layiq
worthy; deserving; fitting; suitable.
A role, opportunity, or path that merits attention, time, and pursuit.
Loading LAYIQ…Job opportunity
Reliant
United States - Remote
Source: Reliant careers · View original posting
From Reliant's posting. “We” and “our” refer to the employer.
Reliant Health Partners is an innovative medical claims repricing service provider, helping employers achieve maximum health plan savings with minimum noise. We tailor our services to each client’s needs, providing everything from individual specialty claims repricing, to full plan replacement as a high-performance, open-access network alternative.
As a Post Payment Claims Specialist, you are responsible for contacting providers to educate on NSA process/payments, respond to appeals for various products, and negotiate these post pay appealed claims to resolve payment disputes.
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.
Compensation
$50,000 — $60,000 USD
LAYIQ is an independent job-discovery service. This listing does not imply a partnership with or endorsement by the employer. Review the original posting for current details and availability.
Employer posted:
REEDS Jewelers · Tupelo, MS, US
Constant Contact · Waltham, MA
Amazing Care Home Health Services · Austin, TX, US; Temple, TX, US; Waco, TX, US
GoGuardian · United States
Brandon J. Broderick · Hackensack, NJ
PracticeTek · San Diego, CA, US