Medical Claims Specialist

Location: Omaha, Nebraska, United States. Hybrid workplace with work from home available up to two days per week.

Company

BHHC is a national insurance group with more than 50 years in business, offering insurance products across the United States.

What you will do

• Complete the Medical Claims Training Program and demonstrate mastery of claims adjusting fundamentals.
• Manage workers’ compensation medical-only claims from inception through resolution.
• Determine coverage, investigate compensability and severity, and gather relevant claim information.
• Calculate and update reserves while ensuring benefits, notices, filings, and claim handling comply with applicable laws.
• Build effective relationships with client contacts and collaborate with Call Center, Medical Management, Client Services, and indemnity adjusting staff.

Requirements

• High school diploma or equivalent certificate required.
• Ability to apply common-sense understanding, follow written and oral instructions, and resolve problems involving several concrete variables.
• Ability to use Microsoft Office Suite effectively and quickly learn proprietary and third-party software.
• Administrative experience in law, medicine, insurance, workers’ compensation, telephonic communication, or negotiation is useful but not required.

Culture & Benefits

• Manageable caseloads and a work-life balance.
• Paid time off, paid holidays, and a retirement savings match.
• Group medical, dental, and vision insurance, plus life, AD&D, and long-term disability insurance.
• Free on-site fitness facility and garage parking.
• Tuition reimbursement, employee assistance, a paid community volunteer day, and an employee referral program.
• Collaborative and inclusive workplace focused on customer service, integrity, and professional development.