Post Payment Claims Specialist

This is a Fully Remote Job
About Our Client:
Reliant Health Partners operates in the medical claims repricing sector, addressing the challenge employers face in managing health plan costs. The organization provides customized services ranging from individual specialty claims repricing to full plan replacement solutions as an open-access network alternative, aiming to maximize health plan savings efficiently.
About the Opportunity:
The POST PAYMENT CLAIMS SPECIALIST is responsible for managing post payment claims by engaging with providers to educate on payment processes, address appeals, and negotiate disputed claims. This role plays a critical part in resolving payment issues and ensuring compliance, directly impacting the accuracy and timeliness of claim payments.
Responsibilities:
Monitor and manage post payment claim queues.
Conduct outreach, education, and negotiation calls with providers.
Communicate payment processes and regulations clearly to providers.
Verify provider understanding of claims payments.
Maintain compliance with confidentiality and HIPAA requirements.
Meet production standards including turnaround times.
Document all communications and negotiation details accurately.
Follow client-specific and organizational protocols and scripts.
Develop knowledge of relevant state and federal payment regulations.
Understand various pricing products offered.
Perform additional duties and special projects as assigned.
Requirements:
2-3 years of experience in appeals, negotiations, or medical billing.
Experience with provider outreach via phone or other communication methods.
Broad understanding of healthcare policy and payment systems.
Familiarity with claims workflow tools or systems.
Pay Range and Compensation Package:
$50,000—$60,000 USD
Compensation commensurate with experience and qualifications.
Eligibility for bonuses, merit increases, and potential sales commissions depending on role.
Benefits & Perks:
Comprehensive medical, dental, vision, and life insurance coverage
401(k) retirement plan with employer match
Health Savings Account (HSA) and Flexible Spending Accounts (FSAs)
Paid time off (PTO) and disability leave
Employee Assistance Program (EAP)
Equal Opportunity Statement: Our client is an equal opportunity employer. They celebrate diversity and are committed to creating an inclusive environment for all employees. All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, gender identity or expression, sexual orientation, or national origin.
Note:
TalentHop is a recruitment partner of this role. Please note that all employment decisions, including candidate assessment, interviews, hiring, compensation, and employment terms, are made exclusively by the hiring employer.

Work arrangement
Yes