Office Specialist - MLTC Claims Team
State of Nebraska

The work we do matters!

Hiring Agency:
Health & Human Services - Agency 25

Location:
Lincoln, NE

Hiring Rate:
$16.277

Job Posting:
JR2024-00009104 Office Specialist - MLTC Claims Team (Open)

Applications No Longer Accepted On (If no date is displayed, job is posted as open until closed):
09-21-2024

Job Description:
Join the vibrant team at the State of Nebraska's Department of Health and Human Services, Division of Medicaid and Long-Term Care Claims as a full-time Office Specialist. We're on the lookout for individuals who are highly organized, boast exceptional customer service skills, and are committed to bolstering our team in delivering top-notch service. Become a part of a team that not only values its members but also knows how to have a good time while achieving excellence! Apply now and be part of something great!
Job Description:
A Medicaid Claims Customer Service Representative (CSR) handles incoming calls regarding claims, eligibility, and payments. They listen actively, solve problems, and manage complaints professionally, providing timely solutions in a busy call center. They assist both internal and external customers with questions about HIPAA compliance, claim submission, and billing. They explain how to fully process claims and use various computer systems and resources to fulfill their duties. They review documents for accuracy, complete office tasks, and receive training to support other roles as necessary.

Job Duties:
Serve as a Medicaid Claims Customer Service Representative (CSR), handling both routine and non-routine inbound calls regarding claim status, client/provider eligibility, and provider payments.
Review and process various documents such as claim forms, adjustment requests, and prior authorizations for accuracy and completeness.
Perform a variety of office tasks including document creation, review, and revision, as well as participation in ongoing training sessions.
Utilize multiple mainframe computer tasks efficiently.
Act as a backup for other job duties within the Fee for Services Claims group or other areas within the MLTC Medicaid Claims Team as required.

Wage: 16.277
Hours: M-F 8-5
Dress Attire: Business Casual

Requirements / Qualifications:

Minimum Qualifications: Coursework/training in administrative/office support functions, procedures, and methods including the operation of personal computers and office equipment; or areas related to the programs and functions of the employing agency. OR Experience in customer service or public contact; or applying criteria/regulations; and/or performing administrative/office/secretarial support work including use of personal computers and office equipment.

Preferred Qualifications: Strong customer service skills, experience in a high-volume call center, and familiarity with verifying claim data for medical claims. Experience working with both Federal and State rules and regulations, including HIPAA compliance (5010 and paper) and NAC Title 471. .

Knowledge/Skills/Abilities:

Solid understanding of program-administrative work, relevant information sources, and record-keeping principles, preferably using Microsoft Office suite.

Ability to formulate and recommend alternative courses of action, communicate effectively via various mediums, summarize technical data into reports, and understand and apply instructions and policies.

Capacity to quickly and accurately retrieve information from different computer mainframes.

Willingness to work consistently Monday to Friday, 8-5, with regular and predictable attendance, and respond to callers' inquiries in a professional manner.

If you are enthusiastic about providing exceptional customer service, possess the necessary qualifications, and are eager to contribute to a vital team within the Department of Health and Human Services, we encourage you to apply for this rewarding opportunity. Join us in making a positive impact on the Medicaid and Long Term Care community in Nebraska.


Benefits

We offer a comprehensive package of pay, benefits, paid time off, retirement and professional development opportunities to help you get the most out of your career and life. Your paycheck is just part of your total compensation.

Check out all that the State of Nebraska has to offer! Benefit eligibility may vary by position, agency and employment status. For more information on benefits, please visit: https://statejobs.nebraska.gov/index.html#benefits

Equal Opportunity Statement

The State of Nebraska values our teammates as well as a supportive environment that strives to promote diversity, inclusion, and belonging. We recruit, hire, train, and promote in all job classifications and at all levels without regard to race, color, religion, sex. age, national origin, disability, marital status or genetics.

Current employees of the State of Nebraska should NOT apply on this external career. Instead go to Workday and access the Jobs Hub - Internal Apply app from your home landing page.