The Nebraska Department of Health and Human Services is seeking an Office Specialist to join their Medicaid and Long-Term Care Claims Division. The role involves reviewing and processing Medicaid claims accurately, ensuring compliance with policies, and providing excellent customer service to providers and clients.
Responsibilities
- Review Medicaid claims and associated provider documents required for claims processing, payments, or denials
- Determine that payment amounts for services are correct and generate computerized payments
- Answer questions and resolve problems involving non-routine handling of forms and documents submitted for updating claims
- Make adjustments authorized by established policies and procedures
- Respond to telephone and written inquiries from providers regarding the status of suspended or deleted claims, including electronic claims submitted by trading partners
- Perform related work as assigned
- Ensure compliance with department policies, procedures, and guidelines, as well as state and federal regulations
- Provide excellent customer service and consistently demonstrate DHHS values and core competencies
- Periodically support the EDI (Electronic Data Interchange) Help Desk, assisting with user access, resolving communication issues, maintaining external user databases, and processing trading partner authorizations
- Periodically assist the Claims Customer Service Call Center, helping providers and clients with claim status, client eligibility, and provider-related inquiries
Skills
- 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
- Experience in customer service or public contact
- Applying criteria/regulations
- Performing administrative/office/secretarial support work including use of personal computers and office equipment
- Customer Service Skills – Ability to communicate clearly, listen actively, and handle questions or complaints with professionalism
- Attention to Detail – Able to review forms and data accurately to catch errors or missing information
- Computer Proficiency – Comfortable using Microsoft Office (Word, Excel, Outlook) and navigating multiple computer systems
- Time Management – Capable of handling a high volume of work, staying organized, and meeting deadlines
- Problem-Solving – Able to identify issues, think critically, and find practical solutions for customers or internal processes
- Communication Skills – Strong written and verbal communication to explain processes, respond to inquiries, and document work
- Teamwork – Willing to work cooperatively with others and assist team members when needed
- Adaptability – Able to learn new systems, take on different tasks, and adjust to changes in a fast-paced environment
- Confidentiality Awareness – Understands and follows privacy regulations like HIPAA when handling sensitive information
- Basic Office Skills – Experience with filing, data entry, email communication, and working with forms or documents
Benefits
- State-matched retirement contribution of 156%!
- 13 paid holidays
- Generous leave accruals that begin immediately
- Tuition reimbursement program
- 79% employer-paid health insurance plans
- Dental and vision insurance plans
- Employer-paid $20,000 life insurance policy
- Career advancement opportunities as the largest and most diverse employer in the state
- Training and development based on your career goals
- Employee Assistance Program
Company Overview
The Department of Health and Human Services team contributes to the lives and health of Nebraskans every day. It was founded in 1997, and is headquartered in Lincoln, Nebraska, USA, with a workforce of 1001-5000 employees. Its website is https://dhhs.ne.gov.
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