Hybrid Medical Claims Specialist — Member Care & Support

CBA; Lincoln (NE); Hybrid; USD 49,000 - 57,000; Full time

Benefits offered by this job

Hybrid work environment

Competitive benefits package

Paid time off and holidays

Job summary

NRECA is seeking a detail-oriented Medical Claims Associate in Lincoln, NE for the Medical and Dental Claims Department. You will provide accurate phone support, explain benefits, and guide members through the claims process with a service-focused approach.

The role requires up to 12 months in claims processing or healthcare billing, a high school diploma or GED (associate degree preferred), and a Medical Terminology Certification or plan to obtain within 6 months.

Qualifications

• Must have customer service experience in healthcare or claims processing.
• Knowledge of medical insurance plans and benefits.
• Excellent communication, listening, and interpersonal skills.
• Ability to manage multiple priorities with strong attention to detail.
• Willingness to work a hybrid schedule and participate in training.

Responsibilities

• Handle a steady volume of member calls with accuracy and empathy.
• Explain medical, vision, and other benefits and coverage to members.
• Assist with claims questions, EOBs, eligibility, deductibles, and copayments.
• research and resolve member concerns, escalating complex issues as needed.
• Document calls and complete follow-up per departmental procedures.

Skills

Customer service

Communication

Attention to detail

Problem solving

Education

High school diploma or GED

Associate degree

Tools

Microsoft Office

Job description

NRECA is seeking a detail-oriented Medical Claims Associate in Lincoln, NE for the Medical and Dental Claims Department. You will provide accurate phone support, explain benefits, and guide members through the claims process with a service-focused approach.

The role requires up to 12 months in claims processing or healthcare billing, a high school diploma or GED (associate degree preferred), and a Medical Terminology Certification or plan to obtain within 6 months.