Description

About Us

Zelis is modernizing the healthcare financial experience in the United States (U.S.) across payers, providers, and healthcare consumers. We serve more than 750 payers, including the top five national health plans, regional health plans, TPAs and millions of healthcare providers and consumers across our platform of solutions. Zelis sees across the system to identify, optimize, and solve problems holistically with technology built by healthcare experts – driving real, measurable results for clients.

Why We Do What We Do

In the U.S., consumers, payers, and providers face significant challenges throughout the healthcare financial journey. Zelis helps streamline the process by offering solutions that improve transparency, efficiency, and communication among all parties involved. By addressing the obstacles that patients face in accessing care, navigating the intricacies of insurance claims, and the logistical challenges healthcare providers encounter with processing payments, Zelis aims to create a more seamless and effective healthcare financial system.

Zelis India plays a crucial role in this mission by supporting various initiatives that enhance the healthcare financial experience. The local team contributes to the development and implementation of innovative solutions, ensuring that technology and processes are optimized for efficiency and effectiveness. Beyond operational expertise, Zelis India cultivates a collaborative work culture, leadership development, and global exposure, creating a dynamic environment for professional growth. With hybrid work flexibility, comprehensive healthcare benefits, financial wellness programs, and cultural celebrations, we foster a holistic workplace experience. Additionally, the team plays a vital role in maintaining high standards of service delivery and contributes to Zelis’ award-winning culture.

Position Overview

This is an entry-level position where you will learn to analyze healthcare reimbursement contracts and load contract terms between payers and providers in an accurate and timely manner using proprietary software. This position reports to the Director of System Integrity. This position is an internal resource to staff and as such is expected to respond to client issues and cases in a timely manner.

KEY RESPONSIBILITIES:

• Manually enter data from contracts for each category of insured persons
• Convert paper contract to a list of data
• Read, view and enter legal documents into the system
• Follow research and resolution steps for the case with 100% precision and accuracy according to the established Standard Operating Procedure.
• Follows established HIPAA, Compliance & Security policies.
• Load contracts negotiated between payers and providers
• Link contracts to payer products
• Perform mapping MRBP groups to contracts
• Implement rate table updates
• Perform structural audit of contracts to ensure quality standards are met
• Respond to client issues in a timely manner.
• Participate in internal client implementation planning, conference calls, meetings, and trainings
• Become knowledgeable about and responsible for internal controls and procedures for the position’s areas of responsibility
• Meeting internal or contractual deadlines. Accuracy is a key measurement
• Zero error rate will be a key indicator of success
• Adherence to established policies and procedures for internal control standards

TECHNICAL SKILLS/ KNOWLEDGE:

• Strong analytical and Maths skills, structural thinking and ability to prioritize tasks
• Attention to details and self-motivation
• Solid communication and Organizational skills
• Computer proficiency and technical aptitude with the ability to utilize Zelis’ proprietary client system and MS Office applications with the ability to use intermediate Excel functions.
• Works on assignments that are minimally complex in nature in which judgment and initiative are required to make recommendations or resolve problems.
• Understands protocols in place to contact and obtain information required.
• Thorough knowledge of company and departmental policies and procedures.

INDEPENDENCE/ ACCOUNTABILITY:

• Requires daily supervision to ensure Assignment metrics are met.
• Ability to follow detailed instructions on assignments.
• Regularly reviews goals and objectives with supervisor.
• Must have professional manner and respect the confidentiality of administrative matters and files.
• Ability to manage and prioritize multiple tasks.
• Ability to work under pressure and meet deadlines.
• Requires excellent verbal and written skills.
• Detail orientated, organized, good problem-solving skills, entrepreneurial spirit

COMMUNICATION SKILLS:

• Must work well with others.
• Communicates accurately, honestly, and effectively, both in oral and written form, practices active listening.
• Clearly conveys information and ideas through a variety of media to individuals and groups in a manner that engages the audience and helps them understand the information.

PROFESSIONAL EXPERIENCE:

• Proficiency with computer and applicable software packages, including Microsoft Office products - Outlook, Word, Excel, etc.
• Experience with Jira or similar work tracking system highly preferred.

EDUCATION

• Bachelor’s Degree or equivalent work experience in Healthcare Revenue Cycle Management/Contracting field

Zelis is a healthcare and financial technology growth company and market-leading provider of claims cost management and payments optimization solutions to price, pay and explain healthcare claims. Zelis delivers integrated network analytics, network solutions, payment integrity, electronic payments and claims communications for payers, healthcare providers and consumers in the medical, dental and workers' compensation markets nationwide. Zelis is backed by Parthenon Capital Partners and Bain Capital.

“We are an equal opportunity employer, and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability status, protected veteran status, or any other characteristic protected by law.”

Commitment to Diversity, Equity, Inclusion, and Belonging

At Zelis, we champion diversity, equity, inclusion, and belonging in all aspects of our operations. We embrace the power of diversity and create an environment where people can bring their authentic and best selves to work. We know that a sense of belonging is key not only to your success at Zelis, but also to your ability to bring your best each day.

Equal Employment Opportunity

Zelis is proud to be an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.

Accessibility Support

We are dedicated to ensuring our application process is accessible to all candidates. If you are a qualified individual with a disability and require reasonable accommodation with any part of the application and/or interview process, please email talentacquisition@zelis.com.