Senior Client Services Representative

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Reliant Health Partners

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Healthcare Insurance • B2B

Reliant Health Partners is a data-driven healthcare cost-containment firm that provides medical-claims repricing and Fair Market Pricing solutions for self-funded health plans. Working with TPAs, brokers, and bill-review organizations, Reliant delivers open-access plan replacement, out-of-network and casualty repricing, end-to-end appeals management, and rapid claim turnaround using proprietary analytics to maximize savings while minimizing provider dispute and administrative noise.

11 - 50 employees

⚕️ Healthcare Insurance

🤝 B2B

📋 Description

• Research and resolve issues for negotiators, providers, and payors. Communicate via telephone and written correspondence. Utilize the Action Request Process to document and manage requests. • Respond to client, negotiator or management requests in a timely manner. Follow department policies and procedures. Meet or exceed production, accuracy and turnaround time requirements. • Review and update claim pends and exceptions, as assigned. • Answer incoming calls, assist callers with questions and transfer calls to the proper individual when needed. Document calls as appropriate. • Perform administrative duties • Perform other job-related duties or special projects as required. • Monitor inventory, queues and workload. Address concerns as appropriate, facilitate resolution of large dollar and high priority claims. • Provide initial and on-going training to team members. Provide feedback to team members and/or management. Assist others in organizing, setting priorities, and monitoring workflow. • Participate and support client implementations. Create and maintain reference materials and complete other assigned tasks. Handle special requests made by clients or account managers. • Serve as backup support for the department leader, as needed.

🎯 Requirements

• 4 – 6 years of insurance claims or customer service experience. • Ability to analyze patient information and determine appropriate course of action. • 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)