Claims Advisor/ Nurse Analyst

Our Lincoln, NE office, NRECA-Lincoln is looking for a Claims Advisor/ Nurse Analyst in their Claims unit.

Purpose and Mission of the Position

Act as a medical resource for claims associates, supervisory staff, management and the membership to facilitate access to quality, cost effective medical services in accordance with policy provisions.  Responsible for providing prompt and courteous customer service and information to member systems, plan participants, and service providers relating to utilization case management, the NRECA prescription drug plan, new treatment methods and other medical services


Description of Accountabilities and Performance Expectations


Benefits: One of the many reasons employees stay at NRECA-Lincoln is the wonderful benefit package offered to our employees. Benefits include:Medical, vision and dental insurance. Life insurance is 100% paid by the company. Short and long term disability programs  Eleven paid holidays and generous paid time off. Pension plan and employer matched 401(k).  We also offer paid college tuition, legal resources, employee wellness programs, and a performance recognition program. 

Job Requirements:  Please read the requirements carefully.  The successful applicant will have to get up to speed quickly and therefore, we will consider only those who meet the criteria listed below:

Formal Education Required




Most Common:

Bachelor of Science in Nursing Degree or an Accredited Nursing Diploma.  

Preferred:

Bachelor of Science in Nursing Degree.

 

Knowledge, Skills and Abilities Required:

1.  Current R.N. license with a minimum of 5 years of nursing and/or medical case management experience required.

2. Strong medical/surgical background preferred.

3. Case Management Certification is helpful.

4. Can effectively coordinate the demands of cost control and service responsiveness for members in catastrophic situations.

5. Effective written and verbal communication skills to interact with medical professionals, vendors, and agencies in a professional manner

6. Experience using MS Office applications with a high level of proficiency (Excel, Word, Outlook)

7. Effective interpersonal skills to establish and maintain a professional environment with internal and external customers.

8. Effective problem-solving skills to independently recognize and define a problem.

9. Is flexible and able to effectively cope when faced with changing conditions/policies/procedures while maintaining a high level of accuracy.

10. Effective decision making skills and able to recognize when it is appropriate to seek assistance.

11. Able to travel away from home as business needs require.

12. Is flexible to work extended hours during the week and/or weekend hours as needed. 

Physical Requirements: These must be met by the employee to successfully perform the essential functions of this job.  Reasonable accommodations may be made to enable employees with disabilities to perform the essential functions. Able to operate office equipment including but not limited to personal computer, copier, printer, 10-key adding machine, and multiple line telephone.Talking and hearing.Repetitive motion of the wrist, hands, and/or fingers entering data and grasping a computer mouse.  Close visual acuity to view a computer terminal and other office machines

Top Competencies: Most critical NRECA competencies for this position Applied LearningCommitment to Learning.Customer Service OrientationEffective CommunicationInnovationManaging WorkProblem Solving

About The Company: NRECA, National Rural Electric Cooperative Association, was founded in 1942 and its headquarters are located in Arlington, Virginia with an additional office located in Lincoln, Nebraska.  NRECA is an advocate for consumer-owned cooperatives on energy, operational, and political issues as well as community and economic development.TODAY there are more than 650 employees company wide with over 150 employees located in the Lincoln, Nebraska office. For more information about our organization please visit our web site at http://www.nreca.org/.

If this position sounds interesting, please click APPLY NOW to submit your resume for consideration.

 

NRECA is committed to diversity and is an equal opportunity employer and a Gold Well Workplace.M/F/D/V.