Top 5 Senior claims representative Jobs in Nebraska

Senior Claims Representative (Remote)
MEM —Nebraska
- $72,800 - $109,200 a year
- Full-time
- Remote
- 7 years
- Driver's License
- Bachelor's degree
- Profit sharing
- Paid jury duty
Senior Representative, Health Plan Provider Relations - Remote Must reside in NE
Molina Healthcare —Nebraska
- $47,433.00 - $97,362.61 a year
- Full-time
- Remote
- Medical office experience
- Contracts
- Senior level
- Health insurance
7d
Senior Patient Billing Representative
Nebraska Methodist Health System —Omaha, NE
- Full-time
- Microsoft Outlook
- Medical office experience
- Mid-level
Sr. Insurance Follow-up & Denial Specialist / FT
Children's Nebraska —Omaha, NE
- Full-time
- Hybrid work
- Word processing
- Computer literacy
- Basic math
NE-Omaha * Insurance Agent/Sales Representative*
AMERICAN SENIOR BENEFITS LLC —Omaha, NE
- $45,000 - $200,000 a year
- Full-time
- In-person
- Entry level

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Senior Claims Representative (Remote)

MEM -
Nebraska

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Job Details

Full-time
$72,800 - $109,200 a year

Benefits

Profit sharing
Paid jury duty
Paid parental leave
Health savings account
AD&D insurance
Disability insurance
Health insurance
Dental insurance
Flexible spending account
Tuition reimbursement
Paid time off
Adoption assistance
Parental leave
Employee assistance program
Vision insurance
401(k) matching
Volunteer time off
Life insurance

Qualifications

Workers' compensation insurance knowledge
Driver's License

Full Job Description

Are you a seasoned claims professional with a passion for navigating complex cases? MEM Insurance is seeking a Senior Claims Representative to join our Claims team. In this pivotal role, you’ll manage high-exposure workers’ compensation claims, lead investigations into coverage and fraud, and collaborate across departments to drive strategic outcomes. You’ll be a key decision-maker, a mentor to junior adjusters, and a champion of process improvement—all while ensuring exceptional service and regulatory compliance.

At MEM Insurance, we don’t just protect our customers—we empower our employees. We foster a culture of integrity, collaboration, and innovation. Our team thrives on solving challenges together, supporting one another, and making a meaningful impact in the lives of our policyholders and injured workers.

Essential Duties and Responsibilities:
Claims Handling & Administration

Manage highly complex claims involving significant financial exposure, legal intricacies, and extended life cycles.
Conduct advanced investigations into coverage and compensability, including nuanced statutory interpretations.
Oversee medical case management for catastrophic injuries and lifetime care needs.
Review and authorize large or complex medical bills, negotiating adjustments to control costs.

Return-to-Work Management

Develop comprehensive RTW strategies in collaboration with policyholders, legal counsel, and vocational consultants.
Ensure precision in benefit calculations for high-exposure claims, addressing tax and compliance risks.
Strategically deploy investigative efforts aligned with broader claims strategy.

Claims Investigation & Loss Prevention

Lead investigations into complex fraud cases and collaborate with the Special Investigations Unit.
Conduct subrogation analysis and negotiate with third-party insurers or attorneys for maximum recovery.

Settlements & Negotiation

Partner with legal teams to negotiate complex settlements and manage litigation processes.
Oversee Medicare compliance initiatives, including Medicare Set-Asides and CMS engagement.
Identify opportunities for structured settlements and lead negotiations.

Reporting

Produce strategic reports on high-profile claims to guide management decisions.
Maintain system data integrity and prepare claims for Corporate Plan of Action meetings.

Collaboration

Lead cross-departmental efforts to improve claims handling and risk management.
Resolve escalated customer service issues and support high-value accounts.
Participate in workflow improvement initiatives and committees.

Team Leadership

Mentor and coach junior and intermediate adjusters.
Review escalated claims and provide actionable feedback.
Support workforce development and succession planning.

Qualifications:

Bachelor’s degree in business or related field preferred, or equivalent industry experience.
7–10 years of claims handling experience, with high exposure to Workers’ Compensation.
Associate in Claims (AIC), AIM, or CPCU designation preferred or ability to obtain.
Texas All-Lines license preferred.
Valid driver’s license required.

Company Culture and Values
At MEM Insurance, we are committed to our vision, mission, and values. We foster a culture of collaboration, integrity, and innovation. Our team is passionate about delivering exceptional service to our customers while supporting each other’s growth and success. We believe in accountability, continuous learning, and creating an environment where employees feel valued and empowered.

Connection and Belonging
MEM Insurance is an equal opportunity employer. We celebrate diversity and are committed to creating an inclusive environment for all employees. We believe that varied perspectives drive innovation and strengthen our ability to serve our customers and communities.

Total Rewards Overview

Health Plans: Medical, Dental, and Vision

Includes fertility benefits, fully paid preventative care, and adult orthodontia.

Employer-Paid Life and Disability Benefits:

Life Insurance (3x base salary), AD&D, Short and Long-term Disability.

Wellness and Recognition Program: Employer-paid incentives for employees and spouses.
Flexible Spending Account and Dependent Care options
Health Savings Account: Generous employer contribution.
Time Away from Work:

Generous PTO, 11 Holidays + 4 Early Releases, 16 Hours Volunteer Time Off, 20 Days Paid Parental Leave, Marriage, Bereavement, and Jury Duty leave.

Employee Assistance Programs
401k Retirement Plan: Employer match and profit sharing.
Adoption Assistance and Tuition Assistance

Notice Regarding Use of Artificial Intelligence
MEM may use artificial intelligence (AI) tools to more efficiently facilitate and assist in decisions involving recruitment, hiring, promotion, renewal of employment, selection for training or apprenticeship, discharge, discipline, tenure, or the terms, privileges, or conditions of employment. Any such use of AI tools will comply with all applicable laws.

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Refine Your Search

senior claims representative jobs in nebraska

Senior Claims Representative (Remote)

Senior Representative, Health Plan Provider Relations - Remote Must reside in NE

Senior Patient Billing Representative

Sr. Insurance Follow-up & Denial Specialist / FT

NE-Omaha * Insurance Agent/Sales Representative*

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