Office Specialist

Are you interested in helping Medicaid maximize funds and reduce Medicaid costs while working to ensure members get needed healthcare and support?

State and federal law requires Medicaid to be the Payer of Last Resort. The RCA unit works with clients, providers, attorneys, insurers, and others to reduce the cost of Medicaid to citizens of the State of Nebraska.

We accomplish this through four separate programs designed to support this aim

Coordination of Benefits (COB): This team adds, verifies and maintains health insurance information of all Medicaid-eligible clients; allowing claims to process and pay timely. They also work with private Long-Term Care (LTC) insurers of Medicaid eligible clients to cover the client’ LTC services. This team cost avoided $2.7 million in total funds SFY2026.

Estate Recovery (ER): This team is responsible for pursuing and recovering eligible Medicaid payments when assets exist after a client passes away. This team recovered $8.9 million in total funds in SFY2026.

Health Insurance Premium Payment Program (HIPP): The HIPP program pays for health insurance premiums of Medicaid-eligible individuals if it is cost-effective for the State. If it costs Medicaid less to cover the equivalent set of services through the private health plan, then it is considered cost-effective. This team cost-avoided $4.7 Million in SFY2026.

Third Party Liability /Casualty (TPL): This team is responsible for ensuring Medicaid is the payer of last resort on all fee-for-service casualty and health claims when liability exists by other parties or insurance companies. This team recovered and cost avoided approximately $3.7 Million in SFY2026

Be a member of a team committed to improving efficiencies and tackling goals that support the Nebraska Medicaid mission to Help people live better lives.

Examples of Work

An Office Specialist on the RCA team will have opportunity to

Support activities of the unit through examining and processing forms, applications, documents, and reports, calculating associated fees or other billings, and responding to requests and inquiries related to agency program-administrative processes and operations

Entering information from lawyers, insurance companies, clients, caseworkers and other internal and external sources to create case files

Screen documents against set requirements, comparing them with established references and guidelines, and verify their accuracy and completeness; discusses problems or deficiencies to provide information or explain regulations and requirements or to provide the supervisor or other employees with information

Searches/identifies and summarizes pertinent data from statistical, financial, work activity, administrative, and/or program records; creates forms, documents, textual-numerical-graphic material, to assist others in collecting and presenting information for decision-making.

Prepares packets of information/material related to agency activities, actions, or requests for distribution to the public, customers, clients, vendors, agency representatives, or contractors.

Requirements / Qualifications

Minimum Qualifications: 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. OR Experience in customer service or public contact; or applying criteria/regulations; and/or performing administrative/office/secretarial support work including use of personal computers and office equipment.

Preferred Qualifications : Familiarity with insurance claim practices and processes. Familiarity with Accident and injury claims and law firm protocol or collections processes. Able to apply knowledge of standardized rules, policies, procedures, guidelines, or practices to plan and carry out tasks and resolve problems. Complete assignments involving related steps, processes, and methods requiring selection of correct process from several options/choices. Use good judgment in applying and locating directives to specific cases. Attention to detail to ensure procedures are followed correctly and work is completed timely.

If you're currently employed by the State of Nebraska, please don't apply through this external career site. Instead, log in to Workday and open the Jobs Hub - Internal Apply app from your home landing page. You can access Workday anytime through the Link web page: https://link.nebraska.gov/

Benefits

We offer a comprehensive package of pay, benefits, paid time off, retirement and professional development opportunities to help you get the most out of your career and life. Your paycheck is just part of your total compensation.

Check out all that the State of Nebraska has to offer! Benefit eligibility may vary by position, agency and employment status. For more information on benefits, please visit: https://statejobs.nebraska.gov/index.html#benefits

Equal Opportunity Statement

The State of Nebraska values our teammates as well as a supportive environment that strives to promote diversity, inclusion, and belonging. We recruit, hire, train, and promote in all job classifications and at all levels without regard to race, color, religion, sex. age, national origin, disability, marital status or genetics.