as assigned. Qualifications: Education and Experience Minimum three (3) years claims examining experience;or Partnership... claims examining experience and completion of Partnership claims training;or equivalent combination of education...
preferred. Valid California driver’s license and proof of current automobile insurance compliant with Partnership policy... Coordinators (CRCs) to develop provider educational/training materials for all Partnership lines of Prepares a quarterly...
. Works closely with Partnership Compliance Department. Reviews quality control audits to ensure compliance... in Partnership delegated entity audits. Collects, monitors, tracks, and reports claims delegation reporting for capitated entities...
Partnership departments and internal staff for additional review. Follows up and completes claims once response to request... has been received. Follows established Partnership policies and procedures, Partnership Claims Operating Instruction...
-specific records in the Partnership computer system, in databases and files as applicable. Participates in committees..., workgroups and/or multidisciplinary teams to support Partnership’s strategic plan, organizational goals, and/or business needs...
and maintaining policies and procedures for PartnershipHealthPlan of California. Alongside designated organizational leadership... California Driver's License and proof of current automobile insurance compliant with Partnership’s policies...
applications. Bi-lingual preferred. Valid California driver’s license and proof of current automobile insurance compliant... with Partnership policy are required to operate a vehicle and travel for company business. Performance Based Competencies Good oral...
and maintaining policies and procedures for PartnershipHealthPlan of California. Alongside designated organizational leadership... California Driver's License and proof of current automobile insurance compliant with Partnership’s policies...
management and staff, external clients, and vendors. Valid California driver’s license and proof of current automobile insurance... compliant with Partnership policy are required to operate a vehicle and travel for company business. Performance Based...
potential reimbursement methodologies and rates, will provide organizational education related to Partnership’s network... Leadership Team or Partnership Board. o Ensures alignment of provider reimbursement strategies with Partnership mission...