EDI Analyst-1

Job Description

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

Zelis is modernizing the healthcare financial experience by providing a connected platform that bridges the gaps and aligns interests across payers, providers, and healthcare consumers. This platform serves more than 750 payers, including the top 5 national health plans, BCBS insurers, regional health plans, TPAs and self-insured employers, and millions of healthcare providers and consumers. Zelis sees across the system to identify, optimize, and solve problems holistically with technology built by healthcare experts – driving real, measurable results for clients.

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. 

We encourage members of traditionally underrepresented communities to apply, even if you do not believe you 100% fit the qualifications of the position, including women, LGBTQIA people, people of color, and people with disabilities.

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 [email protected].

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.