Claims Assistant

Title: Claims Assistant

Location: Omaha, Nebraska

Type: Non-Exempt

Workplace: hybrid

Category: Claims Operations

Job Description:

Berkshire Hathaway Homestate Companies, Workers Compensation Division, is looking for a well-organized, motivated Claims Assistant to support our Claims Adjusting team in our Omaha, NE office. This individual will work closely with Claims Professionals to ensure timely and accurate benefit administration to injured workers, demonstrating ability to apply regulations governing the administration process and company guidelines to ensure timely processing.

 

ESSENTIAL RESPONSIBILITIES

 

• Reviews and prioritizes daily diary instructions from Claims Professional and/or Supervisor, ensuring appropriate urgency is given to time sensitive tasks (e.g., payments, regulatory notices), and promptly notifying of any impediment to task completion. Clarifies and rectifies discrepancies and/or obtains proper approval prior to completion.
• Accurately assesses benefit eligibility pursuant to State regulatory guidelines. Issues compensability notices, as well as correlating payments and benefit notices timely, including amended notices when applicable.
• Generates new claim set-up notifications/correspondence for incoming claims and for those claims identified for transfer from the Medical Claims Specialist Unit to an Indemnity Unit. Secures wage information needed timely upon identification of need for transfer.
• Assists with scheduling medical evaluations as needed and routinely obtains updates on disability status post-appointment.
• Appropriately schedules and manages use of vendors when necessary for transportation, translation, and subpoena services.
• Coordinates service of required documentation to appropriate parties on litigated claims (e.g., prepares index, assists with cover letter as necessary, ensures appropriate documentation is included in package and any necessary redaction is completed) and verifies service completion.
• Timely submits necessary internal service requests with required documentation to appropriate department for handling (e.g., check pulls/voids, payment/stop payment requests, return-to-work referrals).
• Timely and concisely notes updates upon completion of tasks within Claims Tracking System. Appropriately escalates issues/red flags to CP or Supervisor.
• Completes other ancillary services as needed.

 

REQUIRED QUALIFICATIONS

• Education: High School Diploma or HS Equivalency credential (such as GED or HiSET) required.
• Experience: Two (2) years of related administrative experience preferred. Prior industry experience a plus.
• Language Ability: Ability to read and interpret documents such as medical reports, legal documentation (settlement documentation), and State regulatory guidelines governing workers compensation. Ability to write routine business correspondence.
• Math Ability: Ability to add, subtract, multiply, and divide in all units of measure, using whole numbers, common fractions, and decimals. Ability to compute rate, ratio, and percent, and to draw and interpret bar graphs.
• Reasoning Skills: Able to apply common sense understanding to carry out instructions furnished in written, oral, or diagram form. Able to solve practical problems involving several concrete variables in situations with limited standardization.
• Computer Skills: To perform this job successfully, an individual must demonstrate basic technical competencies in the use of computers, standard business applications, and Microsoft Office/365 applications and be able to master and become proficient in proprietary and vended software programs.

ADDITIONAL DESIRED SKILLS

• Attention to Detail: Double-checks the accuracy and completeness of information. Completes work according to regulatory guidelines, Company procedures and standards. Works in a conscientious, consistent, and thorough manner.
• Communication: Communicates clearly and is informative and appropriately concise. Asks questions, listens, and obtains clarification when needed. Speaks clearly and persuasively in a manner suitable to the understanding of the listener. Prepares clear and concise written communication and claim notes. Uses proper grammar and punctuation.
• Time Management: Effectively manages time in order to accomplish work. Appropriately prioritizes tasks according to importance and time constraints. Is always aware of the status of assigned tasks. Regularly keeps others informed of task status. Handles multiple assignments and priorities yet fulfills all commitments. Adapts well to changes in procedure.
• Customer Service: Dedicated to meeting the needs of others in this organization, as well as our insureds and injured workers. Responds timely to requests for service and assistance. Solicits feedback to improve service and enhance existing procedures.

WHAT WE OFFER

• Manageable Caseload
• Work-Life Balance
• Work From Home Program (up to 2 days per week)
• Office Within Walking Distance of The Old Market
• Free On-Site Fitness Facility
• Garage Parking

BENEFITS

• Paid Time Off
• Paid Holidays
• Retirements Savings Match
• Group Health Insurance (Medical, Dental, and Vision)
• Life and AD&D Insurance
• Long Term Disability Insurance
• Accident and Critical Illness Insurance
• Flexible Savings Accounts
• Paid Community Volunteer Day
• Employee Assistance Program
• Tuition Reimbursement Program
• Employee Referral Program - Earn $ for your hired referrals!
• Diversity, Equity and Inclusion Program - Employee Resource Groups

ABOUT US

With more than 50 years in business, BHHC has grown from a regional organization to a national insurance group, offering insurance products from coast to coast. Relationships are the cornerstone of our culture, and we believe in doing the right thing. That means we invest in our business in every way possible to deliver on our mission and demonstrate that people are what powers our success. Our commitment to financial strength and integrity means our customers can rest assured that we will be there when it counts.

 

At BHHC we embrace diversity and foster an environment where our people can be their authentic selves. Our differences make us stronger and better together, which fosters a harmonious workplace-something we truly value. We've created an approachable and collaborative atmosphere. Here you'll find a welcoming workplace where everyone can feel valued, supported, and inspired to do great work. Together, we raise the bar by being curious, remaining customer-focused, and operating with integrity.