Claim Processor

Position: Church Mutual Insurance, S.I. | Location: Merrill, Wisconsin | Posted: 9/25/2026

Responsibilities

• In accordance with application of state and federal laws and company best practices, provide claimants and insureds with clear and correct instructions regarding the claim process.
• Process basic claims by verifying coverage, obtaining and documenting necessary information for the claim, and issuing appropriate payments as directed.
• On any given day, process newly reported claims, initiate basic claim investigation, and redirect moderate and complex claims to a higher level Claim Representative as required.
• Perform Claim Processing System entry and maintenance, including file setup, coverage verification, applicable coding, establishing reserves, and issuing payments.
• Verify coverage and determine our obligation(s) to the insured and/or claimant.
• Review claims to determine type of claim presented, claim documentation/evidence presented, amount of claim, or amount due.
• Establish and monitor case reserves for adequacy during the life of the claim.
• Review loss for subrogation potential and refer to the Subrogation Specialist, if appropriate.
• Provide additional instruction to insured or request additional information.
• Submit necessary state filings and create and send appropriate required state notices and letters.
• Complete the claim process by obtaining and reviewing support documentation in accordance with existing state laws and fee schedules and make appropriate payments.
• Assist other claim handlers as requested.

Requirements

• Two years of insurance processing and/or equivalent customer service work experience.
• Prior claim processing experience is preferred.
• High school diploma or equivalent is required.
• Associate degree in insurance or business preferred.
• Additional courses in insurance and/or medical terminology desirable.

Skills

• Ability to obtain and maintain state adjusting license requirements and complete continuing education requirements.
• Ability to deal effectively and provide positive customer service with insureds and claimants by phone, email, and in writing.
• Proficient keyboarding skills.
• Able and willing to follow instructions.
• Possess a positive attitude.
• Ability to handle rush or unexpected assignments.
• Ability to acquire knowledge of insurance terminology.