Post-Payment Claims Negotiator

Openkrill; United States; Remote; USD 50,000 - 60,000; Full time

Benefits offered by this job

Medical insurance

401(k) with employer match

HSA & FSAs

PTO & disability leave

EAP

Job summary

Reliant Health Partners is seeking a Post Payment Claims Specialist in the United States to educate providers about NSA processes, respond to appeals, and negotiate post payment claims to resolve payment disputes.

The role involves monitoring post payment queues, conducting outreach and negotiation calls, and maintaining HIPAA compliance while achieving production targets. Compensation may include bonuses and commissions based on performance and plan terms.

Qualifications

• 2-3 years of related job experience – appeals, negotiations, medical billing.
• Experience conducting outreach to providers via phone calls or other communication means.
• Broad healthcare policy and payment understanding.
• Experience with claims workflow tools or systems.

Responsibilities

• 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 HIPAA requirements.
• Maintain acceptable levels of production including turnaround time standards as mandated by the regulation(s).
• Document all conversations and record contact details, payment rates offered, and any counter offers by the provider.
• Develop a comprehensive understanding of state and federal regulations that impact payments to providers.
• Develop a comprehensive understanding of our various products.
• Perform other job-related duties and special projects as required.

Skills

Outreach to providers

Negotiation

Medical billing

Healthcare policy understanding

HIPAA compliance

Tools

Claims workflow tools

Job description

Reliant Health Partners is seeking a Post Payment Claims Specialist in the United States to educate providers about NSA processes, respond to appeals, and negotiate post payment claims to resolve payment disputes.

The role involves monitoring post payment queues, conducting outreach and negotiation calls, and maintaining HIPAA compliance while achieving production targets. Compensation may include bonuses and commissions based on performance and plan terms.