Claims Representative I - Workers Compensation Medical Only
West Bend Mutual Insurance Company, West Bend, Wisconsin, United States, 53096
Claims Representative I - Workers Compensation Medical Only
Job Locations: US-WI-West Bend
ID: 2025-3462
Category: Claims
Employment Type: Full-Time
Remote/Hybrid: Hybrid
Company Overview 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 Are you ready to put your problem‑solving skills to the test while learning the ropes of the claims world? As our Medical Claims Detective, you'll dive into low‑complexity workers' compensation claims like a true investigator—examining details, determining what's covered, and figuring out how much is owed. Don't worry, you won't go it alone—you'll have the support of a fantastic manager and top‑notch claims technology at your fingertips.
Work Location This position offers a hybrid schedule (3 days in the office) for collaboration days, team meetings or other in‑person events. The position can be based in West Bend, WI.
The internal deadline to apply is 2/17/2026.
Responsibilities & Qualifications Manage assigned Workers Compensation Medical Only/low complexity claims with supervision and guidance from the manager utilizing current Claims technology. Conduct thorough investigations in order to determine coverage and claim payment also include proactive file management, adequate reserving, and participating in training activities.
Key Responsibilities
Consistently exhibit a high level of customer service.
Adhere to department audit guidelines.
Conduct thorough investigations to determine coverage and payment.
Maintain proactive file management and adequate reserving.
Participate in training activities.
Preferred Experience and Skills
0-2 years of experience in claims handling
Proficiency with computers and current technology
Interpersonal skills
Oral and written communication skills
Time management skills
Customer service skills
Problem‑solving skills
Preferred Education and Training
Bachelor's degree in Business, Insurance or related field
Salary Statement The salary range for this position is $23.15 - $31.00. 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 Program401(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.
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ID: 2025-3462
Category: Claims
Employment Type: Full-Time
Remote/Hybrid: Hybrid
Company Overview 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 Are you ready to put your problem‑solving skills to the test while learning the ropes of the claims world? As our Medical Claims Detective, you'll dive into low‑complexity workers' compensation claims like a true investigator—examining details, determining what's covered, and figuring out how much is owed. Don't worry, you won't go it alone—you'll have the support of a fantastic manager and top‑notch claims technology at your fingertips.
Work Location This position offers a hybrid schedule (3 days in the office) for collaboration days, team meetings or other in‑person events. The position can be based in West Bend, WI.
The internal deadline to apply is 2/17/2026.
Responsibilities & Qualifications Manage assigned Workers Compensation Medical Only/low complexity claims with supervision and guidance from the manager utilizing current Claims technology. Conduct thorough investigations in order to determine coverage and claim payment also include proactive file management, adequate reserving, and participating in training activities.
Key Responsibilities
Consistently exhibit a high level of customer service.
Adhere to department audit guidelines.
Conduct thorough investigations to determine coverage and payment.
Maintain proactive file management and adequate reserving.
Participate in training activities.
Preferred Experience and Skills
0-2 years of experience in claims handling
Proficiency with computers and current technology
Interpersonal skills
Oral and written communication skills
Time management skills
Customer service skills
Problem‑solving skills
Preferred Education and Training
Bachelor's degree in Business, Insurance or related field
Salary Statement The salary range for this position is $23.15 - $31.00. 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 Program401(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.
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