Claims Processor

Job Description

Job Type: Permanent, Hourly

Schedule: Hybrid (Onsite Tuesdays and Thursdays)

Location: Milwaukee, WI

Interview Process:

Round 1: 30-minute interview with Claims Processing Manager and Lead

Round 2: Final interview focused on culture, technical skills, and team fit

Overview:

A growing healthcare financial services organization is seeking a detail-oriented and reliable Claims Processor to join their team. This role plays a critical part in ensuring the accurate and timely processing of medical claims received from Third-Party Administrators (TPAs), contributing directly to efficient payment operations.

Key Responsibilities:

Process claims using internal systems and TPA websites, ensuring accuracy and compliance

Communicate with TPA representatives to resolve discrepancies and ensure smooth processing

Send reports to employer groups and TPAs; respond to related inquiries and emails

Investigate and resolve tickets related to customer complaints, claim adjustments, and general inquiries

Create documentation for employer credits and generate ad hoc reports as needed

Qualifications:

Minimum 3 years of experience in medical claims processing

Strong attention to detail and organizational skills

Ability to manage multiple tasks and meet deadlines in a fast-paced environment

Excellent written and verbal communication skills

Proficiency in Microsoft Office, especially Excel

Bachelor’s degree preferred, or equivalent combination of education and experience

Customer service experience strongly preferred

Experience in medical or health insurance is a plus

$19.00to $23.00 per year annual salary.

Exact compensation may vary based on several factors, including skills, experience, and education.

Benefit packages for this role may include healthcare insurance offerings and paid leave as provided by applicable law.

Full-time

Hybrid remote