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Edit Configuration Analyst
at Zelis Payments
# of Openings:
Zelis is a healthcare information technology company and market-leading provider of end-to-end healthcare claims cost management and payment solutions.
Inc.5000 award winner: One of the fastest growing privately held companies in the US!
Ranked #1 by NJ Biz as the Fastest Growing Company in NJ!
Zelis Healthcare is a mid-cap healthcare technology growth company and market-leading provider of integrated healthcare cost management and payments solutions including network analytics, network access, network cost management, payment integrity and electronic payments to payers, healthcare providers and consumers in the medical, dental and workers' compensation markets nationwide. Zelis Healthcare is backed by Parthenon Capital Partners. www.zelis.com
Our Zelis Purpose
We founded Zelis to help control the rising cost of healthcare and make healthcare more affordable for all of us.
The Edit Configuration Analyst will have responsibility for the setup and management of client’s editing package and customizations, starting in implementation and continuing throughout the lifecycle of the client in Production. This position will manage all client edit customizations that are requested and ensure that setup and customizations are completed accurately and with the highest quality. Will act as the editing Subject Matter Expert (SME) for their assigned clients and will assist Account Management in the analysis and due diligence process for all edit change requests. Will work with the Claims Editing department, IT department and the PMO for any/all requests that are outside their scope of knowledge. This position will also play a critical role in ongoing internal projects that involve front-end configuration of edit setup & customizations and/or process-related initiatives/tools.
- Work closely with the implementation project team during the implementation process of Claims Editing to identify set-up requirements, configuration needs, possible customizations & unique needs of the client.
- Participate in any client communication relating to Claims Editing and the client, including, but not limited to implementation meetings/calls, ongoing education and stewardship meetings.
- Work with Claims Editing Department, Project Management Office, IT & Operations in documenting, coordinating & validating all editing-related customizations.
- Build and maintain client’s edit Decision Matrix which includes documentation of the client’s editing setup and customizations.
- Review Client’s payment policies to ensure Claims Editing setup conforms to policies and make recommendations to clients accordingly.
- Participate in Claims Editing training sessions with new & existing clients in order to obtain the client’s edit package for setup and to pinpoint necessary customizations as well as periodic review of existing customizations to ensure validity and proper maintenance.
- Assist Account Management team in conducting research & analysis and preparing for stewardship meetings for Claims Editing clients based on client request or internal requirements.
- Effectively manage Client issues, concerns and customization requests related to editing.
- Participate with IT and operations to streamline processes, as well as create or enhance reports and tools impacting the edit setup/customization process, including the identification of requirements/functionality and user acceptance testing.
- Maintain awareness of and ensure adherence to ZELIS standards regarding privacy.
- Has foundational knowledge of ZELIS product portfolio, implementation process and overall strategy of ZELIS Account Manager role
- Has foundational knowledge of applicable client base
- Work closely with many departments of organization required to perform tasks (Ops, IT, PM, Acct Mgmt., Sales)
- Has thorough understanding of relevant technical aspects of Claims Editing software and solutions and its impact on Clients
- 5+ years’ experience working with/for Health Insurance companies, cost management company, TPAs or PPO Networks
- Dynamic interpersonal skills that will enable developing strong rapport with clients
- Ability to clearly communicate to clients and internal ZELIS stakeholders
- Sense of urgency, ability to multi-task
- Thorough knowledge of Excel and other MS Suite products
AS Degree preferred but not required
CPC preferred but not required
An attractive compensation package comprised of base salary, plus incentives, as well as full benefits has been created to attract outstanding candidates.
OUR BIG 8 ZELIS VALUES
- We take personal accountability
- We look for a better way
- We serve each other and are always there to help
- We act level-less
- We use humor
- We develop serious expertise
- We act with integrity
- We celebrate
Thank you for your interest in the Zelis team!