to determine the extent of insured's exposure. * Strong emphasis on customer service to both internal and external customers is a major focus for the ACE as this role will handle small commercial claims that require excellent customer service to insureds and agents. * Set reserves within authority (up to $25,000) and resolve claims within a prompt timeframe avoiding expense relating to independent adjusting. Required Qualifications * This role will is responsible for Equine claims; equine knowledge or hands-on experience working with horses is strongly preferred. * Must have or be eligible to receive claims adjuster license. * Successful completion of basic insurance courses or achievement of industry designations. * Ability to be trained in insurance adjusting up to two years of claims experience. * 2-4 years of experience in general liability, construction defect, or related liability lines preferred. * Bachelor's degree preferred * Excellent written and oral communication skills. * Strong organizational and time management skills. #LI-Hybrid US Work Authorization US Work Authorization required. Markel does not provide visa sponsorship for this position, now or in the future. Who we are: Markel Group (NYSE - MKL) a fortune 500 company with over 60 offices in 20+ countries, is a holding company for insurance, reinsurance, specialist advisory and investment operations around the world. We're all about people | We win together | We strive for better We enjoy the everyday | We think further What's in it for you: In keeping with the values of the Markel Style, we strive to support our employees in living their lives to the fullest at home and at work. * We offer competitive benefit programs that help meet our diverse and changing environment as well as support our employees' needs at all stages of life. * All full-time employees have the option to select from multiple health, dental and vision insurance plan options and optional life, disability, and AD&D insurance. * We also offer a 401(k) with employer match contributions, an Employee Stock Purchase Plan, PTO, corporate holidays and floating holidays, parental leave. Are you ready to play your part? Choose 'Apply Now' to fill out our short application, so that we can find out more about you. Caution: Employment scams Markel is aware of employment-related scams where scammers will impersonate recruiters by sending fake job offers to those actively seeking employment in order to steal personal information. Frequently, the scammer will reach out to individuals who have posted their resume online. These "job offers" include convincing offer letters and frequently ask for confidential personal information. Therefore, for your safety, please note that: * All legitimate job postings with Markel will be posted on Markel Careers. No other URL should be trusted for job postings. * All legitimate communications with Markel recruiters will come from Markel.com email addresses. We would also ask that you please report any job employment scams related to Markel to ***********************. Markel is an equal opportunity employer. We do not discriminate or allow discrimination on the basis of any protected characteristic. This includes race; color; sex; religion; creed; national origin or place of birth; ancestry; age; disability; affectional or sexual orientation; gender expression or identity; genetic information, sickle cell trait, or atypical hereditary cellular or blood trait; refusal to submit to genetic tests or make genetic test results available; medical condition; citizenship status; pregnancy, childbirth, or related medical conditions; marital status, civil union status, domestic partnership status, familial status, or family responsibilities; military or veteran status, including unfavorable discharge from military service; personal appearance, height, or weight; matriculation or political affiliation; expunged juvenile records; arrest and court records where prohibited by applicable law; status as a victim of domestic or sexual violence; public assistance status; order of protection status; status as a smoker or nonsmoker; membership or activity in local commissions; the use or nonuse of lawful products off employer premises during non-work hours; declining to attend meetings or participate in communications about religious or political matters; or any other classification protected by applicable law. Should you require any accommodation through the application process, please send an e-mail to the ***********************. No agencies please.
$37k-52k yearly est. Auto-Apply 48d ago
Claims Specialist
Evans Transportation Services 4.2
Claim processor job in Delafield, WI
Requirements QUALIFICATIONS AND REQUIREMENTS Associate's or Bachelor's Degree preferred. 1-3 years of experience in transportation, logistics, freight claims, customer service, or a related operational role. Prior experience handling freight claims or working with carriers is preferred but not required. Strong attention to detail and ability to manage multiple claims simultaneously. Excellent written and verbal communication skills, with the ability to professionally interact with customers and carriers. Strong critical thinking, problem-solving, and negotiation skills. Working knowledge of truckload and less-than-truckload transportation is preferred. Proficiency in Microsoft Office Suite (Excel, Outlook, Word); experience with Transportation Management Systems is a plus. High level of organizational skills with the ability to meet deadlines in a fast-paced environment. Ability to read, write, type, and speak English fluently is a requirement of this position. PHYSICAL DEMANDS / WORK ENVIRONMENT While performing the duties of this job, the employee must be able to use a keyboard, calculator, and telephone. Frequent sitting, talking, hearing, and close-vision work are required, with occasional standing and lifting (up to 10 lbs.). Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Salary Description 60000
$72k-102k yearly est. 4d ago
Associate Claims Specialist - Workers Compensation - Central Region
Liberty Mutual 4.5
Claim processor job in Wisconsin Dells, WI
Are you looking for an opportunity to join a fast-growing company that consistently outpaces the industry in year-over-year growth? Liberty Mutual offers exciting openings for Workers Compensation Claims Specialists within the Central Region! As a Workers Compensation Claims Specialist, the successful candidate will join a dedicated Claims Team, utilizing the latest technology to manage a caseload of routine to moderately complex claims. Responsibilities include investigating claims, assessing liability and compensability, evaluating losses, and negotiating settlements. The role involves interactions with claimants, policyholders, appraisers, attorneys, and other third parties throughout the claims management process. The position offers training developed with an emphasis on enhancing skills needed to help provide exceptional service to our customers. Training is a critical component of your success, and that success starts with reliable attendance. Attendance and active engagement during training are mandatory. Training will require 1 week in our Plano, TX office onsite in February 2026. This position may be filled as a Workers Compensation Associate Claims Specialist, Workers Compensation Claims Specialist I, or a Workers Compensation Claims Specialist II. The salary range posted reflects the range for the varying pay scale across various locations. To be considered for this position, candidates must reside within 50 miles of Hoffman Estates, IL, or Indianapolis, IN, and will be required to work in the office twice a month. Candidates located in Ohio, Montana, and Virginia are eligible for 100% remote work, as we do not have claims offices in these states. Please note that this policy is subject to change. Responsibilities * Manages an inventory of claims to evaluate compensability/liability. * Establishes action plan based on case facts, best practices, protocols, regulatory issues and available resources. * Plans and conducts investigations of claims to confirm coverage and to determine liability, compensability and damages. * Assesses policy coverage for submitted claims and notifies the insured of any issues; determines and establishes reserve requirements, adjusting reserves, as necessary, during the processing of the claim, refers claims to the subrogation group or Special Investigations Unit as appropriate. * Evaluates actual damages associated with claims and conducts negotiations, within assigned authority limits, to settle claims. * Performs other duties as assigned. Qualifications * Effective interpersonal, analytical and negotiation abilities required * Ability to provide information in a clear, concise manner with an appropriate level of detail * Demonstrated ability to build and maintain effective relationships * Demonstrated success in a professional environment; success in a customer service/retail environment preferred * Effective analytical skills to gather information, analyze facts, and draw conclusions; as normally acquired through a bachelor's degree or equivalent * Knowledge of legal liability, insurance coverage and medical terminology helpful, but not mandatory * Licensing may be required in some states About Us Pay Philosophy: The typical starting salary range for this role is determined by a number of factors including skills, experience, education, certifications and location. The full salary range for this role reflects the competitive labor market value for all employees in these positions across the national market and provides an opportunity to progress as employees grow and develop within the role. Some roles at Liberty Mutual have a corresponding compensation plan which may include commission and/or bonus earnings at rates that vary based on multiple factors set forth in the compensation plan for the role. At Liberty Mutual, our goal is to create a workplace where everyone feels valued, supported, and can thrive. We build an environment that welcomes a wide range of perspectives and experiences, with inclusion embedded in every aspect of our culture and reflected in everyday interactions. This comes to life through comprehensive benefits, workplace flexibility, professional development opportunities, and a host of opportunities provided through our Employee Resource Groups. Each employee plays a role in creating our inclusive culture, which supports every individual to do their best work. Together, we cultivate a community where everyone can make a meaningful impact for our business, our customers, and the communities we serve. We value your hard work, integrity and commitment to make things better, and we put people first by offering you benefits that support your life and well-being. To learn more about our benefit offerings please visit: *********************** Liberty Mutual is an equal opportunity employer. We will not tolerate discrimination on the basis of race, color, national origin, sex, sexual orientation, gender identity, religion, age, disability, veteran's status, pregnancy, genetic information or on any basis prohibited by federal, state or local law. Fair Chance Notices * California * Los Angeles Incorporated * Los Angeles Unincorporated * Philadelphia * San Francisco
$60k-82k yearly est. Auto-Apply 3d ago
Adjudicator, Provider Claims-On the phone
Molina Healthcare Inc. 4.4
Claim processor job in Green Bay, WI
Provides support for provider claims adjudication activities including responding to providers to address claim issues, and researching, investigating and ensuring appropriate resolution of claims. * Provides support for resolution of provider claims issues, including claims paid incorrectly; analyzes systems and collaborates with respective operational areas/provider billing to facilitate resolution. * Collaborates with the member enrollment, provider information management, benefits configuration and claims processing teams to appropriately address provider claim issues. * Responds to incoming calls from providers regarding claims inquiries - provides excellent customer service, support and issue resolution; documents all calls and interactions. * Assists in reviews of state and federal complaints related to claims. * Collaborates with other internal departments to determine appropriate resolution of claims issues. * Researches claims tracers, adjustments, and resubmissions of claims. * Adjudicates or readjudicates high volumes of claims in a timely manner. * Manages defect reduction by identifying and communicating claims error issues and potential solutions to leadership. * Meets claims department quality and production standards. * Supports claims department initiatives to improve overall claims function efficiency. * Completes basic claims projects as assigned. Required Qualifications * At least 2 years of experience in a clerical role in a claims, and/or customer service setting, including experience in provider claims investigation/research/resolution/reimbursement methodology analysis within a managed care organization, or equivalent combination of relevant education and experience. * Research and data analysis skills. * Organizational skills and attention to detail. * Time-management skills, and ability to manage simultaneous projects and tasks to meet internal deadlines. * Customer service experience. * Effective verbal and written communication skills. * Microsoft Office suite and applicable software programs proficiency. To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V Pay Range: $21.65 - $38.37 / HOURLY * Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level. About Us Molina Healthcare is a nationwide fortune 500 organization with a mission to provide quality healthcare to people receiving government assistance. If you are seeking a meaningful opportunity in a team-oriented environment, come be a part of a highly engaged workforce dedicated to our mission. Bring your passion and talents and together we can make a difference in the lives of others. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.
$21.7-38.4 hourly 24d ago
Workers' Compensation Claims Specialist (REMOTE - IA, MN, NE, WI)
Holmes Murphy 4.1
Claim processor job in Wisconsin
We are looking to add a Workers' Compensation Claims Specialist to join our Creative Risk Solutions team. The ideal candidate will have jurisdictional experience in Iowa, Minnesota, Nebraska, and Wisconsin. Offering a forward-thinking, innovative, and vibrant company culture, along with the opportunity to share your unique potential, there really is no place like Holmes! Essential Responsibilities: · Receives, gathers and accurately transmits workers' compensation information to the company, from communications with the insured, claimants, and internal staff in a timely manner. · Investigates, evaluates, and resolves lost time Workers' Compensation claims, including litigated claims. · Mediates situations as they arise between the insured and the insurance company, with little to no support from leader, to include researching coverage issues. · Enters and maintains accurate information on a computer system during the claim process, to include final settlement information. · Generates checks for indemnity and medical payments daily. · Develops and monitors consistency in procedural matters of claims handling process within CRS. · Willingness to become licensed if required in jurisdiction where claims are handled. Qualifications: · Education: High school diploma; college degree preferred. Technical designations encouraged, such as AIC and CPCU. · Experience: 3-5 years claims experience with strong background in Workers' Compensation claims handling. · Licensing: Active state specific Workers Compensation License required or the ability to acquire license within three months of hire. Jurisdictional expertise and required licensing in Iowa, Nebraska, Wisconsin, and Minnesota. · Skills: An ideal candidate will have proficient knowledge of Workers' Compensation insurance coverage and claims processing procedures. They will possess the ability to adjudicate lost time claims across multiple jurisdictions and demonstrate the capacity to quickly learn and adapt to various software programs. · Technical Competencies: An ideal candidate will have a strong grasp of claims principles, practices, and insurance coverage interpretation, contributing to workflows and adhering to compliance requirements. They will prioritize problem-solving, actively foster relationships, and collaborate to deliver impactful solutions and a world-class client experience. Here's a little bit about us: Creative Risk Solutions is a leading provider of innovative risk management solutions. We specialize in delivering customized claims management, loss control, and risk consulting services to our clients. Our team is dedicated to excellence, integrity, and creating value for our clients through proactive risk management strategies. In addition to being great at what you do, we place a high emphasis on building a best-in-class culture. We do this through empowering employees to build trust through honest and caring actions, ensuring clear and constructive communication, establishing meaningful client relationships that support their unique potential, and contributing to the organization's success by effectively influencing and uplifting team members. Benefits: In addition to core benefits like health, dental and vision, also enjoy benefits such as: · Paid Parental Leave and supportive New Parent Benefits - We know being a working parent is hard, and we want to support our employees in this journey! · Company paid continuing Education & Tuition Reimbursement - We support those who want to develop and grow. · 401k Profit Sharing - Each year, Holmes Murphy makes a lump sum contribution to every full-time employee's 401k. This means, even if you're not in a position to set money aside for the future at any point in time, Holmes Murphy will do it on your behalf! We are forward-thinking and want to be sure your future is cared for. · Generous time off practices in addition to paid holidays - Yes, we actually encourage employees to use their time off, and they do. After all, you can't be at your best for our clients if you're not at your best for yourself first. · Supportive of community efforts with paid Volunteer time off and employee matching gifts to charities that are important to you - Through our Holmes Murphy Foundation, we offer several vehicles where you can make an impact and care for those around you. · DE&I programs - Holmes Murphy is committed to celebrating every employee's unique diversity, equity, and inclusion (DE&I) experience with us. Not only do we offer all employees a paid Diversity Day time off option, but we also have a Chief Diversity Officer on hand, as well as a DE&I project team, committee, and interest group. You will have the opportunity to take part in those if you wish! · Consistent merit increase and promotion opportunities - Annually, employees are reviewed for merit increases and promotion opportunities because we believe growth is important - not only with your financial wellbeing, but also your career wellbeing. · Discretionary bonus opportunity - Yes, there is an annual opportunity to make more money. Who doesn't love that?! Holmes Murphy & Associates is an Equal Opportunity Employer. #LI-SM1
$70k-97k yearly est. Auto-Apply 21d ago
Claims Representative - Workers Compensation
Thesilverlining
Claim processor job in Appleton, WI
Recognized as a Milwaukee Journal Sentinel Top Workplace for 14 consecutive years, including three years of being honored as number one! Join us at West Bend, where we believe that our associates are our greatest asset. We hire talented individuals who are conscientious, dedicated, customer focused, and able to build lasting relationships. We create and maintain an environment where you feel a sense of belonging and appreciation. Your diversity of thought, experience, and knowledge are valued. We're committed to fostering a welcoming culture, offering you opportunities for meaningful work and professional growth. More than a workplace, we celebrate our successes and take pride in serving our communities. Job Summary When employees are injured on the job, they need someone who can guide them through the process with care and expertise. As a Workers' Compensation Claims Representative at West Bend, you'll guide injured employees through the recovery process, ensure fair and timely claim resolution, and help businesses stay compliant. If you thrive on problem-solving, negotiation, and making a real impact, this is your opportunity to lead with confidence. Work Location This position offers a hybrid schedule with three in-office collaboration days for team meetings and other events. In certain cases, highly qualified candidates with strong jurisdictional experience may be considered for a remote arrangement. External applications will be accepted on a rolling basis while the position remains open. Responsibilities & Qualifications As a Claims Representative, you will manage claims of varying complexity using current claim technology and best practices. You will conduct thorough investigations to determine coverage, evaluate damages/benefits, and assess liability/compensability. You will negotiate settlements with insureds, claimants, and attorneys while maintaining proactive file management, accurate reserving, and adherence to audit and regulatory standards. This role collaborates closely with internal partners and external stakeholders, with the scope of responsibility (including field work and regional liaison duties) increasing with experience level. Key Responsibilities Investigate and resolve claims within assigned authority Determine coverage, damages, and liability Negotiate settlements with insureds, claimants, and attorneys Maintain accurate documentation and reserving Communicate promptly and professionally with all stakeholders Collaborate with internal teams and external partners Adhere to audit and compliance standards Participate in training and team initiatives Preferred Experience and Skills Prior experience managing claims at the appropriate level of complexity (from low/moderate to high-exposure/complex) Proficiency with computers and current claim technology Interpersonal, oral, and written communication skills with customer-focused professionalism Negotiation, problem-solving, and conflict resolution skills Time management and organizational discipline with proactive file handling Independent decision-making ability (higher levels) and results orientation Technical expertise in coverage analysis, compensability, and damages evaluation (higher levels) Prior experience managing claims across multiple jurisdictions (higher levels) with preferred jurisdictions of Illinois, Wisconsin, and North Carolina Preferred Education and Training Bachelor's degree in Business, Insurance or related field Associate in General Insurance (AINS) designation Associate in Claims (AIC) designation CPCU coursework or other continuing education Licensure in jurisdictions where required #LI-LW1 Salary Statement The salary range for this position is $67,000 - $100,000. The actual base pay offered to the successful candidate will be based on multiple factors, including but not limited to job-related knowledge/skills, experience, business needs, geographical location, and internal equity. Compensation decisions are made by West Bend and are dependent upon the facts and circumstances of each position and candidate. Benefits West Bend offers a comprehensive benefit plan including but not limited to: Medical & Prescription Insurance Health Savings Account Dental Insurance Vision Insurance Short and Long Term Disability Flexible Spending Accounts Life and Accidental Death & Disability Accident and Critical Illness Insurance Employee Assistance Program 401(k) Plan with Company Match Pet Insurance Paid Time Off. Standard first year PTO is 17 days, pro-rated based on month of hire. Enhanced PTO may be available for experienced candidates Bonus eligible based on performance West Bend will comply with any applicable state and local laws regarding employee leave benefits, including, but not limited to providing time off pursuant to the Colorado Healthy Families and Workplaces Act for Colorado employees, in accordance with its plans and policies. EEO West Bend provides equal employment opportunities to all associates and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws. This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, and promotion.
$29k-42k yearly est. Auto-Apply 6d ago
Auto Claims Representative
Auto-Owners Insurance Co 4.3
Claim processor job in Appleton, WI
We offer a merit-based work-from-home program based on job responsibilities. After initial training in-person, you could have the flexibility of work-from-home time as defined by the leadership team. Auto-Owners Insurance, a top-rated insurance carrier, is seeking a motivated claims trainee to join our team. This job handles entry-level insurance claims under close supervision through the life-cycle of a claim including but not limited to: investigation, evaluation, and claim resolution. This job provides service to agents, insureds, and others to ensure claims resolve accurately and timely. This job includes training and development completion of the Company's claims training program for the assigned line of insurance and requires the person to: * Investigate, evaluate, and settle entry-level insurance claims * Study insurance policies, endorsements, and forms to develop foundational knowledge on Company insurance products * Learn and comply with Company claim handling procedures * Develop entry-level claim negotiation and settlement skills * Build skills to effectively serve the needs of agents, insureds, and others * Meet and communicate with claimants, legal counsel, and third-parties * Develop specialized skills including but not limited to, estimating and use of designated computer-based programs for loss adjustment * Study, obtain, and maintain an adjuster's license(s), if required by statute within the timeline established by the Company or legal requirements Desired Skills & Experience * Bachelor's degree or direct equivalent experience with property/casualty claims handling * Ability to organize data, multi-task and make decisions independently * Above average communication skills (written and verbal) * Ability to write reports and compose correspondence * Ability to resolve complex issues * Ability to maintain confidentially and data security * Ability to effectively deal with a diverse group individuals * Ability to accurately deal with mathematical problems, including, geometry (area and volume) and financial areas (such as accuracy in sums, unit costs, and the capacity to read and develop understanding of personal and business finance documents) * Ability to drive an automobile, possess a valid driver license, and maintain a driving record consistent with the Company's underwriting guidelines for coverage * Continually develop product knowledge through participation in approved educational programs Benefits Auto-Owners offers a wide range of career opportunities, and we are seeking talent that will help us continue our long tradition of success. We offer a friendly work environment, structured training program, employee mentoring and an excellent compensation/benefits package. Along with a competitive base salary, matched 401(k), fully-funded pension plan (once vested), and bonus programs, Auto-Owners also provides generous paid time off including holidays, vacation days, personal time, and sick leave. If you're looking to do rewarding work alongside great people, Auto-Owners is the place for you! Equal Employment Opportunity Auto-Owners Insurance is an equal opportunity employer. The Company hires, transfers, and promotes on the basis of ability, without consideration of disability, age, sex, race, color, religion, height, weight, marital status, sexual orientation, gender identity or national origin, or any factor contrary to federal, state or local law. * Please note that the ability to work in the U.S. without current or future sponsorship is a requirement. #LI-DNI #IN-DNI
$32k-40k yearly est. Auto-Apply 60d+ ago
Workers' Compensation Claims Specialist (REMOTE - IA, MN, NE, WI)
HMA Group Holdings 3.7
Claim processor job in Wisconsin
We are looking to add a Workers' Compensation Claims Specialist to join our Creative Risk Solutions team. The ideal candidate will have jurisdictional experience in Iowa, Minnesota, Nebraska, and Wisconsin. Offering a forward-thinking, innovative, and vibrant company culture, along with the opportunity to share your unique potential, there really is no place like Holmes! Essential Responsibilities: · Receives, gathers and accurately transmits workers' compensation information to the company, from communications with the insured, claimants, and internal staff in a timely manner. · Investigates, evaluates, and resolves lost time Workers' Compensation claims, including litigated claims. · Mediates situations as they arise between the insured and the insurance company, with little to no support from leader, to include researching coverage issues. · Enters and maintains accurate information on a computer system during the claim process, to include final settlement information. · Generates checks for indemnity and medical payments daily. · Develops and monitors consistency in procedural matters of claims handling process within CRS. · Willingness to become licensed if required in jurisdiction where claims are handled. Qualifications: · Education: High school diploma; college degree preferred. Technical designations encouraged, such as AIC and CPCU. · Experience: 3-5 years claims experience with strong background in Workers' Compensation claims handling. · Licensing: Active state specific Workers Compensation License required or the ability to acquire license within three months of hire. Jurisdictional expertise and required licensing in Iowa, Nebraska, Wisconsin, and Minnesota. · Skills: An ideal candidate will have proficient knowledge of Workers' Compensation insurance coverage and claims processing procedures. They will possess the ability to adjudicate lost time claims across multiple jurisdictions and demonstrate the capacity to quickly learn and adapt to various software programs. · Technical Competencies: An ideal candidate will have a strong grasp of claims principles, practices, and insurance coverage interpretation, contributing to workflows and adhering to compliance requirements. They will prioritize problem-solving, actively foster relationships, and collaborate to deliver impactful solutions and a world-class client experience. Here's a little bit about us: Creative Risk Solutions is a leading provider of innovative risk management solutions. We specialize in delivering customized claims management, loss control, and risk consulting services to our clients. Our team is dedicated to excellence, integrity, and creating value for our clients through proactive risk management strategies. In addition to being great at what you do, we place a high emphasis on building a best-in-class culture. We do this through empowering employees to build trust through honest and caring actions, ensuring clear and constructive communication, establishing meaningful client relationships that support their unique potential, and contributing to the organization's success by effectively influencing and uplifting team members. Benefits: In addition to core benefits like health, dental and vision, also enjoy benefits such as: · Paid Parental Leave and supportive New Parent Benefits - We know being a working parent is hard, and we want to support our employees in this journey! · Company paid continuing Education & Tuition Reimbursement - We support those who want to develop and grow. · 401k Profit Sharing - Each year, Holmes Murphy makes a lump sum contribution to every full-time employee's 401k. This means, even if you're not in a position to set money aside for the future at any point in time, Holmes Murphy will do it on your behalf! We are forward-thinking and want to be sure your future is cared for. · Generous time off practices in addition to paid holidays - Yes, we actually encourage employees to use their time off, and they do. After all, you can't be at your best for our clients if you're not at your best for yourself first. · Supportive of community efforts with paid Volunteer time off and employee matching gifts to charities that are important to you - Through our Holmes Murphy Foundation, we offer several vehicles where you can make an impact and care for those around you. · DE&I programs - Holmes Murphy is committed to celebrating every employee's unique diversity, equity, and inclusion (DE&I) experience with us. Not only do we offer all employees a paid Diversity Day time off option, but we also have a Chief Diversity Officer on hand, as well as a DE&I project team, committee, and interest group. You will have the opportunity to take part in those if you wish! · Consistent merit increase and promotion opportunities - Annually, employees are reviewed for merit increases and promotion opportunities because we believe growth is important - not only with your financial wellbeing, but also your career wellbeing. · Discretionary bonus opportunity - Yes, there is an annual opportunity to make more money. Who doesn't love that?! Holmes Murphy & Associates is an Equal Opportunity Employer. #LI-SM1
$43k-74k yearly est. Auto-Apply 21d ago
Process Support - Probation
Little Rapids Corporation 3.8
Claim processor job in Shawano, WI
Job Description Basic Objective Statement: Process Support in our specialty paper mill requires individuals to perform duties assigned in the manufacturing process to meet the established expectations of safety, quality, production efficiency, and customer satisfaction. Safety Philosophy: Little Rapids Corporation will manufacture products in a manner that respects the safety and health of our associates, the environment, and the communities in which we operate. We believe that every associate plays critical role in creating a safe work environment by exhibiting personal safe behaviors. To be successful as a company, we will have exemplary safety performance. Principal Responsibilities and Accountabilities: Operate multiple work centers, roles, responsibilities and departments Ensure safe work environment Complete and maintain production records (manually and with computer system) Manufacture quality finished products that meets specification Perform manufacturing, packaging and shipping of customer orders Participate in all functions associated with the operation of papermaking equipment. Perform set-ups and changeovers on machines as required. Perform machine clean-ups as required. Maintain a clean, organized environment. Identify critical issues and respond appropriately Assist in resolutions as needed Attend and participate in meetings and training sessions Willingness and flexibility to work a variety of shifts that involve all days and times of the week as needed. Support and participate in continuous improvement efforts All other assignments as assigned by management. This is not an exhaustive list of duties or functions and may not necessarily comprise all the "essential functions" for purposes of the ADA. Experience/Education: High school graduate or equivalent. Experience in a manufacturing or warehouse environment is preferred. Key Functional Competencies: Basic computer skills Mechanical aptitude Ability to read, write, speak and understand the English language Effectively communicate with others Follow and support established Mill policies and rules Key Performance Competencies: Ability to work 12 hour rotating shift weekends and holidays when scheduled. Accomplishment of job responsibilities on a continual and timely basis Regular attendance at work is required. Ability to work during the week or on weekends is required. Physical Requirements: The ability to work in a normal manufacturing environment to include: sitting, standing, or walking for long periods of time; climbing stairs; operating various standard office equipment; carrying paper documents/files; reaching; bending; crawling; speaking on the telephone; wearing required personal protection gear (i.e. hearing, eye and foot protection); tolerating loud noise (maximum of 95 dB); tolerating extreme heat, cold and dusty environment. EOE including disability/veteran
$32k-39k yearly est. 14d ago
Cosmetology Examiner/Proctor, Washington (PT)
Prometric 4.3
Claim processor job in Wisconsin
JOB TITLE: Cosmetology Proctor/Examiner (Part-time) LOCATION: Washington **************************** NO PHONE CALLS PLEASE **************************************** Proctors are responsible for objective observation of candidates performing a demonstration of skills while the candidates is taking the NIC Cosmetology and related discipline licensing examinations. Practical Exams to be Administered - The examiners must be able to examine candidates for the exams below: NIC Barber Styling Practical Exam NIC Cosmetology Practical Exam NIC Esthetics Practical Exam NIC Instructor Practical Exam NIC Nail Technology Practical Exam NIC Hair Design Practical Exam Positions are part-time. The exams will typically be administered on Mondays (with the exception of state holidays). PROCTOR RESPONSIBILITIES Proctors are always present at each examination site at all times the candidates are present Time each section of the exam Read, speak, and write English the instructions and verbal instructions with reasonable proficiency. Dress in a professional manner Test Event Delivery & Security • Control test area by maintaining a working knowledge of Prometric policies and practices • Greet examinees and verify identification • Monitor candidates as they complete their written exam • Observe and rate candidates as they complete their practical exam • Resolve candidate issues or report them to the appropriate supervisor • Protect security of all computer software in Test Center environment • Possess technical proficiency to reboot workstations, and reset passwords as necessary • Report any occurrences which fall outside company guidelines to corporate management REQUIRED EXPERIENCE: Applicants must meet all of the following criteria to be considered for an examiner position: Must be 21 years or older. Active license in good standing with at least 3 years experience in the industry. Cannot be affiliated with schools or teaching in any way for students preparing to take state board examinations. Cannot work for a manufacturer or beauty supply. Examiners must be certified as required by NIC and maintain certification as a condition of employment. NIC Examiner training will be provided. Examiners must dress and handle themselves in a professional manner at all times. Examiners cannot visit or be guest speakers at schools. Examiners cannot grade any candidates that they know either personally or professionally or have had any contact with. Applicants cannot work for a manufacturer, beauty supply, or a school and cannot have any school affiliation for 2 years prior to applying for an Examiner position. **************************** NO PHONE CALLS PLEASE ****************************************
$30k-39k yearly est. 2d ago
Claims Rep II-General Liability (Bodily Injury focused)
Society Insurance Company
Claim processor job in Fond du Lac, WI
Job Information Job Title Claims Representative II-General Liability (Bodily Injury focused) Home Department: Claims Employment Status: Exempt; Full-time Schedule: 40 hours/week with Flexible Scheduling Opportunities Position Location: Home Office, Telecommuting, and Remote Opportunities in CO, GA, IL, IN, IA, MN, TN, TX, & WI Overview Protecting our policyholders' dreams, passions, and livelihoods has a direct impact on the communities we serve. We work towards excellence, conduct ourselves with high integrity, and take our work seriously, but not ourselves. Small Details. Big Difference. Find out how you can make a difference with a career at Society. Society Insurance is seeking a Claims Representative II to join our Claims team. This position has a general liability focus. This position will resolve mildly complex general liability claims by investigating losses and negotiating out-of-court settlements. About the Role Settles mildly complex claims by determining insurance carrier's liability and reaches agreement with claimant according to policy provisions and authority level. Handles mediations, arbitrations, subrogation, and recorded settlement agreements. Determines coverage through investigations by examining claim forms, policies, and other records; interviewing claimants, insureds, and witnesses; consulting police and hospital records; inspecting damages; and consulting with experts when appropriate. Mentors and trains claims representatives in claims expertise by assisting in identifying training needs and opportunities. May be involved with litigation by analyzing negotiated settlement options; evaluating evidence, and overseeing attorney in the handling of discovery and settlement. Resolves questionable claims by investigating the claim and comparing claims information with evidence. Ensures proper file documentation of assigned files by complying with company and state requirements. Prepares reports by collecting, analyzing, and summarizing claim information. Contributes to team effort by participating on catastrophe teams; participating in determining department investigation guidelines; providing feedback to underwriting as needed. About Yo u You enjoy communicating and building relationships with others. You are composed, cool under pressure, and can negotiate without damaging relationships. You hold yourself accountable and act in accordance with rules and regulations. You enjoy analyzing, investigating, and using the facts to make decisions. You are naturally curious and have a desire to know more. What it Will Take Bachelor's Degree and 3+ years of claims handling experience OR 5+ years of claims handling experience. Proficiency in general liability claims demonstrated through knowledge and experience in insurance policies and coverage, claim payment procedures, insurance regulations, and legal terminology. Ability to obtain and maintain proper licensing prior to handling a state that requires it. Professional insurance designations highly desirable. Experience using Guidewire Claims System preferrable. What Society Can Offer Comprehensive Benefits Package: Salary with bonus plan; health, dental, life, and vision insurance Retirement: Traditional or Roth 401(k) Defined Contribution Plan PLUS Profit-Sharing Plan Work-Life Balance: Company-paid holidays; flexible scheduling; PTO; telecommuting options Education: Career Coaching; company-paid courses; student loan and tuition reimbursement Community: Charitable Match; paid volunteer time; team sponsorships Wellness: Employee Assistance Program; wellness initiatives/rewards; health coaching; and more Society Insurance prohibits discrimination and harassment of any type against applicants and employees on the basis of race, color, religion, sex, national origin, age, handicap, disability, genetics, veteran status or military service, marital status or sexual orientation, gender identity or expression, or any other characteristic or status protected by federal, state or local laws. Society Insurance also provides reasonable accommodations to qualified individuals with disabilities in accordance with the requirements of the Americans with Disabilities Act and applicable state and local laws. Society Insurance is a drug-free workplace.
$41k-52k yearly est. Auto-Apply 60d+ ago
Claims Rep II-General Liability (Bodily Injury focused)
Society Insurance
Claim processor job in Fond du Lac, WI
Job Information Job Title Claims Representative II-General Liability (Bodily Injury focused) Home Department: Claims Employment Status: Exempt; Full-time Schedule: 40 hours/week with Flexible Scheduling Opportunities Home Office, Telecommuting, and Remote Opportunities in: CO, GA, IL, IN, IA, MN, TN, TX, & WI Overview Protecting our policyholders' dreams, passions, and livelihoods has a direct impact on the communities we serve. We work towards excellence, conduct ourselves with high integrity, and take our work seriously, but not ourselves. Small Details. Big Difference. Find out how you can make a difference with a career at Society. Society Insurance is seeking a Claims Representative II to join our Claims team. This position has a general liability focus. This position will resolve mildly complex general liability claims by investigating losses and negotiating out-of-court settlements. About the Role * Settles mildly complex claims by determining insurance carrier's liability and reaches agreement with claimant according to policy provisions and authority level. * Handles mediations, arbitrations, subrogation, and recorded settlement agreements. * Determines coverage through investigations by examining claim forms, policies, and other records; interviewing claimants, insureds, and witnesses; consulting police and hospital records; inspecting damages; and consulting with experts when appropriate. * Mentors and trains claims representatives in claims expertise by assisting in identifying training needs and opportunities. * May be involved with litigation by analyzing negotiated settlement options; evaluating evidence, and overseeing attorney in the handling of discovery and settlement. * Resolves questionable claims by investigating the claim and comparing claims information with evidence. * Ensures proper file documentation of assigned files by complying with company and state requirements. * Prepares reports by collecting, analyzing, and summarizing claim information. * Contributes to team effort by participating on catastrophe teams; participating in determining department investigation guidelines; providing feedback to underwriting as needed. About You * You enjoy communicating and building relationships with others. * You are composed, cool under pressure, and can negotiate without damaging relationships. * You hold yourself accountable and act in accordance with rules and regulations. * You enjoy analyzing, investigating, and using the facts to make decisions. * You are naturally curious and have a desire to know more. What it Will Take * Bachelor's Degree and 3+ years of claims handling experience OR 5+ years of claims handling experience. * Proficiency in general liability claims demonstrated through knowledge and experience in insurance policies and coverage, claim payment procedures, insurance regulations, and legal terminology. * Ability to obtain and maintain proper licensing prior to handling a state that requires it. * Professional insurance designations highly desirable. * Experience using Guidewire Claims System preferrable. What Society Can Offer * Comprehensive Benefits Package: Salary with bonus plan; health, dental, life, and vision insurance * Retirement: Traditional or Roth 401(k) Defined Contribution Plan PLUS Profit-Sharing Plan * Work-Life Balance: Company-paid holidays; flexible scheduling; PTO; telecommuting options * Education: Career Coaching; company-paid courses; student loan and tuition reimbursement * Community: Charitable Match; paid volunteer time; team sponsorships * Wellness: Employee Assistance Program; wellness initiatives/rewards; health coaching; and more Society Insurance prohibits discrimination and harassment of any type against applicants and employees on the basis of race, color, religion, sex, national origin, age, handicap, disability, genetics, veteran status or military service, marital status or sexual orientation, gender identity or expression, or any other characteristic or status protected by federal, state or local laws. Society Insurance also provides reasonable accommodations to qualified individuals with disabilities in accordance with the requirements of the Americans with Disabilities Act and applicable state and local laws. Society Insurance is a drug-free workplace.
$41k-52k yearly est. 60d+ ago
Subrogation Examiner
Carebridge 3.8
Claim processor job in Waukesha, WI
Virtual: This role enables associates to work virtually full-time, with the exception of required in-person training sessions, providing maximum flexibility and autonomy. This approach promotes productivity, supports work-life integration, and ensures essential face-to-face onboarding and skill development. Alternate locations may be considered if candidates reside within a commuting distance from an office. Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law. Schedule: Monday - Friday; 8:30am-5:00pm Eastern Time The Subrogation Examiner is responsible for researching and examining routine health claims that may be related to Third Party Liability, Workers' Compensation and other subrogation/reimbursement recovery cases. How you will make an impact: * Initiates calls to groups, insurance companies, attorneys, members and others as necessary to determine if claims have potential for reimbursement from another party. * Responds to inquiries regarding information on injury claims. * Utilizes various research methods and vendor systems to gather information. * Works with subrogation staff, other departments and outside clients to assist with the recovery process. * Prepares written communications. * Reviews diagnostic and procedure codes to determine claims relevant to each case. * Reviews internal systems/applications for various information needs. * Assists with small scale special projects. Minimum Requirements: * Requires a minimum of 1 year of inbound or outbound call experience; or any combination of education and experience, which would provide an equivalent background. Please be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with Elevance Health. Any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health. Who We Are Elevance Health is a health company dedicated to improving lives and communities - and making healthcare simpler. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve. How We Work At Elevance Health, we are creating a culture that is designed to advance our strategy but will also lead to personal and professional growth for our associates. Our values and behaviors are the root of our culture. They are how we achieve our strategy, power our business outcomes and drive our shared success - for our consumers, our associates, our communities and our business. We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few. Elevance Health operates in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager, associates are required to work at an Elevance Health location at least once per week, and potentially several times per week. Specific requirements and expectations for time onsite will be discussed as part of the hiring process. The health of our associates and communities is a top priority for Elevance Health. We require all new candidates in certain patient/member-facing roles to become vaccinated against COVID-19 and Influenza. If you are not vaccinated, your offer will be rescinded unless you provide an acceptable explanation. Elevance Health will also follow all relevant federal, state and local laws. Elevance Health is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process may contact ******************************************** for assistance. Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state, and local laws, including, but not limited to, the Los Angeles County Fair Chance Ordinance and the California Fair Chance Act.
$28k-36k yearly est. Auto-Apply 60d+ ago

Learn more about claim processor jobs

How much does a claim processor earn in Appleton, WI?

The average claim processor in Appleton, WI earns between $22,000 and $58,000 annually. This compares to the national average claim processor range of $26,000 to $62,000.

Average claim processor salary in Appleton, WI

$36,000

$22,00010%

$36,000Median

$58,00090%

What are the biggest employers of Claim Processors in Appleton, WI?

The biggest employers of Claim Processors in Appleton, WI are:

Jewelers Mutual Group

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Claim processor jobs in Appleton, WI - 100 jobs

Subrogation Investigative Claim Representative II

Claims Representative - Workers Compensation

Claims Examiner

Claims Examiner

Billing and Claims Specialist

Claims Specialist

Stop Loss & Health Claim Analyst

Associate Claims Examiner - Equine

Claims Specialist

Associate Claims Specialist - Workers Compensation - Central Region

Adjudicator, Provider Claims-On the phone

Workers' Compensation Claims Specialist (REMOTE - IA, MN, NE, WI)

Claims Representative - Workers Compensation

Auto Claims Representative

Workers' Compensation Claims Specialist (REMOTE - IA, MN, NE, WI)

Process Support - Probation

Cosmetology Examiner/Proctor, Washington (PT)

Claims Rep II-General Liability (Bodily Injury focused)

Claims Rep II-General Liability (Bodily Injury focused)

Subrogation Examiner

Learn more about claim processor jobs

How much does a claim processor earn in Appleton, WI?

What are the biggest employers of Claim Processors in Appleton, WI?