Client Integration Specialist
Client Integration Specialist
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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 across payers providers and healthcare consumers. We serve more than 750 payers including the top five national health plans regional health plans TPAs and millions of healthcare providers and consumers across our platform of solutions. Zelis sees across the system to identify optimize and solve problems holistically with technology built by healthcare experts driving 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 Client Integration Specialist is primarily responsible for achieving key performance goals for the Zelis Claims Cost Solutions department. This role involves aligning daily activities with the mission of Zelis Claims Cost Solutions adhering to best practices and acting as a liaison between the Implementation and Edit Configuration teams during the onboarding of new editing clients.What youll do:
- Work autonomously on long-term activities; may lead or teach others about processes or tasks.
- Identify and correct issues that may not be immediately evident; present unsolicited ideas to leaders.
- Disseminate information with some guidance; interact mainly with internal and external colleagues.
- Lead day-to-day client-facing activities new initiatives processes and system enhancements while supporting pre-production testing processes.
- Demonstrate outstanding presentation and communication skills during new editing client implementations providing an overview of the Zelis edit suites.
- Partner effectively with Implementation business partners to provide coding guidance and Zelis editing product support during internal and external client meetings.
- Provide coding and claim adjudication guidance while interpreting client pre-production data to ensure alignment with assigned client payment policies.
- Collaborate with configuration business partners to ensure appropriate setup and customization based on client-specific payment policies and lines of business.
- Facilitate debriefing of client decisions and research policy-related issues identified during the editing testing process.
- Support the pre-production testing process for client-selected edit suites and provide ongoing support to Implementation partners.
- Serve as a subject matter expert (SME) to provide coding and client-specific guidance regarding internal policies and various lines of business.
- Utilize reporting tools and metrics to manage deliverables for external and internal client meetings.
- Actively participate in day-to-day client-facing activities new initiatives processes and system enhancements.
- Facilitate internal work solutions to issues and communication of status with the Claims Edits ECR and CPS teams.
- Ensure compliance with HIPAA regulations and requirements.
- Adhere to Zelis standards regarding privacy.
What youll bring to Zelis:
- Typically requires a Bachelors degree with 4 years of experience or a Masters degree with 2 years of experience.
- Attends company and regional training in areas of expertise; presents work to department members external consultants and at professional meetings.
- Extensive knowledge of reimbursement methodologies and acceptable billing practices.
- Knowledge of payer reimbursement policies state and federal regulations and applicable industry standards.
- Certified Professional Coder (CPC) required.
- Outstanding presentation and communication skills with proven ability to deliver client presentations.
- Project management experience.
- Experience managing internal and external relationships.
- Excellent verbal and written communication skills.
- Proficient in Microsoft Office Word and Excel.
Please note at this time we are unable to proceed with candidates who require visa sponsorship now or in the future.
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. In-office work and activities if applicable vary based on the work and team objectives in accordance with Company policies.
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:
Unclear Seniority
Employment Type
Full-Time
