IBR Reviwer

Reposted 6 Days Ago
Be an Early Applicant
Hyderabad, Telangana, IND
In-Office
Entry level
Information Technology • Consulting
The Role
The IBR Reviewer at Zelis analyzes medical insurance claims, ensuring compliance with coding and billing guidelines, while optimizing the financial experience for healthcare providers.
Summary Generated by Built In

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

Skill Requirements:

 

  • CPC Certification (preferred, not mandatory)
  • Strong understanding of medical insurance and claims processes
  • Knowledge of medical billing and coding, payer policies, and reimbursement policies
  • Familiarity with NCC coding guidelines and AHA Coding Clinic updates

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

  • CPC Certification
  • Strong understanding of medical insurance and claims processes
  • Knowledge of medical billing and coding, payer policies, and reimbursement policies
  • Familiarity with NCC coding guidelines

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

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The Company
HQ: Bedminster, NJ
924 Employees
Year Founded: 2016

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.

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