Provider Reimbursement Strategist

We need to output HTML fragment with sections: About the role? The posting includes Introduction, Overview, Responsibilities, Education, Work Experience, Knowledge, Skills, And Abilities, Licenses and Certifications, Pay, Benefits, And Other Information. We need to use

for section headings: About the role, Responsibilities, Requirements, Qualifications, Skills, Benefits, Pay, Schedule. However we should only include sections when posting has real specific content. The posting includes Introduction and Overview (maybe combine as About the role). Responsibilities present. Education and Work Experience could be Requirements? Qualifications? Knowledge, Skills, And Abilities could be Skills. Licenses and Certifications maybe part of Qualifications? Benefits present. Pay present. Schedule not present, so omit. We must not repeat job title as heading. No Job ID etc. Remove boilerplate: EEO, equal opportunity, scam warning, application instructions, etc. Also remove navigation/cookie/legal. So we need to strip those paragraphs at end about equal opportunity, accommodation request, etc. Also remove "Zenith typically posts jobs for a minimum of 8 to 14 calendar days..." etc. Also remove "For more information, review details on the Benefits page..." maybe keep? That's a link to benefits page; it's part of Benefits info. Might keep as part of Benefits? It's a reference; but it's not boilerplate? It's a link to benefits page; could be considered part of Benefits info. However it's a directive to review details; might be considered application instruction? It's not exactly application instruction; it's just a link for more info. Might keep but it's not essential. Safer to keep Benefits section content as listed; we can include that sentence as part of Benefits. We must preserve ALL substantive information; do not invent or summarize away detail. So we need to include all bullet points from Responsibilities, Education, Work Experience, Knowledge, Skills, And Abilities, Licenses and Certifications, Benefits, Pay. We need to format as

headings and then content: For prose use

. For lists use

• . For Responsibilities we have many sentences each starting with a verb; we can make each as
• . Similarly for Education, Work Experience, Knowledge, Skills, And Abilities, Licenses and Certifications maybe as list. We need to decide section headings: About the role (introduction + overview). Responsibilities. Requirements (maybe combine Education and Work Experience). Qualifications (maybe Knowledge, Skills, And Abilities + Licenses and Certifications). Skills (maybe separate? but we have Knowledge, Skills, And Abilities; could be Skills). Benefits. Pay. We must not create sections with filler. Ensure each heading has substantive content. Let's extract content. Introduction: "Zenith is a team of Workers' Compensation Specialists committed to helping businesses succeed by protecting against the financial and human consequences of workplace injuries, providing for the needs of injured employees and making the workplace safer. To distinguish ourselves as the desired provider of Workers' Compensation Insurance, values such as collaboration, work-life balance, and integrity are placed at the center of all our operations. In addition, Zenith supports career advancement through a dedication to ongoing learning and development. An individual coming to Zenith will not only receive competitive compensation and a comprehensive benefits package, but continuous opportunities to grow as a professional." Overview: "Under general direction and within Zenith guidelines, in collaboration with team members, develops and and executes negotiation strategies to achieve the most reasonable and fair reimbursement." We can combine these into About the role. Responsibilities list: many bullet points. Let's extract each sentence after "Responsibilities". The text: "Negotiate directly with providers for the most reasonable reimbursement of medical bills in accordance with the respective jurisdictional rules and regulations.Use critical-thinking to make decisions affecting the outcome of payments to direct-providers.Provides consultative recommendations to other departments on disputes, pre-servioce agreements, and settlements based upon negotiations experience and knowledge of successful strategies employed in those negotiations.Contract directly with providers and execute legible, effective and concise negotiation agreements.Ensure negotiations comply with regulatory and company timelines.Document all negotiation activities and savings that occur.Develop and preserve effective working relationships with the provider communities and billing entities that render health services to Zenith insureds.Seek, identify and implement process improvements.Periodically evaluate plan of action on projects and change approach when it appears that the desired outcome is not being reached.Understand Workers' Compensation regulations to determine negotiation strategies for fair and reasonable reimbursement.Coordinate and perform research as required (i.e. provider participation assisting in lien defense, special projects, assist in A/R research, etc.).Applies principles of logical thinking to define problems, collect data, establish facts, and draw valid conclusions.Provide problem solving regarding network information requests.Evaluate provider trends and collaborate with various business functions to arrive at the best negotiated outcomes with direct-providers.Review and discuss cost drivers and opportunities for further control.Manage the overall relationship of select trading partners.Develop direct in-person relationships with providers identified through trend analysis to impact overall medical cost.Identify and execute cost containment strategies for all states.Serve as a local resource of the Provider Relations department to impact provider relations for branch offices.Work productively and harmoniously with others on a consistent basis.Respond positively to direction and feedback on performance.Consistently maintain professional and appropriate demeanor.Perform other duties as assigned." We need to split into separate items. Some sentences missing punctuation; we can treat each clause before a period as separate. We'll create
• for each. Education: "High School Diploma Or equivalent requiredBachelor’s Degree or equivalent combination of training/experience preferred" We need to separate: maybe two items. Work Experience: "2+ years progressively responsible Workers' Compensation bill review experience required2+ years in position(s) where negotiation was an integral part of the job duties preferred" Two items. Knowledge, Skills, And Abilities: list: "California Bill Review Designation preferred.Expert negotiation/influencing skills with demonstrated ability to influence negotiated outcomes.Excellent written and verbal skills.Meets all state regulatory standards regarding licensing, continuing education, and other requirements.Action-oriented; results-oriented; with demonstrated ability to work with sense of urgency and manage multiple projects simultaneously and expeditiously.Strong customer-service skills" We can split each. Licenses and Certifications: "Certified Coder-AHIMA or AAPC preferred." Benefits: list: "Medical, Dental and Vision InsuranceFlexible Spending AccountsPaid Parental LeaveLife, AD&D and Disability Insurance401(k), Employee Share Purchase Plan (ESPP)Education and Training ReimbursementPaid Leave: 3 weeks/year Vacation, 2 weeks/year Sick Leave10 paid Company Holidays, 2 Personal Days, 2 Floating HolidaysEmployee Assistance Program (EAP)For more information, review details on the Benefits page of our Career Site: https://www.thezenith.com/careers/benefits/" We need to split items; but some are concatenated without spaces. We'll need to parse manually. Let's split by capital letters or known delimiters. The string: "Medical, Dental and Vision InsuranceFlexible Spending AccountsPaid Parental LeaveLife, AD&D and Disability Insurance401(k), Employee Share Purchase Plan (ESPP)Education and Training ReimbursementPaid Leave: 3 weeks/year Vacation, 2 weeks/year Sick Leave10 paid Company Holidays, 2 Personal Days, 2 Floating HolidaysEmployee Assistance Program (EAP)For more information, review details on the Benefits page of our Career Site: https://www.thezenith.com/careers/benefits/" We can separate: - Medical, Dental and Vision Insurance - Flexible Spending Accounts - Paid Parental Leave - Life, AD&D and Disability Insurance - 401(k), Employee Share Purchase Plan (ESPP) - Education and Training Reimbursement - Paid Leave: 3 weeks/year Vacation, 2 weeks/year Sick Leave - 10 paid Company Holidays, 2 Personal Days, 2 Floating Holidays - Employee Assistance Program (EAP) - For more information, review details on the Benefits page of our Career Site: https://www.thezenith.com/careers/benefits/ That seems fine. Pay: "The expected salary range for this position is $59,765 - $74,707. Actual pay will be adjusted based on experience, geographic location, and other job-related factors as permitted by law. Qualifications may warrant placement in a different job level." We'll keep as prose. Now we need to output HTML fragment with sections. We'll use

  About the role

  then

  containing introduction + overview combined maybe as two paragraphs? Could be one paragraph with both. We'll put introduction as

  then overview as

  maybe. But we need to avoid duplicate headings. We'll do:

  About the role

  Zenith is a team of Workers' Compensation Specialists committed to helping businesses succeed by protecting against the financial and human consequences of workplace injuries, providing for the needs of injured employees and making the workplace safer. To distinguish ourselves as the desired provider of Workers' Compensation Insurance, values such as collaboration, work-life balance, and integrity are placed at the center of all our operations. In addition, Zenith supports career advancement through a dedication to ongoing learning and development. An individual coming to Zenith will not only receive competitive compensation and a comprehensive benefits package, but continuous opportunities to grow as a professional.

  Under general direction and within Zenith guidelines, in collaboration with team members, develops and executes negotiation strategies to achieve the most reasonable and fair reimbursement.

  Note: there was a typo "develops and and executes" we should preserve as is? The text says "develops and and executes". We should preserve exactly? The instruction: Preserve ALL substantive information; do NOT invent or summarize away detail. So we should keep the exact wording, including the duplicate "and". So we keep "develops and and executes". We'll copy that. Now Responsibilities:

  Responsibilities

  • Negotiate directly with providers for the most reasonable reimbursement of medical bills in accordance with the respective jurisdictional rules and regulations
  • Use critical-thinking to make decisions affecting the outcome of payments to direct-providers
  • Provides consultative recommendations to other departments on disputes, pre-servioce agreements, and settlements based upon negotiations experience and knowledge of successful strategies employed in those negotiations
  • Contract directly with providers and execute legible, effective and concise negotiation agreements
  • Ensure negotiations comply with regulatory and company timelines
  • Document all negotiation activities and savings that occur
  • Develop and preserve effective working relationships with the provider communities and billing entities that render health services to Zenith insureds
  • Seek, identify and implement process improvements
  • Periodically evaluate plan of action on projects and change approach when it appears that the desired outcome is not being reached
  • Understand Workers' Compensation regulations to determine negotiation strategies for fair and reasonable reimbursement
  • Coordinate and perform research as required (i.e. provider participation assisting in lien defense, special projects, assist in A/R research, etc.)
  • Applies principles of logical thinking to define problems, collect data, establish facts, and draw valid conclusions
  • Provide problem solving regarding network information requests
  • Evaluate provider trends and collaborate with various business functions to arrive at the best negotiated outcomes with direct-providers
  • Review and discuss cost drivers and opportunities for further control
  • Manage the overall relationship of select trading partners
  • Develop direct in-person relationships with providers identified through trend analysis to impact overall medical cost
  • Identify and execute cost containment strategies for all states
  • Serve as a local resource of the Provider Relations department to impact provider relations for branch offices