Post Payment Claims Specialist

Job not on LinkedIn

🔥 0 minutes ago

🇺🇸 United States – Remote

💵 $50k - $60k / year

⏰ Full Time

🟢 Junior

🟡 Mid-level

📋 Claims Specialist

🚫👨‍🎓 No degree required

👻 Ghost score 0%

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Reliant Health Partners

WebsiteLinkedInAll Job Openings

11 - 50 employees

🏥 Healthcare

⚕️ Healthcare Insurance

🤝 B2B

Healthcare • 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.

📋 Description

• Monitor and manage post payment queues • Conduct outreach, education, and negotiation calls to providers for post payment claims • Communicate with providers to verify and confirm understanding of NSA claims payments and regulations • Explain claim payments for various pricing products • Maintain compliance with Confidentiality and HIPAA requirements • Maintain production levels, including turnaround-time standards mandated by regulations • Document conversations, provider contact details, payment rates offered on behalf of clients, and provider counteroffers • Adhere to client-specific and Reliant protocols, scripts, and other requirements • Develop understanding of state and federal regulations impacting provider payments • Develop understanding of various products • Perform other job-related duties and special projects as required

🎯 Requirements

• 2-3 years of related job experience – appeals, negotiations, medical billing • Experience conducting outreach to providers via phone calls or other communication means • 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)