Zelis
Client Inquiry Analyst – Zelis
Join to apply for the Client Inquiry Analyst role at Zelis.
3 days ago – Be among the first 25 applicants.
At Zelis, we Get Stuff Done. So, let’s 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 you've learned along the way. You are more than just your resume; you are a reflection of your achievements, the knowledge you've gained, and the personal interests that shape who you are.
Position Overview The Client Inquiry Analyst is responsible for the resolution of inquiries for all assigned Zelis editing clients. The role serves as a subject matter expert (SME) on coding/claim adjudication guidelines and the Zelis editing product. The Analyst supports day‑to‑day activities of the assigned team, ensuring alignment with mission and adherence to best practice policies. Responsibilities include analyzing client data, identifying trends, and providing actionable insights to improve client satisfaction and retention.
What You’ll Do
Serve as SME to provide coding and claim adjudication guidance for all assigned clients.
Demonstrate an expert level of understanding of the Zelis editing products and articulate correct coding and claim adjudication guidelines.
Provide written responses that provide clarity and guidance to all internal and external client inquiries.
Effectively utilize all tools and applications for the resolution and escalation of all internal/external edit/claim inquiries.
Manage day‑to‑day activities to ensure all inquiries received are responded to and resolved within appropriate service level agreements (SLAs).
Actively participate in all client meetings by providing an overview of identified inquiry or edit trends.
Proactively identify, resolve, and elevate client issues while partnering with business partners to maintain strong relationships.
Analyze data to proactively identify, elevate, and resolve client issues.
Prioritize tasks to deliver on‑time completion.
Ensure compliance with HIPAA regulations and requirements.
Build and maintain strong, long‑lasting relationships with other teams through regular communication and proactive engagement.
Analyze client data to identify trends, patterns, and areas for improvement.
Develop and deliver insightful reports and presentations to clients, highlighting key findings and recommendations.
Monitor client performance metrics and provide actionable insights to drive client success.
Collaborate with cross‑functional teams to identify and implement process improvements that enhance the client experience.
Collect and analyze client feedback to inform product development and service enhancements.
Stay up to date with industry trends and best practices.
What You’ll Bring To Zelis
Bachelor’s degree in Business, Healthcare, Data Analytics, or a related field. Or equivalent experience.
3+ years of relevant education and work experience with healthcare payers.
Current certified coder (AAPC or AHIMA), Registered Health Information (RHIA/RHIT) certifications, or RN/LPN with coding knowledge required.
Extensive knowledge of correct coding, industry standard claim adjudication guidelines, and policies.
Ability to translate coding and adjudication guidelines, policies, and references into edit policies and rules.
Excellent verbal and written communication skills.
Strong analytical skills with the ability to interpret complex data and provide actionable insights.
Proficiency in data analysis tools and software (e.g., Excel, SQL, Tableau).
Strong problem‑solving skills and critical strategic thinking.
Ability to work independently and as part of a team in a fast‑paced, dynamic environment.
Note: We are unable to consider 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. All employee work locations are determined by the needs of the position and Leadership team. In‑office work and activities, if applicable, vary based on the work and team objectives in accordance with company policies.
Base Salary Range $65,000 - $87,000
At Zelis we are committed to providing fair and equitable compensation packages. The base salary range reflects experience, education, qualifications, job‑related and industry‑related knowledge and skills. Base pay is part of a Total Rewards package that may include discretionary bonus plans, commissions, or other incentives depending on the role.
Zelis’ full‑time associates are eligible for a highly competitive benefits package, including 401(k) with employer match, flexible paid time off, holidays, parental leaves, life and disability insurance, and health benefits (medical, dental, vision, prescription drug). All benefits are offered for U.S. based employees.
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 don’t meet 100% of the qualifications. We value diverse perspectives and experiences and are committed to building an inclusive workplace.
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 TalentAcquisition@zelis.com.
Disclaimer 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 their normal responsibilities, duties, and skills from time to time.
#J-18808-Ljbffr
3 days ago – Be among the first 25 applicants.
At Zelis, we Get Stuff Done. So, let’s 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 you've learned along the way. You are more than just your resume; you are a reflection of your achievements, the knowledge you've gained, and the personal interests that shape who you are.
Position Overview The Client Inquiry Analyst is responsible for the resolution of inquiries for all assigned Zelis editing clients. The role serves as a subject matter expert (SME) on coding/claim adjudication guidelines and the Zelis editing product. The Analyst supports day‑to‑day activities of the assigned team, ensuring alignment with mission and adherence to best practice policies. Responsibilities include analyzing client data, identifying trends, and providing actionable insights to improve client satisfaction and retention.
What You’ll Do
Serve as SME to provide coding and claim adjudication guidance for all assigned clients.
Demonstrate an expert level of understanding of the Zelis editing products and articulate correct coding and claim adjudication guidelines.
Provide written responses that provide clarity and guidance to all internal and external client inquiries.
Effectively utilize all tools and applications for the resolution and escalation of all internal/external edit/claim inquiries.
Manage day‑to‑day activities to ensure all inquiries received are responded to and resolved within appropriate service level agreements (SLAs).
Actively participate in all client meetings by providing an overview of identified inquiry or edit trends.
Proactively identify, resolve, and elevate client issues while partnering with business partners to maintain strong relationships.
Analyze data to proactively identify, elevate, and resolve client issues.
Prioritize tasks to deliver on‑time completion.
Ensure compliance with HIPAA regulations and requirements.
Build and maintain strong, long‑lasting relationships with other teams through regular communication and proactive engagement.
Analyze client data to identify trends, patterns, and areas for improvement.
Develop and deliver insightful reports and presentations to clients, highlighting key findings and recommendations.
Monitor client performance metrics and provide actionable insights to drive client success.
Collaborate with cross‑functional teams to identify and implement process improvements that enhance the client experience.
Collect and analyze client feedback to inform product development and service enhancements.
Stay up to date with industry trends and best practices.
What You’ll Bring To Zelis
Bachelor’s degree in Business, Healthcare, Data Analytics, or a related field. Or equivalent experience.
3+ years of relevant education and work experience with healthcare payers.
Current certified coder (AAPC or AHIMA), Registered Health Information (RHIA/RHIT) certifications, or RN/LPN with coding knowledge required.
Extensive knowledge of correct coding, industry standard claim adjudication guidelines, and policies.
Ability to translate coding and adjudication guidelines, policies, and references into edit policies and rules.
Excellent verbal and written communication skills.
Strong analytical skills with the ability to interpret complex data and provide actionable insights.
Proficiency in data analysis tools and software (e.g., Excel, SQL, Tableau).
Strong problem‑solving skills and critical strategic thinking.
Ability to work independently and as part of a team in a fast‑paced, dynamic environment.
Note: We are unable to consider 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. All employee work locations are determined by the needs of the position and Leadership team. In‑office work and activities, if applicable, vary based on the work and team objectives in accordance with company policies.
Base Salary Range $65,000 - $87,000
At Zelis we are committed to providing fair and equitable compensation packages. The base salary range reflects experience, education, qualifications, job‑related and industry‑related knowledge and skills. Base pay is part of a Total Rewards package that may include discretionary bonus plans, commissions, or other incentives depending on the role.
Zelis’ full‑time associates are eligible for a highly competitive benefits package, including 401(k) with employer match, flexible paid time off, holidays, parental leaves, life and disability insurance, and health benefits (medical, dental, vision, prescription drug). All benefits are offered for U.S. based employees.
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 don’t meet 100% of the qualifications. We value diverse perspectives and experiences and are committed to building an inclusive workplace.
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 TalentAcquisition@zelis.com.
Disclaimer 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 their normal responsibilities, duties, and skills from time to time.
#J-18808-Ljbffr