Reliant Health Partners · 8 hours ago
Post Payment Claims Specialist
United States
Full-time
Remote
Entry, Mid Level
$50K/yr - $60K/yr
2+ years expReliant Health Partners is an innovative medical claims repricing service provider, and they are seeking a Post Payment Claims Specialist. In this role, you will be responsible for contacting providers to educate them on the NSA process/payments, respond to appeals, and negotiate post-pay appealed claims to resolve payment disputes.
Health CareHealth InsuranceInsuranceMedical
Responsibilities
Monitor and manage your post payment queues
Conduct outreach, education, and negotiation calls to providers for post payment claims
Effectively communicate with providers to verify/confirm understanding of NSA claims payments and regulations
Effectively communicate with providers to explain claim payments for various pricing products
Maintain compliance, including but not limited to Confidentiality and HIPAA requirements
Maintain acceptable levels of production including but limited to turn around time standards as mandated by the regulation(s)
Document all conversations and record name, phone number, and email of contact person if available, payment rates offered on behalf of clients, and any counter offers by the provider
Adhere to client specific and Reliant protocols, scripts, and other requirements
Develop a comprehensive understanding of the state and federal regulations that will impact payments to providers
Develop a comprehensive understanding of our various products
Perform other job-related duties and special projects as required
Qualification
Required
2-3 years of related job experience – appeals, negotiations, medical billing
Experience conducting outreach to providers via phone calls or other communication means
Experience understanding Reliant critical behaviors and compliance requirements
Broad healthcare policy and payment understanding
Experience with claims workflow tools or systems
Benefits
Comprehensive medical, dental, vision, and life insurance coverage
401(k) retirement plan with employer match
Health Savings Account (HSA) & Flexible Spending Accounts (FSAs)
Paid time off (PTO) and disability leave
Employee Assistance Program (EAP)
Company
Reliant Health Partners
Reliant Health Partners is a medical cost containment and specialty bill review company.
11-50 employees
Funding
Current Stage
Early StageLeadership Team
D
Douglas Farquhar
VP of Strategy
Company data provided by crunchbase