Workers' Compensation Appeal Specialist
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 Workers’ Compensation Appeals Specialist, you will play a critical role in resolving post-payment disputes related to Workers’ Compensation bills. This includes conducting provider outreach, negotiating disputed charges, and ensuring compliance with state-specific regulations. Your work will directly support our cost containment efforts and ensure appropriate bill reimbursement for our clients.
Primary Responsibilities:
- Manage a caseload of post-payment Workers’ Compensation bills, including those related to state balance billing and usual and customary rate (UCR) disputes.
- Conduct proactive outreach to medical providers to explain payment methodologies, resolve disputes, and negotiate reductions on appealed or outlier bills.
- Communicate effectively and professionally with clients to coordinate and investigate information as it re
