Medical Claims Coordinator

Overview

Job Posting JR Medical Claims Coordinator (Open)

Hiring Agency Health & Human Services - Agency 25

Location Lincoln, NE

Hiring Rate $21.041 per hour. Non-Exempt

Application Status Applications No Longer Accepted On (If no date is displayed, job is posted as open until closed): 01-27-2026

We’re seeking candidates who bring a strong attention to detail and a commitment to accuracy, along with the ability to work effectively in a structured, fast-paced environment.

Join Our Team! Are you looking for a workplace where your attention to detail, passion for helping others, and love for teamwork are valued and make a difference every day? Join our dedicated team at the Department of Health and Human Services as a Medical Claims Coordinator in our Medicaid and Long-Term Care Claims Division. We are committed to service, collaboration, and making an impact on the lives of Nebraskans — and we like to have a little fun along the way!

As a Medical Claims Coordinator for the Recovery and Cost Avoidance team you’ll play a vital role in ensuring Medicaid appropriately remains the payor of last resort for health and casualty claims. This detail-oriented role involves investigating the circumstances surrounding health claims when there is indication that payment for the claim may be obtained from sources other than Title XIX Medicaid funds.

• Answer and direct calls placed or referred to the Coordination of Benefits /Casualty call line.
• Analyze claims for payor accuracy, investigate and resolve liability issues, and ensure compliance with Medicaid policies and procedures.
• Communicate with team members to address claim inquiries and support both internal teams and external partners.
• Initiate research and bring resolution to processed claims which may have been processed and paid and now need to be recouped and billed to a liable third-party resource.
• Research extent and sources of third-party liability for medical claims payment and ensure these payments are fully utilized.
• Perform Third Party verifications and accurately enter the findings into a database.
• Collaborate with appropriate program staff to report and follow-up if fraud, waste or abuse activities are identified.
• Perform related work as assigned.

Minimum Qualifications

Bachelor’s degree in business administration, management, public administration, accounting, behavioral sciences, or a closely related field AND one year of investigative research experience OR five years’ continued education and/or experience in a field such as public or business administration, accounting, or any discipline related to the work assigned. Any equivalent combination of education and experience will be considered.

Preferred Qualifications

• Experience with health insurance terminology/processes, Microsoft Office (Excel, Word, Outlook, etc.) databases, Medicaid Claims Processing, and Medicaid eligibility. Experience with C1/MMIS, N-FOCUS, and OnBase would be beneficial.
• Strong analytical and problem-solving skills, including the ability to interpret and apply regulations, identify discrepancies, and recommend appropriate actions.
• A professional, customer-focused approach when communicating with providers, clients, business partners and internal team members.
• Comfort using multiple computer systems and databases to research, update, verify and manage insurance related information efficiently.

• 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…