Medical Claims Associate

NRECA•Lincoln, NE

2d•Hybrid

About The Position

The Medical Claims Associate is a primary point of contact for members, providing timely, accurate, and compassionate phone support. The role answers questions about benefits, claims, and financial matters; explains coverage; guides members through the claims process; and helps resolve concerns. The Associate combines customer service skills with insurance and claims expertise to support a positive member experience and efficient claims operations. The position is based in Lincoln, Nebraska, and is eligible for NRECA’s hybrid schedule, allowing work from home up to two days per week. Work hours are Monday through Friday, 8:15 a.m. to 5:00 p.m. NRECA is a national trade association representing more than 900 consumer-owned electric cooperatives. Its Insurance & Financial Services department develops and administers employee benefit plans and services. The organization describes its culture as emphasizing diversity, integrity, belonging, communication, creative problem-solving, collaboration, and accountability.

Requirements

High school diploma or GED.
Up to 12 months of experience in claims processing involving medical insurance plans, or 12 months of experience in a healthcare billing office.
Medical Terminology Certification, or the ability to obtain certification within six months of completing claims training.
Inbound and outbound telephone customer service experience.
Knowledge of medical insurance plans and healthcare benefits.
Strong interpersonal skills and a member service orientation.
Excellent customer service and communication skills.
Ability to manage multiple priorities with attention to detail.
Proficiency with Microsoft Office applications.
Ability to report to the office when required.

Nice To Haves

Associate degree.

Responsibilities

Manage a steady volume of member calls while delivering accurate, efficient, and high-quality service.
Explain medical, vision, financial, and other benefit programs so members understand their coverage and available resources.
Assist members with questions about claims, Explanation of Benefits (EOBs), eligibility, deductibles, copayments, and payment information.
Research and resolve member concerns, escalating complex claim issues when appropriate.
Accurately document calls, complete follow-up activities, and maintain detailed records in accordance with departmental procedures.