Manager Post Pay Claim Settlement
Manager Post Pay Claim Settlement
Employer Active
Job Alert
You will be updated with latest job alerts via email
Share
Job Alert
You will be updated with latest job alerts via email
Not Disclosed
Salary Not Disclosed
1 Vacancy
Job Description
At Zelis we Get Stuff Done. So lets get to it!
A Little About Us
Zelis is modernizing the healthcare financial experience for all by providing a connected platform that bridges the gaps and aligns interests across payers providers and healthcare consumers. This platform serves more than 750 payers including the top 5 national health plans BCBS insurers regional health plans TPAs and selfinsured employers and millions of healthcare providers and consumers. Zelis sees across the system to identify optimize and solve problems holistically with technology built by healthcare expertsdriving real measurable results for clients.
A Little About You
You bring a unique blend of personality and professional expertise to your work inspiring others with your passion and dedication. Your career is a testament to your diverse experiences community involvement and the valuable lessons youve learned along the way. You are more than just your resume; you are a reflection of your achievements the knowledge youve gained and the personal interests that shape who you are.
Position Overview
The Manager Post Pay Claim Settlement will be responsible for the leadership and continuous development of the post payment claim settlement team. As the team leader the Manager will be accountable for exceeding department business objectives to drive best in class claim settlement while collaborating with cross functional partners to support our Out of network and Reference Based Pricing products.What youll do:
Manage people process and technology required to deliver leading customer experience related to post payment claim settlement for clients providers and members.
Drive initiatives and recommendations for inquiry management and resolution process and system improvements to optimize accuracy and efficiency.
Establish key performance indicators and coach employees toward performance and development objectives.
Manage operations by monitoring system performance; identifying and resolving problems; preparing and completing action plans; completing system audits and analyses; managing quality assurance programs.
Manage staffing levels and team structure to optimize performance including planning assigning and directing work.
Resolve escalated inquiries from providers clients and internal teams.
Leads the expansion oversight and performance of the global resources and workflows.
Collaborate with and present data trends and expectations with external and internal clients.
Partner with leadership to develop and manage flex staffing models to support claim volumes
Communicate goals vision and purpose of team to improve team engagement and align team to expectations
What youll bring to Zelis:
Proven leader with the ability to motivate empower and drive collaboration
7 years of healthcare claims related experience
Demonstrated expertise in claim settlement and advocacy services
Bachelors degree preferred
Excellent communication and interpersonal skills
Experience leading matrixed and/or global teams preferred
Recognize deviations or red flags escalate issues to senior leaders and devise and implement solutions.
Ability to set & manage and enhance team performance & expectations; coaching & counseling and if not successful moving forward with formal performance management successfully.
Must be able to communicate effectively with team in public and in client settings. Communicate progress needs and updates to direct management timely and effectively.
Utilize data analytics to forecast inventory trends and balance workloads.
Leverage data analytics to identify and implement efficiency improvements.
Be able to identify strengths and opportunities to help develop associates in alignment with business need and individual career interests.
Ability to pull analyze interpret and communicate data effectively down and up through the organization.
Domestic travel around 10
Location and Workplace Flexibility
We have offices in Atlanta GA Boston MA Morristown NJ Plano TX St. Louis MO St. Petersburg FL and Hyderabad India. We foster a hybrid and remote friendly culture and all our employees work locations are based on the needs of the position and determined by the Leadership team. Inoffice work and activities if applicable vary based on the work and team objectives in accordance with Company policies.
Our Values and Culture
We are always thinking about life beyond the laptop and how we can drive positive change for our clients our associates and our communities. Our IMPACT Value Behaviors are how we elevate that thinking and turn it into action:
Drive Innovation
Embrace a Growth Mindset
Put People First
Act With Agility
Champion Collaboration
Build Trust
We look at the big picture when it comes to our associates and our culture. We work to effectively build a thriving exciting experience for our associates. We leverage these values to continuously evolve an awardwinning culture that has a longevity greater than the novelty of a ping pong table in the break room. Our idea of a great workplace is where we can show up as our authentic selveswhich is the best way to bring together extraordinary talented people who feel empowered to make a positive IMPACT.
A Lot of Respect
This is a collaborative organization where everyone is on your team. Each personfrom the newest intern to the CEOis in their position because they are an expert and they view you with the same lens. No matter who you are where you sit in the organization or the span of your tenure everyone at Zelis is treated with respect.
We respect your time (so much so that we arent asking you to write a cover letter). We make sure you have time to focus by offering MeetingFree Wednesdays as well as time for you with Zelis Cares Fridays early dismissal.
We respect and prioritize worklife balance. With flexible PTO a hybrid/remote work environment and a culture that encourages disconnecting after hours we ensure you have the time and space to manage lifes surprises and fully engage outside of work. Working 9 to 5 isnt just a hit song; we respect business hours and promote wellness offerings to keep you at your best both on and off the clock.
We respect diverse opinions. There are always seats at the table and were eager to add more chairs. We continue to build our Diversity Equity and Inclusion initiatives including training guest speakers associateled Business Resource Groups inoffice DEI events and more.
We respect that everyone has different needs. Zelis has built and continues to add to our benefits offerings by including medical dental 401k fertility and family building education assistance pet insurance menopause and midlife care and more.
We respect YOU. As an Equal Opportunity Employer we believe that everyones voice has a place in the chorus. We encourage members of traditionally underrepresented communities to apply.
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.
We welcome applicants from all backgrounds and encourage you to apply even if you dont meet 100 of the qualifications for the role. We believe in the value of diverse perspectives and experiences and are committed to building an inclusive workplace for all.
Accessibility Support
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 .
Disclaimer
We are an equal opportunity employer and all qualified applicants will receive consideration for employment without regard to race color religion sex gender identity national origin disability status protected veteran status or any other characteristic protected by law.
The above statements are intended to describe the general nature and level of work being performed by people assigned to this classification. They are not to be construed as an exhaustive list of all responsibilities duties and skills required of personnel so classified. All personnel may be required to perform duties outside of their normal responsibilities duties and skills from time to time.
Required Experience:
Manager
Employment Type
Full-Time
