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- Bedminster Township, NJ 07921
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Zelis Healthcare • Bedminster Township, NJ
Posted 19 days ago
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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 an information technology company which utilizes an end-to-end technology platform to fulfill the claims cost management and payments needs of healthcare payors including large and medium-sized health plans, TPAs, Taft-Hartley Plans, providers and individuals. The company provides a comprehensive portfolio of network management, claims integrity, payment remittance solutions and analytical services for medical, dental and workers' compensation claims to over 500 payor clients. Additionally, the company delivers electronic payments and explanation of payments to over 200,000 healthcare providers and serves individuals with provider lookup and medical referral services.
The Coding Analyst will be responsible for reviewing claims and/or medical records for appropriate billing as well as processing/responding to any incoming appeals and/or inquiries related to determinations with providers .
- Researching manuals/guidelines (including but not limited to AMA, CMS, and ZELIS Clinical Manual) once an appeal is received by ZELIS
- Utilizing the most up to date documentation/guidelines in responding to appeals
- Customizing and/or creating appeal letters in a professional manner
- Handling appeals and/or telephone/email inquiries related to determination of appeal
- Mentor and/or assist with Junior/ Coding Analysts
- Performs other related responsibilities as assigned.
- Maintain awareness of and ensure adherence to ZELIS standards regarding privacy.
- Has proficiency in Medical coding and use of various research materials used to render savings decisions on behalf of clients
- 5+ years healthcare and medical claims processing experience within a provider/facility’s office or Payer
- Appeals experience preferred
- Excellent customer service skills
- Exceptional professionally written communication skills
- Diligent research and organizational skills
- Ability to multi-task and detailed-oriented required
- Knowledge of Microsoft Word & Excel a must
- Associates Degree Preferred. CPC or equivalent credentialing, maintained in good status, required.
An attractive compensation package as well as comprehensive benefits plans are available to attract outstanding candidates.
Thank you for your interest in the Zelis team!