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.
Serves customers by assisting staff questions and handling phone escalations from inbound call inquiries regarding coding and the Zelis Claims Editing product; resolving problems; fulfilling requests; educating on claims and performing audits for the call center staff.
Assist staff with questions regarding coding and claim edits applied on a claim
Assist with and/or handle escalated calls regarding coding and claim edits applied on a claim
Ask appropriate questions and listen actively to identify specific questions or issues while documenting required information in computer systems
Resolve inquiries by researching and exploring answers and alternative solutions; implement solutions with Manager; escalate unresolved problems to the appropriate department.
Ability to multitask including performing coding research during calls.
Perform audits to measure the call center performance to ensure productivity and quality metrics are being met
Answer incoming phone calls during peak times from healthcare providers nationwide and identify the type of assistance the customer needs.
Maintain awareness of and ensure adherence to Zelis standards regarding privacy.
Perform other job-related duties as required.
Excellent customer service & telephone skills
Outstanding written & verbal communication skills
Strong prioritizing & organizational skills
Computer proficiency and technical aptitude with the ability to utilize the Zelis operating system (priZem)
MS Outlook, MS Word, and proficiency in Excel
Proficiency with web browsers including Internet Explorer and Google Chrome
Healthcare industry knowledge, preferably:
2+ years of experience within healthcare industry
2+ years Medical claims processing
2+ years coding and/or billing experience
Coding research experience preferred
Call center environment
Understands Medicare/Medicaid guidelines, medical coding billing practices regarding denials and appeals.
EncoderPro or other encoder software experience
Judgment and initiative to make recommendations or resolve escalated inquiries and/or complex assignments.
Has basic understanding and ability to interpret Explanation of Benefits, Complementary Network discounts, as well as all Zelis products and services.
Thorough knowledge of company and departmental policies and procedures.
Certified Professional Coder (CPC), or equivalent required
High School Diploma and/or some College
Associate degree preferred
An attractive compensation package comprised of base salary, plus incentives, as well as full benefits has been created to attract outstanding candidates.