Reliant Health Partners
Reliant Health Partners
Reliant Health Partners өз қаражаты есебінен қаржыландырылатын медициналық жоспарларға деректерге негізделген талаптарды қайта бағалау және әділ нарықтық баға белгілеу шешімдері арқылы медициналық шығындарды басқаруға көмектеседі. Денсаулық сақтау шығындарын оңтайландыруға маманданған компания үшінші тарап әкімшілеріне, брокерлерге және шоттарды тексеру ұйымдарына ашық қолжетімді жоспарды алмастыру, желіден тыс және жазатайым оқиғаларға байланысты талаптарды қайта бағалау, шағымдарды басқару және талаптарды жедел өңдеу қызметтерін ұсынады. Оның меншікті талдауы медициналық қызмет көрсетушілермен келіспеушіліктер мен әкімшілік күрделілікті азайта отырып, үнемдеу мүмкіндіктерін анықтауға бағытталған.

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.

Сипаттама

  • 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

Талаптар

  • 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

Артықшылықтар

  • 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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