Claims Settlement Analyst
The Claims Analyst will provide new and existing Claims Settlement reporting metrics and work with their reporting Manager to create or enhance reporting solutions to Zelis Clients. He or She will also contribute to the team by assisting with identifying barriers, providing resolutions and also collaborate with internal Zelis resources. This role allows the individual to execute at many levels within the organization.
- Drive data driven decision making to inform and present Zelis’ response packages to contracted clients
- Acts as end-to-end SME to triage and anticipate client requirements.
- Lead process improvement opportunities to support team priorities.
- Partner with internal and external stakeholders to create strategies to meet Non-Regulated Claims Settlement objectives.
- Provides monthly performance reporting to departmental leadership.
- Confirms that all documentation adheres to Zelis standards regarding privacy, compliance, legal aspects, and HIPAA standards.
- Performs other related responsibilities as assigned.
- Bachelor’s degree in related field or equivalent work experience
- Five years or more experience in healthcare, health insurance, or healthcare compliance
- Demonstrated success in arbitration, mediation, or contract negotiation setting
- Knowledge of the full Microsoft Office Suite of products to include, but not limited to, MS Outlook, MS Word, MS Excel, and MS PowerPoint
- A background in healthcare collections, provider billing, negotiations or compliance is beneficial.
- Project Management experience a plus.
As a leading payments company in healthcare, we guide, price, explain, and pay for care on behalf of insurers and their members. We’re Zelis in our pursuit to align the interests of payers, providers, and consumers to deliver a better financial experience and more affordable, transparent care for all. We partner with more than 700 payers, including the top-5 national health plans, BCBS insurers, regional health plans, TPAs and self-insured employers, over 4 million providers, and 100 million members, enabling the healthcare industry to pay for care, with care. Zelis brings adaptive technology, a deeply ingrained service culture, and a comprehensive navigation through adjudication and payment platform to manage the complete payment process.
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 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.
We encourage members of traditionally underrepresented communities to apply, even if you do not believe you 100% fit the qualifications of the position, including women, LGBTQIA people, people of color, and people with disabilities.
We are dedicated to ensuring our application process is accessible to all candidates. If you are a qualified individual with a disability or a disabled veteran and require a reasonable accommodation with any part of the application and/or interview process, please email TalentAcquisition@zelis.com
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