Reliant Health Partners
Reliant Health Partners
Reliant Health Partners डेटा-आधारित क्लेम रीप्राइसिंग और Fair Market Pricing समाधानों के माध्यम से स्व-वित्तपोषित स्वास्थ्य योजनाओं को चिकित्सा लागत प्रबंधित करने में सहायता करता है। यह स्वास्थ्य सेवा लागत-नियंत्रण कंपनी थर्ड-पार्टी प्रशासकों, ब्रोकरों और बिल-समीक्षा संगठनों को ओपन-एक्सेस प्लान रिप्लेसमेंट, नेटवर्क से बाहर और कैजुअल्टी रीप्राइसिंग, अपील प्रबंधन तथा तेज़ क्लेम निपटान जैसी सेवाएँ प्रदान करती है। इसके स्वामित्व वाले विश्लेषणात्मक उपकरण बचत के अवसरों की पहचान करने के साथ-साथ प्रदाता विवादों और प्रशासनिक जटिलता को कम करने के लिए तैयार किए गए हैं।

Post-Payment Claims Specialist — Remote, United States

Manage appealed medical claims after payment, negotiate with providers, and explain No Surprises Act payment requirements. Oversee post-payment queues, regulatory compliance, documentation, and payment disputes for Reliant Health Partners.

विवरण

  • Oversee post-payment claims queues and related case activity
  • Conduct provider outreach, education, and negotiation calls regarding post-payment claims
  • Confirm that providers understand No Surprises Act payments and applicable regulations
  • Explain claim payments across different pricing products
  • Protect confidential information and comply with HIPAA requirements
  • Meet production goals and legally required turnaround-time standards
  • Record provider communications, contact details, client-authorized payment rates, and counteroffers
  • Follow Reliant and client-specific protocols, scripts, and operating requirements
  • Build knowledge of state and federal regulations affecting provider payments
  • Develop familiarity with the organization’s various products
  • Handle additional job-related responsibilities and special projects as assigned

आवश्यकताएँ

  • Two to three years of relevant experience in appeals, negotiations, or medical billing
  • Background conducting provider outreach by phone or other communication channels
  • Working knowledge of healthcare policies and payment processes
  • Experience using claims workflow tools or systems

लाभ

  • Medical, dental, vision, and life insurance coverage
  • 401(k) retirement plan with an employer match
  • Health Savings Account and Flexible Spending Account options
  • Paid time off and disability leave
  • Employee Assistance Program

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