Wisconsin Claims Analyst

Job Summary

To support end-to-end claims operations, the full-time Wisconsin Claims Analyst will manage the accurate entry, processing, adjudication, and auditing of medical and pharmacy claims while working in a hybrid environment with occasional office visits in Menasha or Brookfield.

Key responsibilities

• Perform accurate and timely data entry of medical and pharmacy claims
• Process and audit claims to ensure compliance with policies, procedures, and regulatory guidelines
• Collaborate with cross-functional stakeholders to resolve issues and enhance operational efficiencies

Required qualifications

• High school diploma required; associate degree preferred
• 2+ years of experience in the health insurance industry preferred
• Strong experience in data entry and medical/pharmacy claims processing
• Familiarity with medical terminology preferred