Special Risk Claim Analyst - Omaha, NE

This role is a hybrid position located at our Corporate Headquarters in Omaha, NE. Training hours are 6:30am–3pm Monday through Friday and will be in person. After training, you can start any time between 6:30am–8:00am.

Responsibilities

• Manage participant accident claims for college athletes, conducting thorough reviews, analysis, investigation, and determination of benefits.
• Perform accurate data entry, imaging, and system updates related to claims, policy, eligibility, and correspondence to support proper claim setup.
• Analyze various documents, including diagnosis codes, and gather extensive information, often secondary to initial insurance assessments.
• Apply policy provisions and government regulations with precision and limited discretion to determine benefits.
• Initiate payments or denials through the claims system once all claim-related questions are resolved, adhering strictly to policy guidelines.
• Handle routine or manual adjustments to claims, ensuring accuracy and attention to detail.
• Stay up-to-date with industry changes, federal and state regulations, and internal process adjustments.
• Achieve and exceed predetermined productivity and quality standards.
• Identify and implement process enhancements to drive continuous improvement initiatives.

Requirements

• Exceptional attention to detail with the ability to analyze complex information, identify discrepancies, and ensure accurate claim processing.
• Comfortable using various software for word processing, spreadsheets, email, and presentations.
• Proven ability to prioritize competing responsibilities, manage a diverse workload, and meet deadlines in a fast-paced environment.
• Demonstrated ability to work independently, exercise sound judgment, and make informed decisions with minimal supervision.
• Adaptability and resilience when managing complex claims that require flexibility, investigation, and creative problem-solving.
• Promote a collaborative culture, value different ideas and opinions, and remain curious.
• Able to work at our office in Omaha, NE, in a hybrid environment.

Preferred Qualifications

• Medical claims processing, healthcare administration, insurance claims, or medical customer service experience.

Benefits

• Hourly wage: $20.50 – $21.00, plus annual bonus opportunity.
• 401(k) plan with a 2% company contribution and 6% company match.
• Work-life balance with vacation, personal time, and paid holidays.