Medical Claims Associate

Job Description

Medical Claims Associate

Work Location: Lincoln, NE

Hybrid Schedule: The position is eligible for NRECA’s hybrid schedule which allows flexibility to work from home up to 2 days per/week.  

Work Hours: Monday – Friday, 8:15 a.m. – 5:00 p.m.

Join a Mission-Driven Organization

We're seeking someone who is detail-oriented, adaptable, and passionate about customer service to join our Medical and Dental Claims Department team in Lincoln, NE. 

We’re proud to be named one of Lincoln’s Best Places to Work—and we’re looking for people who care deeply about helping others and want to grow with a mission-driven organization.

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 over 900 consumer-owned electric cooperatives across the country serve their communities and we operate with integrity, transparency, and a spirit of innovation.

The work in the Insurance & Financial Services department (I&FS) is dynamic and intellectually challenging, engaging, and deeply impactful. They work to develop and administer employee benefit plans and services which are diverse and the results help improve the quality of life for hard working Americans across the country. They foster a culture that emphasizes a strong sense of diversity, integrity, and belonging, driven by NRECA’s core values like communication, creative problem-solving, collaboration and accountability.

If you’re motivated by purpose, enjoy variety, and care about people and outcomes, this is the team for you.

Position Summary

As a Medical Claims Associate, you will be a primary point of contact for members, providing timely, accurate, and compassionate phone support. You will answer questions about benefits, claims, and financial matters; explain coverage; guide members through the claims process; and help resolve concerns. By combining strong customer service skills with insurance and claims expertise, you will contribute to a positive member experience and efficient claims operations.

Key Responsibilities

• Manage a steady volume of member calls while delivering accurate, efficient, and high-quality service.
• Explain medical, vision, financial, and other benefit programs to help members understand their coverage and available resources.
• Assist members with questions regarding 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.

Salary Range: $49,000 - $57,000

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

Benefits

NRECA has a robust total rewards program, including but not limited to, competitive pay and recognition, comprehensive health benefits, a 401(k) with employer match, pension plan, generous paid time off and holidays, wellness programs, educational assistance, professional development opportunities, and a flexible hybrid work environment.

Qualifications

Education, Experience, and Certifications

Required Education: High school diploma or GED

Preferred Education: Associate degree

Required Experience:

• Up to 12 months experience in claims processing working with medical insurance plans or 12 months in a healthcare billing office.
• Medical Terminology Certification required, or the ability to obtain certification within 6-months of completing claims training.
• Inbound and outbound telephone customer service experience. 

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.
• 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.

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.

Disclaimer Statement: 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 [email protected] 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. 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.