Zelis
Claims Settlement Specialist (Healthcare)
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!
COMPANY BACKGROUND/CULTURe
Our Zelis Purpose
We founded Zelis to help control the rising cost of healthcare and make healthcare more affordable for all of us.
Position Overview
The Claims Settlement Specialist position will handle the financial settlement of medical claims/bills on behalf of Zelis payor clients. 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 billed on the claim/bill; (2) the estimate of the fair value of the payment that was remitted to the provider based on Medicare pricing, location/facility/provider comparisons, and Zelis' proprietary evaluation software; (3) identify settlement points for that particular provider if payment is not accepted, as is; and, (4) reach an acceptable payment below the provider's billed charges. This position requires a minimum 60-day training period.
KEY RESPONSIBILITIES
professional experience/qualifications
EDUCATION:
COMPENSATION:
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
Thank you for your interest in the Zelis team!
See Job Description