Claims Analyst Jobs in Wisconsin
Claims Analyst jobs in Wisconsin are consistently in demand, with strong hiring concentrated in health insurance, property and casualty, and workers' compensation across Milwaukee, Madison, and Green Bay. Established employers like American Family Insurance, Unum, and Sentry Insurance maintain large claims operations in the state and hire at every level from entry-level examiner to senior specialist. The most sought-after specialties in Wisconsin right now are medical claims review, liability investigation, and subrogation. Find a role that fits below and apply directly.
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See related jobsThis is a full-time position based in our Sheboygan, WI location. The position includes an initial in-person training period of approximately 2–3 months, after which a hybrid remote work arrangement is available. The ideal candidate will be based in Wisconsin. Monday–Friday schedule, 8:30 AM–4:30 PM, with no weekends, holidays, or on-call rotations.
Prairie States Enterprises, Inc. is a third party administrator, a benefits industry leader, and a trusted advisor to self-insured companies and their employees. We provide a complete range of medical benefit management services, all performed in-house, and to exacting standards of excellence.
- Provides claims adjudication services by reviewing, researching, investigating, adjudicating and processing claims for assigned relationships.
- Provides high-level customer service when interacting with members, Human Resource contacts, employees, providers, and internal staff.
- Has the ability to read and comprehend instructions and draft short correspondence, and memos. Also has the ability to effectively present information in one-on-one and small group situations to customers, clients, and other employees of the organization.
- Understands all aspects of plan documents for assigned groups, and groups within their assigned pod.
- Demonstrates understanding of electronic claims from exceptions to pass-through audits. Should also be able to identify potential large claims and have a good understanding of the stop-loss process and pend claims appropriately.
- Performs daily duties and processes claims with minimal direction and asks questions appropriately.
- Is responsible and accountable for the accurate and timely entry of claims data. Claims data must be entered with a high level of quality and in accordance with department claims policies and procedures.
- Consistently meets established productivity and quality standards:
- Minimum turn-around time is 10 days for clean claims. Claims requiring further investigation will be paid within 1 month unless extenuating circumstances arise and are documented.
- Once additional information is received, claims must be paid within 10 days from receipt of the documentation.
- Required to meet the department standards related to procedural and financial accuracy.
- Assists in answering overflow of outside phone calls, directing the call to the appropriate person or handling the call if that person is not available.
- Other Claims Dept duties and special projects as assigned.
- High School Diploma or GED required. Post HS education in medical field and medical terminology highly preferred.
- Experience – 1 to 3 years experience in an insurance or medical office setting strongly preferred.
- Strong customer service and communication skills required.
- Change Management – Accepts, supports, and executes assignments in conditions of change which support attaining department goals.
- Effective Communication – Demonstrates effective and responsive communications following the appropriate reporting structure.
- Accountability/Results – Achieves and/or exceeds result based goals that were specific, measurable, and timely.
- Teamwork – Demonstrates teamwork behaviors and makes positive contributions and which support the achievement of department goals.
- Customer Satisfaction – Dedicated to the PSE service model and meets or exceeds PSE customer satisfaction expectations in providing exemplary service.
- Professional Growth – Takes ownership of one’s professional growth within one’s current position and to advancement at PSE.
To the selected candidate, we offer:
Competitive compensation based on experience and a comprehensive benefit package provided to include Medical, Dental, Vision, Life, STD/LTD, FSA, Paid Time Off, personal days, 401k with match, wellness and exercise membership and more. Click HERE to view our full-time benefits flyer.
Opportunity for meaningful career growth within a results-driven company and our company culture is one of ambition, integrity, empowerment, teamwork and a passion for personal and company success.
If this sounds like you and you’re seeking career growth with an exciting new career path in overseeing the quality of health care for our clients and their members, please send your cover letter and resume following the instructions for this site.
Prairie States Enterprises
Equal Opportunity Employer
This is a full-time position based in our Sheboygan, WI location. The position includes an initial in-person training period of approximately 2–3 months, after which a hybrid remote work arrangement is available. The ideal candidate will be based in Wisconsin. Monday–Friday schedule, 8:30 AM–4:30 PM, with no weekends, holidays, or on-call rotations.
Prairie States Enterprises, Inc. is a third party administrator, a benefits industry leader, and a trusted advisor to self-insured companies and their employees. We provide a complete range of medical benefit management services, all performed in-house, and to exacting standards of excellence.
- Provides claims adjudication services by reviewing, researching, investigating, adjudicating and processing claims for assigned relationships.
- Provides high-level customer service when interacting with members, Human Resource contacts, employees, providers, and internal staff.
- Has the ability to read and comprehend instructions and draft short correspondence, and memos. Also has the ability to effectively present information in one-on-one and small group situations to customers, clients, and other employees of the organization.
- Understands all aspects of plan documents for assigned groups, and groups within their assigned pod.
- Demonstrates understanding of electronic claims from exceptions to pass-through audits. Should also be able to identify potential large claims and have a good understanding of the stop-loss process and pend claims appropriately.
- Performs daily duties and processes claims with minimal direction and asks questions appropriately.
- Is responsible and accountable for the accurate and timely entry of claims data. Claims data must be entered with a high level of quality and in accordance with department claims policies and procedures.
- Consistently meets established productivity and quality standards:
- Minimum turn-around time is 10 days for clean claims. Claims requiring further investigation will be paid within 1 month unless extenuating circumstances arise and are documented.
- Once additional information is received, claims must be paid within 10 days from receipt of the documentation.
- Required to meet the department standards related to procedural and financial accuracy.
- Assists in answering overflow of outside phone calls, directing the call to the appropriate person or handling the call if that person is not available.
- Other Claims Dept duties and special projects as assigned.
- High School Diploma or GED required. Post HS education in medical field and medical terminology highly preferred.
- Experience – 1 to 3 years experience in an insurance or medical office setting strongly preferred.
- Strong customer service and communication skills required.
- Change Management – Accepts, supports, and executes assignments in conditions of change which support attaining department goals.
- Effective Communication – Demonstrates effective and responsive communications following the appropriate reporting structure.
- Accountability/Results – Achieves and/or exceeds result based goals that were specific, measurable, and timely.
- Teamwork – Demonstrates teamwork behaviors and makes positive contributions and which support the achievement of department goals.
- Customer Satisfaction – Dedicated to the PSE service model and meets or exceeds PSE customer satisfaction expectations in providing exemplary service.
- Professional Growth – Takes ownership of one’s professional growth within one’s current position and to advancement at PSE.
To the selected candidate, we offer:
Competitive compensation based on experience and a comprehensive benefit package provided to include Medical, Dental, Vision, Life, STD/LTD, FSA, Paid Time Off, personal days, 401k with match, wellness and exercise membership and more. Click HERE to view our full-time benefits flyer.
Opportunity for meaningful career growth within a results-driven company and our company culture is one of ambition, integrity, empowerment, teamwork and a passion for personal and company success.
If this sounds like you and you’re seeking career growth with an exciting new career path in overseeing the quality of health care for our clients and their members, please send your cover letter and resume following the instructions for this site.
Prairie States Enterprises
Equal Opportunity Employer
See All 5 Claims Analyst Jobs in Wisconsin
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Find Claims Analyst JobsClaims Analyst Jobs by City in Wisconsin
Where Wisconsin roles are concentrated, by current openings.
Claims Analyst Job Market in Wisconsin
A snapshot from current Wisconsin openings, updated as new roles post.
Who's Hiring
What Wisconsin Employers Look For
The qualifications that appear most often in claims analyst jobs across Wisconsin.
- Associate or bachelor's degree in business, finance, healthcare administration, or a related field
- One to three years of claims processing or insurance industry experience
- Working knowledge of Wisconsin insurance regulations and coverage statutes
- Proficiency with claims management software such as Guidewire, Xactimate, or similar platforms
- Strong analytical and written communication skills for documenting claim determinations
- Professional designation such as AIC, CPCU, or AINS preferred for mid-level and senior roles
Claims Analyst Jobs in Wisconsin: Frequently Asked Questions
How do you become a claims analyst in Wisconsin?
Most claims analyst roles in Wisconsin require at least an associate degree, though employers in health insurance and workers' compensation increasingly prefer a bachelor's in business, healthcare administration, or a related field. Wisconsin does not require a general state license for claims analysts, but adjusters handling property and casualty claims independently must hold a Wisconsin Adjuster License issued through the Office of the Commissioner of Insurance. Earning a designation like the Associate in Claims strengthens your candidacy considerably.
Which companies hire claims analysts in Wisconsin?
Employers hiring claims analysts in Wisconsin right now include Emplify Health, Aspirus Health, and Society Insurance, based on current listings on Migrate Mate as of September 2026. Wisconsin's deep roots in mutual insurance and managed care create steady, year-round demand from both large carriers and regional third-party administrators headquartered in the state.
Which Wisconsin cities have the most claims analyst jobs?
The cities with the most claims analyst openings in Wisconsin are Wisconsin, Wausau, and Green Bay. Milwaukee dominates due to its concentration of regional insurance carriers and large hospital systems with internal claims departments, while Madison's mix of state government agencies and university health networks generates consistent openings, and Green Bay draws demand from manufacturing-sector workers' compensation and agricultural insurance operations.
Are there remote claims analyst jobs in Wisconsin?
Yes, and more than most fields. Claims analysis is largely desk-based work involving documentation review, data entry, and communication, making it well suited to remote arrangements. About 67% of claims analyst openings tied to Wisconsin are remote or hybrid as of September 2026, reflecting how broadly carriers have adopted flexible models since expanding distributed teams. Medical and liability review roles are the most consistently offered as fully remote positions.
How can I get hired as a claims analyst in Wisconsin with little or no experience?
The most realistic entry path is applying to claims examiner or claims assistant roles at Wisconsin-based carriers and third-party administrators that run structured onboarding programs, including American Family Insurance and Sentry Insurance, both of which regularly bring in new graduates through entry-level claims tracks. Lateral moves from adjacent roles such as medical billing specialist, customer service representative at an insurer, or paralegal also open doors quickly. Earning an Associate in Claims designation before applying gives candidates with no prior insurance experience a clear edge.
Where can I find and apply to claims analyst jobs in Wisconsin?
You can find and apply to claims analyst jobs in Wisconsin on Migrate Mate, which lists current Wisconsin openings across carriers, TPAs, and self-insured employers. Find roles that fit your experience level and specialty and apply directly to each employer through the listing.
See All 5 Claims Analyst Jobs in Wisconsin
Find roles in Wisconsin that match your experience and apply in just a few clicks.
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