Disability Claims Specialist

NRECA•Lincoln, NE

19h•Hybrid

About The Position

Under general supervision, reviews, investigates, and analyzes disability claim information for the NRECA membership in accordance with established policy provisions, procedures, and service standards. Evaluates claims using standardized guidelines and escalation protocols, with support from senior staff and leadership and treats each disability claim as an individual case by researching the claimant’s education, training, experience, functional limitations, and identifying potential opportunities for return to work where appropriate. Assists in developing recommended plans of action for assigned claims and maintains high standards of customer service while meeting productivity and timeliness expectations. Applies judgment within defined parameters to support the development and execution of a claim management approach, escalating complex, disputed, or unusual cases to senior specialists or management. Position is eligible for NRECA’s hybrid schedule which allows flexibility to work from home up to 2 days per/week.

Requirements

Associate degree in business or related field or 3 years of experience in disability or workers compensation claims processing working with group insurance plans and service providers.
Insurance coursework or designations obtained through organizations such as LOMA, AHIP, ICA, and IFEBP.
Three years of claims related experience in the areas of disability, workers’ compensation, medical dental, and/or life insurance.
Knowledge of the disability claims lifecycle, integrating medical evidence, vocational factors, functional limitations, and policy provisions to support consistent decisions.
Strong analytical and critical thinking skills with sound decision-making within established policies and authority levels.
Clear and professional verbal and written communication, effectively engaging diverse members and employees using approved messaging; and with the ability to speak the English language both fluently and clearly.
Ability to identify, investigate, and document issues accurately.
Strong customer service skills, including active listening, needs assessment, and de-escalation of challenging situations.
Accountable for attendance and adherence to a hybrid work schedule.
Ability to report to the office when required.

Responsibilities

Reviews, investigates, and analyzes disability claim information.
Evaluates claims using standardized guidelines and escalation protocols.
Researches claimant's education, training, experience, and functional limitations.
Identifies potential opportunities for return to work.
Assists in developing recommended plans of action for assigned claims.
Maintains high standards of customer service while meeting productivity and timeliness expectations.
Applies judgment within defined parameters to support claim management.
Escalates complex, disputed, or unusual cases to senior specialists or management.