Clinical Dispute Analyst

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. education to Use of strong coding and industry knowledge to create and maintain bill review content, including but not limited to DRG Reviewer Rationales, DRG Clinical Validation Policies, CCR Review Guidelines and Templates, and Dispute RationalesExperience and working knowledge of Health Insurance, Medicare guidelines and various healthcare programsClinical skills to evaluate appropriate Medical Record CodingExperience performing regulatory research from multiple sources, formulating an opinion, and presenting findings in an organized, concise manner.Knowledge of payer reimbursement policies. Creative problem-solving skills, leveraging insights and input from other parts of an organization.Consistently demonstrate ability to act and react swiftly to continuous challenges and changes.Excellent analytical skills with data and analytics related solutions.Excellent communication skills.Strong organization and project/process management skills.Good negotiation, problem solving, planning and decision-making skills.Ability to manage projects simultaneously and achieve goals.Excellent follow through, attention to detail, and time management skills.***Please note at this time we are unable to proceed with 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, and all our employee's work locations are based on the needs of the position and determined by the Leadership team. In-office work and activities, if applicable, vary based on the work and team objectives in accordance with Company policies.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.Zelis maintains a transparent, fee-free recruitment process. All genuine offers originate from our Talent Acquisition team using the “@zelis.com” domain. We do not use WhatsApp or personal emails for recruitment. Forward any suspected fraud to verify-offers@zelis.com for prompt investigation. Thank you for staying vigilant. #J-18808-Ljbffr