Specialty Claims Associate

NRECA; Oklahoma; Hybrid; USD 48,000 - 60,000; Full time

Benefits offered by this job

Hybrid work environment

Pension plan

401(k) with employer match

Comprehensive medical, dental, and vis

PTO and holidays

Wellness programs

Professional development opportunities

Competitive compensation

Job summary

NRECA, located in Lincoln, Nebraska, is seeking a detail-oriented Specialty Claims Associate to adjudicate FSA and HRA claims and deliver exceptional member service. You will review claim information, research documentation, and ensure accurate processing in a fast-paced environment.

The role offers a hybrid schedule with up to two days working from home per week, competitive benefits, and opportunities for professional development within a mission-driven organization that values service and

Qualifications

• Required: High school diploma or GED.
• Preferred: Associate degree in a business-related field.
• Required experience: Medical office experience with billing, claims processing, or benefits verification.
• Preferred: Experience with FSA/HRA plans.

Responsibilities

• Process FSA and HRA claims accurately and efficiently.
• Review and analyze claim documentation and eligibility.
• Respond to member inquiries via phone, email, fax, and correspondence.
• Analyze and respond to requests for information and reconsideration reviews and follows policies and procedures to make decisions on reconsideration requests.
• Re-adjudicates basic claim corrections on the claim software.
• Communicate with members and providers regarding claim status.
• Maintain accurate claim records and documentation.

Skills

Customer service

Microsoft Office

Analytical thinking

Communication skills

Education

High school diploma or GED

Associate degree in business-related field

Tools

Microsoft Office

Job description

Job Description

Specialty Claims Associate

Location: Lincoln, Nebraska

Join a Mission-Driven Organization

Are you detail-oriented, customer-focused, and passionate about helping people navigate their specialty benefit accounts? NRECA is seeking a Specialty Claims Associate to join our Insurance & Financial Services team in Lincoln, Nebraska. Join a team that’s proud to be named one of Lincoln’s Best Places to Work!

About NRECA

NRECA is the national trade association representing more than 900 consumer-owned electric cooperatives across the United States. We provide advocacy, financial services, and business solutions that help electric cooperatives serve their communities. The work in the Insurance & Financial Services department (I&FS) is diverse, intellectually engaging, and deeply impactful. They foster a culture of belonging, driven by values like communication, creative problem-solving, and accountability. If you’re motivated by purpose, enjoy variety, and care about people and outcomes, this is the team for you.

What We Offer

• Competitive compensation
• Comprehensive medical, dental, and vision benefits
• 401(k) with employer match
• Pension plan
• PTO and holidays
• Wellness programs
• Professional development opportunities
• Hybrid work environment

Position Summary

The Specialty Claims Associate processes and adjudicates FSA and HRA claims, research claim information, and delivers exceptional member service while meeting productivity and quality standards. The work schedule is 8:15 a.m. to 5:00 p.m. and the positioniseligible for NRECA’s hybrid schedule whichallows flexibility to work from home up to 2 days per/week.

Key Responsibilities

• Process FSA and HRA claims accurately and efficiently.
• Review and analyze claim documentation and eligibility.
• Respond to member inquiries via phone, email, fax, and correspondence.
• Analyzes and responds to requests for information and claim reconsideration reviews and follows policies and procedures to make decisions on reconsideration requests.
• Re-adjudicates basic claim corrections on the claim software.
• Communicate with members and providers regarding claim status.
• Maintain accurate claim records and documentation.

Qualifications

Education, Experience, and Certifications (required and preferred)

• Required Education : High school diploma or GED
• Preferred Education : Associate degree in a business-related field
• Required Experience : Medical office experience with exposure to medical billing, claims processing, verifying medical benefits with insurance companies, or has at least two years in healthcare or insurance related field. Effective telephone customer service skills.
• Preferred Experience : Experience in FSA/HRA plans, claims processing.

Knowledge, Skills and Abilities (as demonstrated by prior work experience)

• Knowledge of medical insurance plans and healthcare benefits.
• Strong interpersonal skills and member service orientation.
• Strong analytical and problem-solving skills.
• Excellent customer service and communication skills.
• Proficiency with Microsoft Office applications.
• Ability to manage multiple priorities with attention to detail.
• Ability to report to the office when required.

Essential Physical Requirements

• Reasonable accommodation may be made to enable individuals with disabilities to perform the essential functions of the job.
• Primarily sedentary work with extended periods of sitting.
• Visual acuity is sufficient for computer work and data analysis.
• Manual dexterity for frequent keyboard use.
• Occasional light lifting (up to 10 lbs).
• Effective communication in person, by phone, and via email.

Salary Range: $48,000 - $60,000

Final Compensation determined by individual qualifications, experience, and internal equity.

Disclaimer Statemen t : The preceding job description has been written to reflect management’s assignment of essential functions. It does not prescribe or restrict the tasks that may be assigned.

Additional Requirement:

The preceding job description has been written to reflect management’s assignment of essential functions. It does not prescribe or restrict the tasks that may be assigned. All qualified applicants will receive consideration for employment without regard to race, color, sex, sexual orientation, gender identity, religion, national origin, disability, veteran status, or other legally protected status.

NRECA is committed to working with and providing reasonable accommodation to individuals with physical and mental disabilities. If you need special assistance or an accommodation while seeking employment, please e-mail [e-mail] or call: 703-907-5992 - NRECA Arlington Human Resources. Please call 402-483-9275 - NRECA Lincoln Human Resources, for Lincoln, NE employment opportunities. We will make a determination on your request for reasonable accommodation on a case-by-case basis.

The U.S. Equal Employment Opportunity Commission (EEOC) recently released the ‘[Know Your Rights](https://urldefense.com/v3/ https:/kairosservicesinc.com/wp-content/uploads/2022/11/22-088_EEOC_KnowYourRights.pdf ;!!KtIFMA!N6hDifJ8EvdJGENBG7C7jlCMshvSmtk6ElgoIVRvsgxSpExrtgD4atxJzSHu2J1DxQs2KgrikFSBy-V-1XycNWk$)’ poster, which updates and replaces the previous “EEO is the Law” poster and “EEO Is the Law Poster Supplement”.

Pay Transparency Non-Discrimination. NRECA will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their own pay. Please see the Pay Transparency Nondiscrimination Provision for more information.

E-Verify. As a Federal Contractor, NRECA is required to participate in the E-Verify Program to confirm eligibility to work in the United States. For information please click on the following link: E-Verify.

For more information about life at NRECA please visit www.Electric.coop.