Post-Payment Claims Negotiator & Educator

Reliant Health Partners, LLC; United States; On-site; USD 50,000 - 60,000; Full time

Benefits offered by this job

Medical, dental, vision, and life ins.

401(k) with employer match

HSA & FSAs

PTO & disability leave

Employee Assistance Program

Job summary

Reliant Health Partners is a forward-thinking medical claims repricing service provider helping employers maximize plan savings with minimal disruption.

As a Post Payment Claims Specialist, you will educate providers on NSA processes, respond to appeals, and negotiate post payment claims to resolve disputes, while ensuring HIPAA compliance and adherence to client protocols. You will manage queues, document interactions, and contribute to product understanding and regulatory knowledge.

Qualifications

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

Responsibilities

• Monitor and manage post payment queues.
• Conduct outreach, education, and negotiation calls to providers for post payment claims.
• Explain NSA payments and regulations to providers clearly.
• Explain claim payments for various pricing products to providers.
• Maintain compliance, including HIPAA requirements.
• Maintain acceptable production levels as mandated by regulations.
• Document conversations, record contact details, and note payment rates and counter offers.
• Adhere to client-specific Reliant protocols and scripts.
• Develop understanding of state and federal regulations affecting payments.
• Develop understanding of Reliant's various products.
• Perform other job-related duties and special projects.

Skills

Appeals

Negotiations

Medical Billing

Provider outreach

Healthcare policy

Claims systems

Tools

Claims workflow tools

Job description

Reliant Health Partners is a forward-thinking medical claims repricing service provider helping employers maximize plan savings with minimal disruption.

As a Post Payment Claims Specialist, you will educate providers on NSA processes, respond to appeals, and negotiate post payment claims to resolve disputes, while ensuring HIPAA compliance and adherence to client protocols. You will manage queues, document interactions, and contribute to product understanding and regulatory knowledge.