Top 37 Claims specialist Jobs in Madison, Wi

Payment Records Adjuster (Claims Support Specialist)
Wis Phys Svc Ins Corp —Madison, WI
- 8 hour shift
- Customer service
- High school diploma or GED
- Continuous improvement
- Health insurance
- Dental insurance
1d
Group Claims Support Specialist
Horace Mann —Madison, WI
- $21.44 - $29.16 an hour
- Microsoft Excel
- Microsoft Access
- Microsoft Outlook
Quick Apply
Operations Specialist
HOME AGAIN ASSISTED LIVING INC —Sun Prairie, WI
- Full-time
- 18 years or older
- Bachelor's degree
- Reliable transportation
- Dental insurance
Quick Apply
1d
Safety Specialist
Shared Medical Services —Cottage Grove, WI
- Full-time
- Clean driving record
- Mid-level
- Organizational skills
- AD&D insurance
- Paid holidays
Pharmacy Specialist
Quartz —Madison, WI
- $20.72 - $25.91 an hour
- Full-time
- Mid-level
- High school diploma or GED
- Criminal background check
- Opportunities for advancement
Employee Relations Specialist - Human Resources
The Medical College of Wisconsin, Inc. —Madison, WI
- Full-time
- Word processing
- Research
- Office
- Paid parental leave
- Paid holidays
Quick Apply
11d
Medical Coding Specialist
Group Health Cooperative of South Central Wisconsin —Madison, WI
- Full-time
- Anatomy knowledge
- Customer service
- Word processing
- Disability insurance
- Health insurance
Quick Apply
Patient Care Coordinator and Insurance Specialist
Affiliated Dentists —Madison, WI
- $20 - $25 an hour
- Full-time
- Dental office
- In-person
- 1 year
- Profit sharing
- Health savings account
Quick Apply
6d
Pharmacy Technician Specialist – Community Pharmacy
UW Health —Madison, WI
- $21.70 - $32.55 an hour
- 8 hour shift
- Customer service
- High school diploma or GED
- Math
- Paid parental leave
- Health insurance
12d
New Business Specialist (Temporary up to 12 months)
National Guardian Life Insurance Company —Madison, WI
- Temporary
- Hybrid work
- Computer literacy
- Mid-level
- High school diploma or GED
Quick Apply
5d
Oasis Coding Specialist
Interim HealthCare - Great Lakes Health Partners —Madison, WI
- $31.25 - $36.06 an hour
- Full-time
- Remote
- Nursing
- Anatomy knowledge
- Data analysis skills
Quick Apply
7h
Billing and Customer Service Support Specialist
Attic Angel Community —Middleton, WI
- Full-time
- Mid-level
- 3 years
- Finance
- Paid training
- Dental insurance
Quick Apply
1d
Logistics Specialist II
Sub-Zero Group, Inc. —Madison, WI
- Background check
- Microsoft Excel
- Mid-level
- Profit sharing
- Health insurance
Quick Apply
12d
EFT Specialist
UW Credit Union —Madison, WI
- From $20.50 an hour
- Full-time
- Hybrid work
- Writing skills
- Mid-level
- Office
- Paid holidays
- Health insurance
Inventory Specialist
Walgreens —Madison, WI
- $17 - $20 an hour
- Full-time
- Merchandising
- Mid-level
- Cleaning
Commercialization Expert
CLEAResult Consulting Inc. —Madison, WI
- $120,000 - $140,000 a year
- Full-time
- Remote
- Analysis skills
- Travel
- US work authorization
- Health insurance
- Dental insurance
Quick Apply
Cycle Dealership Sales Specialist
Sentry Insurance —Madison, WI
- $68,100 - $112,310 a year
- Full-time
- Hybrid work
- Mid-level
- Office
- 3 years
- Health insurance
- Dental insurance
14d
Billing Specialist - Dental Clinic Experience Required
Dental Health Associates of Madison —Fitchburg, WI
- Full-time
- Dental office
- HIPAA
- Clinic experience
- Profit sharing
- Health insurance
Quick Apply
13h
Installer Service Specialist
O'Reilly Automotive Stores —Madison, WI
- Full-time
- ASE Certification
- Mid-level
- Team management
- Employee stock purchase plan
- Health insurance
Quick Apply
Coding Specialist II, Psychiatry - Clinical Practice Services
The Medical College of Wisconsin, Inc. —Madison, WI
- $53,500 - $66,400 a year
- Full-time
- Psychiatry
- Computer literacy
- Mid-level
- Paid parental leave
- Paid holidays
Quick Apply

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claims specialist jobs near madison, wi

Payment Records Adjuster (Claims Support Specialist)

Wis Phys Svc Ins Corp -
Madison, WI

Apply Now

Job Details

1 day ago

Benefits

Health insurance
Dental insurance
Paid time off
On-the-job training
401(k) matching
Flexible schedule

Qualifications

High school diploma or GED
10 key typing
Quality data entry

Full Job Description

U.S. Citizenship is required for this position due to Department of Defense restrictions.

Correct payment errors on a post-processing basis, including credits, additional payments, statistical adjustments, recoupments, correspondence, and patient or sponsor updates. Must live within 45 miles of WPS Corporate Center Building (1717 W. Broadway) in Madison, WI 53713

Additional Information

Start Date: 8/23/26
Starting Base Salary: At least $17.75
Training Location/Schedule:
On the job Training Monday-Friday core hours between 6:00am CT and 4:00pm CT
Scheduled Shift: Flexible schedule once trained, 8-hours shifts between 6am-10pm
Work Location: Remote and onsite options are available.

How do I know this opportunity is right for me? If you:

Have processed adjustments according to TRICARE Policy by making an additional payment, reissue, or statistical adjustment.
Like to identify and credit refunds to correct claim history. Contact beneficiaries, providers, and other agencies as necessary to obtain information to ensure refunds are posted to correct account.
Can request recoupment of payments in accordance with TRICARE Policy and Operational Manual.
Enjoy responding to correspondence from internal and external customers to include departments within MVH Division, attorneys, insurance companies, TRICARE Management Activity (TMA), government agencies, and prime contractors.
Can coordinate benefits with commercial insurance, Medicare, and other plans.
Like to review computer generated and inventory reports to prioritize workflow to ensure claims processing timeline standards are met.
Have reported aging inventory concerns or system issues to supervisor or unit coordinator.
Enjoy processing adjustments and credits with an understanding of TRICARE Encounter Data editing requirements imposed by TMA.
Like to review claims to determine if processing is correct according to automated claims processing system’s methodology for pricing, reimbursement, and cost-sharing.
Have interpreted legal documents for payments involving judgments such as custodial or bankruptcy.
Enjoy making recommendations for process improvements by filing an Improvement Corrective Preventative Action (ICPA) and Potential Non-Conformance (PNC) forms.
Can complete Sponsor Patient Information Updates (SPIU) accordingly.

Minimum Qualifications

U.S. Citizenship is required for this position due to Department of Defense restrictions.
High school diploma or equivalent.
1 or more years recent TRICARE claims entry (claims support) or processing OR
2 or more years office experience involving account reconciliations and customer contact including bookkeeping, billing, or financial services.
Possess data entry and 10-key skills Ability to learn and apply TRICARE benefits, Policy, Operations Manual, and federal regulations.
Ability to learn TRICARE claims processing methodologies and systems in resolution of payment errors.
Ability to interpret legal documents and documents from primary insurance.

Remote Work Requirements

Wired (ethernet cable) internet connection from your router to your computer.
High speed cable or fiber internet.
Minimum of 10 Mbps downstream and at least 1 Mbps upstream internet connection (can be checked at https://speedtest.net (https://speedtest.net/)).
Please review Remote Worker FAQs (https://secure.wpsic.com/files/remote-work-faqs.pdf) for additional information.

Benefits

Bargaining Unit position
Remote and hybrid work options available
Performance bonus and/or merit increase opportunities
401(k) with dollar-per-dollar match up to 6% of salary (100% vested immediately)
Competitive paid time off
Health insurance, dental insurance, and telehealth services start DAY 1
Employee Resource Groups
Professional and Leadership Development Programs
Review additional benefits: (https://www.wpshealthsolutions.com/careers/ (https://www.wpshealthsolutions.com/careers/))

Who We Are

WPS, a health solutions company, (https://www.wpshealthsolutions.com/about/index.shtml) is a leading not-for-profit health insurer and federal government contractor headquartered in Madison, Wisconsin. WPS offers health insurance plans for individuals, families, seniors and group health plans for small to large businesses. We process claims and provide customer support for beneficiaries of the Medicare program and manage benefits for millions of active-duty and retired military personnel across the U.S. and abroad. WPS has been making healthcare easier for the people we serve for nearly 80 years (https://www.wpshealthsolutions.com/75/). Proud to be military and veteran ready.

Culture Drives Our Success

WPS’ culture is where the great work and innovations of our people are seen, fueled and rewarded. We accomplish this by creating an open and empowering employee experience. We recognize the benefits of employee engagement as an investment in our workforce—both current and future—to effectively seek, leverage, and include differing and unique perspectives that fuel agility and innovation on high-performing teams. This results in people bringing their authentic selves to work every day in an organization that successfully adapts to business changes and new opportunities.

We are proud of the recognition we have received from local and national organization regarding our culture and workplace: WPS Newsroom - Awards and Recognition. (https://www.wpshealthsolutions.com/news/?c=awards)

Sign up for Job Alerts (http://recruiting2.ultipro.com/WIS1003/JobBoard/e6da0c90-f987-63dc-99a9-fb8c9014f57e/Account/Register?cancelUrl=https%3A%2F%2Frecruiting2.ultipro.com%2FWIS1003%2FJobBoard%2Fe6da0c90-f987-63dc-99a9-fb8c9014f57e%2F%3Fq%3DWPS%26o%3Drelevance&redirectUrl=%2FWIS1003%2FJobBoard%2Fe6da0c90-f987-63dc-99a9-fb8c9014f57e%2FJobSearchAgent)

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LinkedIn (https://www.linkedin.com/company/wps-health-solutions/)
Facebook (https://www.linkedin.com/company/wps-health-solutions/)
WPS Health Blog (https://www.facebook.com/WPSHealthSolutions/)

TRICARE (MVH)
This position supports services under U.S. Department of Defense (DoD) Defense Health Agency (DHA) contract(s). As such, the role is subject to all applicable federal regulations, DoD contract requirements, and WPS internal policies, including but not limited to standards for data security, privacy, confidentiality, and program integrity. DoD contractors and their personnel are subject to screening and background investigation prior to being granted access to information systems and/or sensitive data to safeguard government resources that provide critical services.

Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities
This employer is required to notify all applicants of their rights pursuant to federal employment laws. For further information, please review the Know Your Rights (https://www.eeoc.gov/poster) notice from the Department of Labor.

Apply Now

Refine Your Search

claims specialist jobs in madison, wi

Payment Records Adjuster (Claims Support Specialist)

Group Claims Support Specialist

Operations Specialist

Safety Specialist

Pharmacy Specialist

Employee Relations Specialist - Human Resources

Medical Coding Specialist

Patient Care Coordinator and Insurance Specialist

Pharmacy Technician Specialist – Community Pharmacy

New Business Specialist (Temporary up to 12 months)

Oasis Coding Specialist

Billing and Customer Service Support Specialist

Logistics Specialist II

EFT Specialist

Inventory Specialist

Commercialization Expert

Cycle Dealership Sales Specialist

Billing Specialist - Dental Clinic Experience Required

Installer Service Specialist

Coding Specialist II, Psychiatry - Clinical Practice Services

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