About Us
Zelis is modernizing the healthcare financial experience in the United States (U.S.) 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.
At Zelis, AI is woven into the fabric of how we work. Every associate is expected - and empowered - to partner with AI to challenge the status quo, accelerate innovation, and amplify their impact. This is a place for builders with a growth mindset who act with agility, embrace change, and use modern technology to shape smarter solutions, exceptional experiences, and the future of our industry for our clients, customers, and our culture.
Why We Do What We Do
In the U.S., consumers, payers, and providers face significant challenges throughout the healthcare financial journey. Zelis helps streamline the process by offering solutions that improve transparency, efficiency, and communication among all parties involved. By addressing the obstacles that patients face in accessing care, navigating the intricacies of insurance claims, and the logistical challenges healthcare providers encounter with processing payments, Zelis aims to create a more seamless and effective healthcare financial system.
Zelis India plays a crucial role in this mission by supporting various initiatives that enhance the healthcare financial experience. The local team contributes to the development and implementation of innovative solutions, ensuring that technology and processes are optimized for efficiency and effectiveness. Beyond operational expertise, Zelis India cultivates a collaborative work culture, leadership development, and global exposure, creating a dynamic environment for professional growth. With hybrid work flexibility, comprehensive healthcare benefits, financial wellness programs, and cultural celebrations, we foster a holistic workplace experience. Additionally, the team plays a vital role in maintaining high standards of service delivery and contributes to Zelis’ award-winning culture.
Position Overview
objECTIVES AND RESPONSIBILITIES:
Successfully manages both medical record claim audit requests and facility itemized bill claim requests.
Manages 2 or more nurse auditor staff in the medical claim audit process by requesting medical records and applicable documents from medical providers nationwide.
Contacts healthcare providers to request and obtain medical and billing documents via phone, fax, mail & e-mail for claims processing.
Organize and prioritize claims daily for follow up of billing documents not received.
Learn and process according to various provider/client stipulations.
Utilize AutoFax – document retrieval platform efficiently.
Performs other related responsibilities as assigned.
Maintain awareness of and ensure adherence to ZELIS standards regarding privacy.
What You Will bring:
Has foundational proficiency in requesting medical records and applicable documents from medical providers.
2+years of medical record experience or 1+year prior DR I experience.
Has a solid understanding of various types of medical documents.
Has a solid understanding of processes and techniques in obtaining documents.
Great verbal communication skills
Knowledge of MS Outlook, MS Word, & Internet Explorer
Strong prioritizing & organizational skills
Excellent customer service & telephone skills
Independence/ Accountability:
Meets or exceeds the Document Retrieval Performance Standards established by the Document Retrieval department.
Requires minimal daily supervision on day to day tasks but seeks guidance on more complex tasks
Accountable for day to day tasks
Ability to follow detailed instructions on new assigments
Must have professional manner and respect the confidentiality of administrative matters and files
Ability to manage and prioritize multiple tasks.
Ability to work under pressure and meet deadlines.
Completes work in a timely fashion
Outstanding ability to multiplex tasks as required
Attention to detail.
Communication Skills:
Must work well with others
Effectively communicates with others by giving and receiving feedback
Call Center Phone edicate
Communicates ideals and information clearly
education:
Graduate
Associates Degree a plus
Commitment to Diversity, Equity, Inclusion, and Belonging
At Zelis, we champion diversity, equity, inclusion, and belonging in all aspects of our operations. We embrace the power of diversity and create an environment where people can bring their authentic and best selves to work. We know that a sense of belonging is key not only to your success at Zelis, but also to your ability to bring your best each day.
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.
Accessibility Support
We are dedicated to ensuring our application process is accessible to all candidates. If you are a qualified individual with a disability and require reasonable accommodation with any part of the application and/or interview process, please email [email protected].
Skills Required
- 2+ years of medical record experience or 1+ year prior DR I experience
- Foundational proficiency in requesting medical records
- Great verbal communication skills
- Knowledge of MS Outlook, MS Word, & Internet Explorer
Zelis Compensation & Benefits Highlights
The following summarizes recurring compensation and benefits themes identified from responses generated by popular LLMs to common candidate questions about Zelis and has not been reviewed or approved by Zelis.
-
Healthcare Strength — Feedback suggests comprehensive medical, dental, and vision coverage is paired with mental health resources, telehealth, women’s health, and gender-affirming care. An Employee Assistance Program and a Lifestyle Spending Account reinforce depth of health support.
-
Retirement Support — Feedback suggests a 401(k) with company match and HSA with employer contributions strengthen financial security. Financial planning resources and tools further bolster this area.
-
Flexible Benefits — Feedback suggests flexible time off, hybrid/remote options, and meeting-free Wednesday afternoons support varied needs and work styles. Home office setup support adds practical flexibility.
Zelis Insights
What We Do
As a leading healthcare payments company, we price, explain and pay for care on behalf of 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.
