Reliant Health Partners
Reliant Health Partners
Reliant Health Partners ajută planurile de sănătate autofinanțate să gestioneze costurile medicale prin repricingul bazat pe date al cererilor de despăgubire și soluții de tarifare la valoarea echitabilă de piață. Compania specializată în controlul costurilor din domeniul sănătății sprijină administratorii terți, brokerii și organizațiile de verificare a facturilor prin înlocuirea planurilor cu acces deschis, repricingul cererilor din afara rețelei și al cererilor rezultate din accidente, gestionarea contestațiilor și procesarea rapidă a cererilor. Instrumentele sale analitice proprietare sunt concepute pentru a identifica oportunități de economisire, reducând în același timp disputele cu furnizorii și complexitatea administrativă.

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.

Descriere

  • 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

Cerințe

  • 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

Beneficii

  • 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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