Post Payment Claims Specialist

Claims SpecialistClaims SpecialistFull TimeRemoteMid LevelTeam 11-50H1B No SponsorCompany SiteLinkedIn

Location

United States

Posted

51 days ago

Salary

$50K - $60K / year

Seniority

Mid Level

2 yrs expEnglish

Job Description

• Monitor and manage your post payment queues. • Conduct outreach, education, and negotiation calls to providers for post payment claims. • Effectively communicate with providers to verify/confirm understanding of NSA claims payments and regulations. • Effectively communicate with providers to explain claim payments for various pricing products. • Maintain compliance, including but not limited to Confidentiality and HIPAA requirements. • Maintain acceptable levels of production including but limited to turn around time standards as mandated by the regulation(s). • Document all conversations and record name, phone number, and email of contact person if available, payment rates offered on behalf of clients, and any counter offers by the provider. • Adhere to client specific and Reliant protocols, scripts, and other requirements. • Develop a comprehensive understanding of the state and federal regulations that will impact payments to providers. • Develop a comprehensive understanding of our various products. • Perform other job-related duties and special projects as required.

Job Requirements

  • 2-3 years of related job experience – appeals, negotiations, medical billing.
  • Experience conducting outreach to providers via phone calls or other communication means.
  • Experience understanding Reliant critical behaviors and compliance requirements.
  • 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)

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