Specialty Claims Associate

About the role

The Specialty Claims Associate processes and adjudicates FSA and HRA claims, reviews and analyzes claim documentation and eligibility, responds to member inquiries, communicates with members and providers regarding claim status, maintains accurate claim records and documentation, and adheres to productivity and quality standards.

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 claim reconsideration reviews and follow policies and procedures to make decisions on reconsideration requests.
• Adjudicate basic claim corrections on the claim software.
• Communicate with members and providers regarding claim status.
• Maintain accurate claim records and documentation.

Requirements

• Education: High school diploma or GED.
• Experience: Medical office experience with exposure to medical billing, claims processing, verifying medical benefits with insurance companies, or at least two years in healthcare or insurance related field.

Qualifications

• Knowledge: Knowledge of medical insurance plans and healthcare benefits.
• Skills: 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.

Skills

• 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.
• Able to manage multiple priorities with attention to detail.

Benefits

NRECA offers 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.

Pay

Salary Range: $48,000 - $60,000 Final Compensation determined by individual qualifications, experience, and internal equity.

Disclaimer

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 humanresources@nreca.coop 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' 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.