Medical Claims Specialist (entry level)

Omaha NationalOmaha NationalOmaha, Nebraska, United States
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Posted

8/21/2026

Employment

Full time

Range

Check website

Work style

On-site

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AI summary

Core responsibilities

The Medical Claims Specialist determines coverage and compensability for workers' compensation claims while managing reserves and regulatory compliance. They also direct vendors and negotiate settlements to achieve favorable outcomes for the company.

Requirements overview

Candidates must have the ability to learn complex workers' compensation regulations and interpret legal and medical documents. Strong communication skills and proficiency in Microsoft Office are required, with a bachelor's degree considered a plus.

Key skills

Workers' compensation claims adjustingNegotiationPersuasionAnalytical thinkingLegal principlesMedical principlesRegulatory complianceCommunicationMicrosoft WordMicrosoft ExcelConflict resolutionData entryTime managementCritical thinkingInterpersonal skills

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Education requirements

bachelor degree

About Omaha National

Industry

Insurance

Employees

185

Type

Privately Held

Size

201-500 employees

Omaha National provides workers compensation insurance with three ways to pay premium for small and mid-size companies through independent agents and brokers. Our approach is simple – do everything smarter, better, and faster than anyone else. We’ve taken decades of experience and built a company that replaces archaic industry practices with smarter strategies and streamlined processes. Employers benefit from superior claims outcomes and a high level of customer service. Every employer will experience a level of service, professionalism, and attention to detail not normally seen in the industry. It’s a difference you’ll notice from day one.

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Job categories

Finance & AccountingLegalAdministrativeHealthcare

Description

This is an excellent opportunity to be trained into the world of workers’ compensation claims adjusting.  The Medical Claims Specialist is a junior role to the Workers Compensation Claims Adjusters. In this role you will handle light to moderate claims. Your role will allow indemnity adjusters time to focus on more in-depth and complex cases. Workers compensation adjusting is an intellectually interesting and professionally rewarding position that plays a critical role in the success of the company while positively impacting lives. Your strong negotiation and persuasion skills; high aptitude to learn and effectively apply medical and legal principles; and ability to thrive in a challenging and fast paced role are attributes we want on our team.   RESPONSIBILITIES: * Determine coverage and compensability for reported claims * Accurately set reserves, ensuring that timely updates are made with claim developments * Maintain compliance with regulatory deadlines, benefit calculations, state reporting, and benefit notices * Achieve favorable settlements through timely identification of settlement opportunities; accurate settlement valuations; and effective negotiation practices * Direct vendors such as field nurses, investigators, defense attorneys to positively impact claims outcomes   REQUIREMENTS: * Ability to comprehend and learn new workers’ compensation regulations while interpreting complex legal and medical documents. * Strong verbal and written communication skills with the ability to effectively communicate with a broad audience of varying backgrounds, frequently conveying complicated information in a way easily understood by a layperson * Working knowledge of Microsoft Word, Excel, with aptitude to learn other software programs   QUALIFICATIONS: * A keen, logical mind and a strong aptitude for analytical thinking * Strong oral and written communication skills  * Rock-solid honesty, openness, and ethical values * Highly collaborative, ego-free work style; fit into a culture in which people genuinely enjoy working together * Working knowledge of Microsoft Word and Excel and the ability to rapidly master specialized software programs  * Bachelor’s degree is a plus but not required   BENEFITS: Omaha National provides a stable, positive work environment, competitive pay, excellent benefits, such as paid parental bonding leave, tuition reimbursement, 401K, and paid vacation and sick leave.  

Requirements

  • Workers' compensation claims adjusting
  • Negotiation
  • Persuasion
  • Analytical thinking
  • Legal principles
  • Medical principles
  • Regulatory compliance
  • Communication
  • Microsoft Word
  • Microsoft Excel
  • Conflict resolution
  • Data entry
  • Time management
  • Critical thinking
  • Interpersonal skills

Benefits

  • Paid parental bonding leave
  • Tuition reimbursement
  • 401k
  • Paid vacation
  • Paid sick leave

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