Regulated Claims Settlement Coordinator

Zelis • Atlanta, GA

3d • $19 - $24 • Hybrid

About The Position

The Regulated Claims Settlement Coordinator supports the Claims Settlement Team through leading the review and response to disputed claims submitted through state and federal arbitration processes. The Regulated Claims Settlement Coordinator will be responsible for supporting Zelis’ settlement offers and pricing after disputes have been filed with federal and state arbitrations, packaging and summarizing objective data and the arguments in support of Zelis’ position.

Requirements

• Three years or more experience with healthcare claims settlement
• Experience with healthcare arbitration, mediation, or contract negotiation setting
• Knowledge of the full Microsoft Office Suite of products to include, but not limited to, MS Outlook, MS Word, MS Excel, and MS PowerPoint

Nice To Haves

• A background in healthcare collections, provider billing, negotiations or compliance is helpful.
• Bachelor’s degree helpful

Responsibilities

• Prepares and presents Zelis’ response packages to cases submitted for arbitration at both the state and federal level under the NSA
• Provide input and guidance on the selection process for certified arbitration entities under the NSA
• Create a scalable IDR defense package through improved automation in the creation and compilation of the necessary data elements
• Ensure Claims Settlement processes deliver required information for arbitration reviews and position Zelis for optimal success
• Provides monthly performance reporting to departmental leadership.
• Confirms that all documentation adheres to Zelis standards regarding privacy, compliance, legal aspects, and HIPAA standards.
• Ensures all cases remain compliant with required timelines for responses and required Zelis input
• Performs other related responsibilities as assigned.

Benefits

• Zelis’ full-time associates are eligible for a highly competitive benefits package as well, which demonstrates our commitment to our employees’ health, well-being, and financial protection.
• The US-based benefits include a 401k plan with employer match, flexible paid time off, holidays, parental leaves, life and disability insurance, and health benefits including medical, dental, vision, and prescription drug coverage.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Number of Employees: 1,001-5,000 employees