Post Payment Claims Specialist

This is a fully remote position, open to applicants in United States.

📋 Description

• Oversee and manage post-payment queues.

• Conduct outreach, education, and negotiation calls with providers regarding post-payment claims.

• Communicate with providers to ensure verification and understanding of NSA claims payments and regulations.

• Clarify claim payments related to various pricing products.

• Ensure compliance with Confidentiality and HIPAA standards.

• Maintain production levels, including adherence to turnaround time standards set by regulations.

• Document conversations, provider contact information, payment rates offered on behalf of clients, and any provider counteroffers.

• Follow client-specific and Reliant protocols, scripts, and other guidelines.

• Build knowledge of state and federal regulations affecting provider payments.

• Acquire understanding of different products.

• Perform additional job-related tasks and special projects as needed.

⛳️ Requirements

• 2-3 years of relevant experience in appeals, negotiations, or medical billing.

• Proven experience in outreach to providers through phone calls or other communication methods.

• Comprehensive understanding of healthcare policy and payment processes.

• Familiarity with claims workflow tools or systems.

🏝️ Benefits

• Extensive medical, dental, vision, and life insurance coverage.

• 401(k) retirement plan with employer matching.

• Health Savings Account (HSA) and Flexible Spending Accounts (FSAs).

• Paid time off (PTO) and disability leave.

• Employee Assistance Program (EAP).