Santa Clarita Jobs

the appropriate pricing of claims. A. SPECIFICS *Prior Claims Experience. *3 years or more experience, processing ... *Detail oriented. *Proficient in multiple areas of data management look-up (fee sets, benefits, eligibility,...

employers, and claims professionals by providing nurse case management services for workers compensation claims. ... with claimants, medical professionals, employers, claims staff and others * Good negotiation skills to...

issue and risk management, change management and vendor management Health Plan Claims Project Management experience ... Experience, with overall Health Plan and specific Claims EDI IT Project Management and vendor management...

Recent experience within past 2-3 years in Health Plan Claims, EDI and Benefits Solution Analysis and Design Prior ... a matrix team environment with strong customer relationship management and customer service skills. MBA or MS a plus JOB...

to supervisor and management. * Negotiates settlement of claims up to designated authority level. * Maintains ... preferred. Experience Two (2) years benefits or disability claims management experience required. Skills & Knowledge *...

in interpreting appropriateness of care and accurate claims payment. May also manage appeals for services denied. ... high quality, cost effective care throughout the medical management process. Collaborates with providers to assess...

team. Essential Functions: * Program Leadership and Management: Successful track record of leading moderately ... Initiatives. Deep understanding of program and project management methodology; ability to negotiate, and work...

Specific Description Rep & Warrants Claims Management, under the broader Representations and Warranties group, is ... bond insurers, and mortgage insurers, and asserting claims against counterparties who sold residential mortgages...

of another function. Recognized as authority in program management across IT. Leverages program management ... Project Management Professional (PMP) from the Project Management Institute. Primary Location :...

and program framework in conjunction with the KP project management methodology (including status reporting and ... in technology consulting and/or client relationship management (defining engagement scope, negotiating...