Claims Specialist II

BCBSNE

Country: United States of America

Location: Work at Home - Nebraska

Time Type: Full time

Posted On: September 27, 2024

Blue Cross and Blue Shield of Nebraska (BCBSNE) is more than just an insurance company; we exist to be there for people in the best and hardest moments of their lives.


Our team is the power behind that promise. And, as the industry rapidly evolves and we seek ways to optimize business processes and customer experiences, there’s no greater time for forward-thinking professionals like you to join us in delivering on it!

As a member of Team Blue, you’ll find purpose, opportunities and the support you need to build a meaningful career and make a powerful impact in our community.

This position allows remote work but you must live in the state of Nebraska or in the Council Bluffs area.

This role is responsible for handling mid-complex to complex inquires & tasks relating to Health Insurance Claims. Individuals in this role will work closely with internal & external customers to provide information, investigate & resolve claim issues. Individuals must have a good understand of Claims fundamentals & must be able to interpret company, federal, & state claims standards when needed. Effective communication & a comprehensive understanding of industry guidelines & also key. This role will also provide guidance and mentorship to the Claims Specialist I role.

What you'll do:

  • Ability to handle mid-complex tasks & escalations relating to health insurance claims.
  • Communicates with internal & external customers via all means of communication.
  • Considered proficient in claims related knowledge, escalating issues to higher level staff when needed.
  • Ability to apply company, federal, & state regulations.
  • Researches & analyzes information, as it pertains to Claims.
  • Reporting & project work, as needed.
  • May provide mentorship and guidance to Claims Specialist I role.

To be considered for this position, you must have:

  • HS Diploma + 3 years' experience.

Learn more about what makes BCBSNE such an exceptional place to work by visiting .

We strongly believe that diversity of experience, perspective and background will lead to a better workplace for our employees and a better product for our customers and members.

Blue Cross and Blue Shield of Nebraska is an Equal Opportunity /Affirmative Action Employer - Minorities/Females/Disabled/Veterans