Medical/Health Claims Analyst - (Special Risk Claims) - Omaha, NE

Location: Nebraska
Work Type: Full Time Regular
Job No: 503226
Categories: Claims/Claims Processing
Application Closes: Open Until Filled

This role involves processing medical and health claims promptly by examining, assessing, investigating, and deciding on benefits. Additionally, it includes managing larger or intricate claims. You will examine, analyze, and decide on benefits for high-value or intricate claims, following policy provisions and government regulations. It involves applying some discretion within set rules and procedures for claim handling.  

WHAT WE CAN OFFER YOU:

  • Estimated Hourly Wage: (Levels have variable responsibilities and qualifications)
    • Special Risk Claim Analyst: $19.25 - $23.50, plus annual bonus opportunity. 
    • Sr Special Risk Claim Analyst: $20.25 - $25.38, plus annual bonus opportunity. 
  • Benefits and Perks, 401(k) plan with a 2% company contribution and 6% company match.
  • Regular associates working 40 hours a week can earn up to 15 days of vacation each year.
  • Regular associates receive 11 paid holidays in 2024, which includes 2 floating holidays that are added to your prorated personal time to be used at your discretion.
  • Regular associates are provided sick leave through the use of personal time. Associates working 40 hours a week can receive up to 40 hours of personal time in 2024, which is prorated based on the start date. Additionally you will receive two floating holidays in 2024 by way of personal time that may be used at your discretion.
  • Applicants for this position must not now, nor at any point in the future, require sponsorship for employment. 

WHAT YOU'LL DO:

  • Processes claim payments or denials once all queries are resolved, adhering to policy provisions.
  • Engages with both internal and external stakeholders to gather precise claim details and clarify claim procedures.
  • Manages routine or manual adjustments to claims as necessary.
  • Generates and distributes diverse reports for both internal and external recipients.
  • Required to meet predetermined benchmarks for productivity and quality, while actively contributing to enhancing processes.

WHAT YOU’LL BRING:

  • Proficient in applying business policies, practices, and procedures in a corporate setting.
  • Familiarity with corporate products and government claim handling regulations.
  • Strong organizational skills, attention to detail, and capability to work somewhat independently.
  • Capacity to perform under pressure, meeting deadlines, and exhibiting good analytical and decision-making skills.
  • Excellent verbal and written communication skills, along with knowledge of medical terminology.
  • You promote a culture of diversity and inclusion, value different ideas and opinions, and listen courageously, remaining curious in all that you do.
  • Ability to work at our home office located in Omaha, Nebraska, in a hybrid environment. 

PREFERRED:

• Medical and/or Health Claims processing skills/experience.
• Heath care related claims knowledge/terminology.
• Experience as a Claim Analyst or other claims environment.

We value diverse experience, skills, and passion for innovation. If your experience aligns with the listed requirements, please apply! 

If you have questions about your application or the hiring process, email our Talent Acquisition area at careers@mutualofomaha.com. Please allow at least one week from time of applying if you are checking on the status.

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