Provider Reimbursement Strategist

Zenith Insurance Company (United States)

. Negotiate directly with providers for the most reasonable reimbursement of medical bills in accordance with the respective jurisdictional rules and regulations .

Posted 9/18/2026full-timeWoodland Hills • California • United StatesJuniorMid-Level💰 $59,765 - $74,707 per yearWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expert negotiation and influencing skills to achieve favorable reimbursement outcomes while ensuring compliance with regulatory standards. Capable of developing effective relationships with providers and implementing process improvements to enhance operational efficiency.

Highest-signal resume keywords

Expert Negotiation SkillsCalifornia Bill Review DesignationCustomer-Service SkillsCritical ThinkingProcess Improvement

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Negotiation AgreementsReimbursement StrategiesData CollectionProblem SolvingProject Evaluation

Soft Skills

Excellent Written SkillsExcellent Verbal SkillsAction-OrientedResults-OrientedRelationship Management

Certifications & Qualifications

High School DiplomaBachelor’s Degree (Preferred)California Bill Review Designation

Industry Keywords

Workers' Compensation RegulationsProvider RelationsCost Containment StrategiesBilling EntitiesNegotiated Outcomes

About the role

Key responsibilities & impact

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
Provide consultative recommendations to other departments on disputes, pre-servioce agreements, and settlements based upon negotiations experience and knowledge of successful strategies
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
Develop and preserve effective working relationships with provider communities and billing entities
Seek, identify and implement process improvements
Evaluate project plans and change approach when desired outcomes are not being reached
Understand Workers' Compensation regulations to determine negotiation strategies for fair and reasonable reimbursement
Coordinate and perform research as required, including provider participation, lien defense, special projects, and A/R research
Define problems, collect data, establish facts, and draw valid conclusions
Provide problem solving regarding network information requests
Evaluate provider trends and collaborate with business functions to achieve negotiated outcomes
Review and discuss cost drivers and opportunities for further control
Manage relationships with select trading partners
Develop direct in-person relationships with providers identified through trend analysis to impact medical cost
Identify and execute cost containment strategies for all states
Serve as a local resource of the Provider Relations department for branch offices
Perform other duties as assigned

Requirements

What you’ll need

High School Diploma Or equivalent Required
Bachelor’s Degree or equivalent combination of training/experience preferred
2+ years in position(s) where negotiation was an integral part of the job duties preferred
California Bill Review Designation
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

Benefits

Comp & perks

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)
Competitive compensation
Comprehensive benefits package
Ongoing learning and development
Career advancement opportunities