The DRG Validation Nurse Reviewer will be primarily responsible for conducting post service, pre payment and post pay comprehensive inpatient DRG reviews based on industry standard inpatient coding guidelines and rules, evidence based clinical criteria plan, and policy exclusions. Conduct reviews on inpatient DRG claims as they compare with medical records ICD 10 Official

The Senior Marketing Events Manager is an experienced and strategic event marketing professional responsible for driving the strategy and tactical execution of all facets of how we showcase Zelis content at Industry and Zelis events. This role will also be responsible for building a comprehensive communications strategy for all revenue generating events, in partnership wi

The Certified Edit Dispute Resolution Analyst will be responsible for researching and auditing medical records for complex, diverse, multi specialty provider claims to identify and determine appropriately coded billed services when compared to the Zelis Claim Edits Product. The Certified Edit Dispute Resolution Analyst demonstrates an understanding of Zelis edits as an in

This newly created role reports to the Senior Tax Director and is an integral part of the Finance organization. It will support activities to keep Zelis in compliance with indirect tax filing and reporting requirements, including but not limited to analyzing, reviewing, and filing required returns and tracking associated due dates and payments. Essential Duties and Functi

We are seeking energetic and reliable professionals to join the Zelis team as a Provider Services Specialist. This call center position is primarily responsible for answering inbound calls from providers and healthcare facilities. The Provider Services Specialist ensures providers successfully register for services and navigate the portal to view payment details. Our Prov

The Claims Settlement Manager is 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 Pr

The primary responsibility of the Segment Marketing Director is to build and execute Account Based Marketing (ABM) plans for the Regional Health Plan segment that follows a path from account selection/prioritization, contact/persona identification, and nurturing, through to conversion. To enable the ABM plans, you will build and curate content, in partnership with product

The Senior Member Advocate is a vital role in ensuring service excellence to Zelis clients and their members. The Senior Member Advocate is proficient in and supports all Preservice Outreach, Balance Bill Resolution, and No Surprises Act assignment categories. This position requires the ability to act independently within the scope of assigned duties and responsibilities

Create annual strategic marketing plans to grow Provider Payments business Provide product based, strategic guidance for key marketing decisions. Use competitive intelligence as well as commercial goals to define a strategic roadmap that can address key business challenges and help Zelis win. Develop and manage product's value proposition and asset catalog, and align thos

The Public Relations Director manages the flow of communication between Zelis and the media and manages the creation of marketing messages that positively raise the public image of Zelis. They work with the Brand and Content team, Marketing Leadership, and various subject matter experts within Zelis to create and control the public narrative around the Zelis brand, ensuri

We're seeking an Analytics Manager for PINS (Payee Identification and Network Security) to join our team, reporting to the Senior Director. In this role, you'll lead the PINS analytics team and drive the development of a structured analytics program. Your focus will be on managing ongoing and ad hoc reporting, automation, and operational enhancements for the PINS team, en

The Project Manager, PINS (Payee Identification and Network Security) will report to the Sr Director overseeing Zelis Payments' Fraud, Risk Management, and Identity Verification organization (PINS). The PINS team centrally manages Fraud, Onboarding/Verifications, and Account Servicing for Zelis clients, addressing issues related to account takeover, business identificatio

We are currently seeking an experienced Director of Accounts Receivable to support Price Optimization Business Unit. The Director of Accounts Receivable will provide overall accounts receivable leadership for the Business Unit, including and not limited to overseeing a team of approximately 15 associates, providing strategic finance direction, process simplification, and