Nurse Claims Advisor

Lincoln, NE - USA

Monthly Salary: Not Disclosed

Posted on: 30+ days ago

Vacancies: 1 Vacancy

Job Summary

Job Description

Make a Difference at NRECA and Join Us as a Nurse Claims Advisor in Lincoln NE.

Are you passionate about helping others and making a meaningful impact Join a team thats proud to be named one of Lincolns Best Places to Work! At NRECA were looking for a compassionate and detail-oriented Nurse Claims Advisor who thrives in a mission-driven environment and is ready to grow their career while supporting our members. Plus this position is eligible for NRECAs hybrid schedule which allows flexibility to work from home up to 2 days per/week.

About NRECA
NRECA is a unique national trade association providing advocacy financial services and business support services to over 900 consumer owned electric cooperatives across the country. NRECA employees are united by our mission inclusive culture collaborative workplace and commitment to service excellence. As a best place to work employer we operate with integrity transparency and a spirit of innovation.

About the Insurance & Financial Services Team
Join a dynamic and inclusive team that administers industry-leading employee benefit plans. Our work is diverse intellectually engaging and deeply impactful. We foster a culture of belonging driven by values like communication creative problem-solving and accountability. If youre motivated by purpose enjoy variety and care about people and outcomes this is the team for you.

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

What Youll Do

Serve as a medical resource for the Group Benefit Department Product Development & Management (PDM) and NRECA members.
Coordinate and oversee medical peer review processes.
Maintain and update nurse-related policy and procedure documentation.
Provide exceptional customer service to members plan participants and providers regarding utilization and case management prescription drug plans and emerging treatments.
Review complex medical reports and claims for eligibility and medical necessity.

What Youll Gain

Competitive compensation and outstanding benefits.
Medical dental and vision insurance.
Matching 401(k) and pension plan.
Wellness programs and professional development opportunities.
A supportive team and a culture that values your contributions.

Qualifications

Whats Required of You

Bachelor of Science in Nursing (BSN) with a current RN license or an accredited Nursing Diploma/Associate Degree with 10 years of clinical/case management experience.
Minimum of 5 years in nursing or medical case management.
Strong medical/surgical background preferred.
Case Management Certification preferred.
Excellent collaboration communication and multitasking skills.
Ability to report to the office when needed.

Work Schedule

Location: Hybrid (Lincoln NE)
Schedule: MondayFriday 8:15 a.m. 5:00 p.m. 3-days in-office 2-days at home.

Ready to take the next step in your NRECA journey
Apply today and help us continue delivering excellence to our members!

Additional Requirement:

The preceding job description has been written to reflect managements 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 or call: - NRECA Arlington Human Resources. Please call - 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 .

Required Experience:

Unclear Seniority

Job DescriptionMake a Difference at NRECA and Join Us as a Nurse Claims Advisor in Lincoln NE.Are you passionate about helping others and making a meaningful impact Join a team thats proud to be named one of Lincolns Best Places to Work! At NRECA were looking for a compassionate and detail-oriented ...