Medical Claim Representative - Omaha, NE

Location: Nebraska, Remote

Work Type: Full Time Regular

Job No: 503304

Categories: Administrative/Support, Claims/Claims Processing

Application Closes: Open Until Filled

Mutual of Omaha is hiring for a Special Risk Claim Analyst position. In this role, you will be responsible for handling participant accident claims for college athletes, focusing on the thorough review, analysis, investigation, and determination of benefits. You will be required to actively analyze various documents, including diagnosis codes, and gather extensive information, often secondary to initial insurance assessments. The ability to organize meticulously and pay close attention to detail is crucial. Each claim presents a unique challenge, necessitating strong communication skills and the capacity to collaborate both internally and externally to ensure timely and accurate claim processing. This role demands a proactive approach to managing a diverse workload and delivering precise results. If you excel in dynamic environments and are keen on making a significant impact in the insurance sector, we encourage you to apply.

This role is a hybrid position that will be located at our Corporate Headquarters in Omaha, NE.

WHAT WE CAN OFFER YOU:

Hourly Wage: $19. 25-$23
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:

Manage Complex Claims: You will delve into claims, conducting thorough reviews and analyses to determine benefits. Your work will be guided by policy provisions and government regulations, where you'll apply rules and procedures with precision and limited discretion.
Resolve and Execute Claims: Once all questions related to a claim are resolved, you'll be responsible for initiating payments or denials through our advanced claims system, adhering strictly to our policy guidelines.
Adjust and Update: You may also handle routine or manual adjustments to claims, ensuring accuracy and attention to detail.
Stay Informed and Inform: Keep up-to-date with industry changes, federal and state regulations, and internal process adjustments. You may also be called upon to provide various reports to stakeholders, keeping them informed and aligned.
Drive Quality and Efficiency: Achieve and exceed predetermined productivity and quality standards, contributing actively to our continuous improvement initiatives by identifying and implementing process enhancements.

WHAT YOULL BRING:

Industry Expertise: Proficient in applying policies and understanding regulations, with solid knowledge of our products and claim processes. Good understanding of medical terminology to aid in claim handling.
Tech Savvy: Comfortable using various software for word processing, spreadsheets, email, and presentations.
Strong Organizational Skills: Excellent at managing tasks with precision and independence, capable of delivering results under tight deadlines.
Analytical Thinker: Sharp analytical skills for effective problem-solving and decision-making.
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:

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 . @mutualofomaha. com. Please allow at least one week from time of applying if you are checking on the status.

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