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Zelis EDI Analyst in St. Petersburg, Florida

Zelis is pursuing an aggressive organic and non-organic growth strategy focused on providing superior healthcare claim lifecycle solutions to payors, providers and individuals from pre-payment through payment. As the company executes its growth strategy, Zelis is seeking to identify an accomplished EDI Analyst. Reporting to the EDI Department Manager and working closely with managers and other team members.

Use EDI notepad and other technology tools to review X12 835 files for issues, including but not limited to:

  • Balancing, structure, syntactical, data type and content errors; then develop and execute strategies to solve them. Troubleshooting activities include querying our database using SQL Management Studio to review stored values and/or using a text editor to manually review data files sent to Zelis by our Payer clients

  • Support Payer and Provider client implementation activities by generating 835s files, reviewing their content and then presenting your findings to Zelis clients

  • Respond to inquiries regarding 835 issues, claims, payments, and/or clearinghouse activities

  • Work closely with other departments on communication issues related to customer and third-party vendor connectivity

  • Communicate with vendor contacts to identify file issues and then disseminate the resolutions to the provider or payer to maintain compliance with all HIPAA and Zelis data security standards

  • Understand Zelis Payment products, protocols, systems and processes.

  • Support multiple client projects simultaneously

  • Must be proactive to ensure proper follow up and completion of projects.

  • Must maintain a professional demeanor in sensitive situation.

    PROFESSIONAL EXPERIENCE/QUALIFICATIONS:

  • Must have Healthcare industry knowledge – preferably provider billing and/or claims payment

  • Experience writing and executing queries in Microsoft SQL Server Management Studio

  • Must have high technical aptitude

  • Have worked on assignments that are complex in nature in which judgment, critical thinking and initiative are required to accomplish the objectives of the assignment

  • Have successfully completed work tasks with minimal oversight

  • Have successfully managed and prioritized multiple tasks.

  • Ability to work under pressure and meet deadlines.

  • Must have excellent communication and presentation skills to effectively interface with the Operations staff, and external representatives from the payer and provider communities.

    EDUCATION:

  • 4-year college degree or equivalent technology, 835 and/or Healthcare experience

    WORK ENVIRONMENT:

  • Walking, standing and sitting.

  • Long periods of computer usage.

  • Handling - seizing, holding, grasping and fingering of objects, tools and controls.

  • Reaching

  • Vision - close vision

  • Office Setting

  • Moderate noise level.

  • May be required to work on off hours and weekends

    #LI-jj1

    #LI-Remote

As a leading payments company in healthcare, we guide, price, explain, and pay for care on behalf of insurers and their members. We’re Zelis in our pursuit to align the interests of payers, providers, and consumers to deliver a better financial experience and more affordable, transparent care for all. We partner with more than 700 payers, including the top-5 national health plans, BCBS insurers, regional health plans, TPAs and self-insured employers, over 4 million providers, and 100 million members, enabling the healthcare industry to pay for care, with care. Zelis brings adaptive technology, a deeply ingrained service culture, and a comprehensive navigation through adjudication and payment platform to manage the complete payment process.

SCAM ALERT: There is an active nationwide employment scam which is now using Zelis to garner personal information or financial scams. This site is secure, and any applications made here are with our legitimate partner. If you’re contacted by a Zelis Recruiter, please ensure whomever is contacting you truly represents Zelis Healthcare. We will never asked for the exchange of any money or credit card details during the recruitment process. Please be aware of any suspicious email activity from people who could be pretending to be recruiters or senior professionals at Zelis.

As the leading healthcare payments company, we price, pay and explain care for payers, providers, and healthcare consumers. Zelis was founded on a belief there is a better way to determine the cost of a healthcare claim, manage payment-related data, and make the payment because more affordable and transparent care is good for all of us. We partner with over 700 payers, 1.5 million providers, and millions of members -- enabling the healthcare industry to pay for care, with care.Zelis brings adaptive technology, a deeply ingrained service culture, and an integrated pre-payment through payments platform to manage the complete payment process.

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