Regulated Claims Settlement Coordinator

Zelis • Atlanta, GA

3d • $19 - $24 • Hybrid

About The Position

At Zelis, we Get Stuff Done. So, let’s get to it! A Little About Us 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. A Little About You 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. Position Overview 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