The Claims Settlement Specialist supports claim settlement with providers through post payment negotiation. The Claims Settlement Specialist will be responsible for handling provider telephone calls regarding the payment amount paid to a provider by a payor based on Zelis data points. During this call, the Claims Settlement Specialist must understand (1) the procedures bi

The DRG Validation Nurse Reviewer will be primarily responsible for conducting post service, pre payment and post pay comprehensive inpatient DRG reviews based on industry standard inpatient coding guidelines and rules, evidence based clinical criteria plan, and policy exclusions. Conduct reviews on inpatient DRG claims as they compare with medical records ICD 10 Official

The Certified Edit Dispute Resolution Analyst will be responsible for researching and auditing medical records for complex, diverse, multi specialty provider claims to identify and determine appropriately coded billed services when compared to the Zelis Claim Edits Product. The Certified Edit Dispute Resolution Analyst demonstrates an understanding of Zelis edits as an in

This newly created role reports to the Senior Tax Director and is an integral part of the Finance organization. It will support activities to keep Zelis in compliance with indirect tax filing and reporting requirements, including but not limited to analyzing, reviewing, and filing required returns and tracking associated due dates and payments. Essential Duties and Functi

We are seeking energetic and reliable professionals to join the Zelis team as a Provider Services Specialist. This call center position is primarily responsible for answering inbound calls from providers and healthcare facilities. The Provider Services Specialist ensures providers successfully register for services and navigate the portal to view payment details. Our Prov

The primary responsibility of the Segment Marketing Director is to build and execute Account Based Marketing (ABM) plans for the Regional Health Plan segment that follows a path from account selection/prioritization, contact/persona identification, and nurturing, through to conversion. To enable the ABM plans, you will build and curate content, in partnership with product

The Senior Member Advocate is a vital role in ensuring service excellence to Zelis clients and their members. The Senior Member Advocate is proficient in and supports all Preservice Outreach, Balance Bill Resolution, and No Surprises Act assignment categories. This position requires the ability to act independently within the scope of assigned duties and responsibilities

Create annual strategic marketing plans to grow Provider Payments business Provide product based, strategic guidance for key marketing decisions. Use competitive intelligence as well as commercial goals to define a strategic roadmap that can address key business challenges and help Zelis win. Develop and manage product's value proposition and asset catalog, and align thos

The Public Relations Director manages the flow of communication between Zelis and the media and manages the creation of marketing messages that positively raise the public image of Zelis. They work with the Brand and Content team, Marketing Leadership, and various subject matter experts within Zelis to create and control the public narrative around the Zelis brand, ensuri