Medical/Health Claims Analyst - (Special Risk Claims) - Omaha, NE
Mutual Of Omaha
The role involves processing medical and health claims promptly by examining, assessing, investigating, and deciding on benefits. Additionally, it includes managing larger or intricate claim. The job entails examining, analyzing, and deciding 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. Previous claims paying experience is a must have for this role. This position may require working in the office.
WHAT WE CAN OFFER YOU:
- Hourly Wage: Minimum: $18.75 MidPoint: $23.03 Maximum: $27.30, plus annual bonus opportunity.
- 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 9 paid holidays in 2023.
- Regular associates are provided sick leave through the use of personal time. Associates working 40 hours a week can receive up to 56 hours of personal time in 2023, prorated based on the start date.
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; occasional travel may be required while maintaining consistent attendance as per company expectations.
- You promote a culture of diversity and inclusion, value different ideas and opinions, and listen courageously, remaining curious in all that you do.
- Able to work both in office and remotely with access to a high-speed internet connection and located in the United States or Puerto Rico.
- 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 email@example.com. Please allow at least one week from time of applying if you are checking on the status.