What are the responsibilities and job description for the Claims Negotiator in Healthcare position at Zelis Payments, part of Zelis?
Job Overview
We are seeking a detail-oriented Healthcare Claims Negotiator to join our team at Zelis. This role is focused on developing and nurturing strong relationships with medical providers, while strictly adhering to our clients’ policies and regulatory standards. Your primary goal will be to maximize cost savings for clients through strategic negotiation on out-of-network claims.
Key Responsibilities
At Zelis, we are committed to fostering your professional development. This role presents the opportunity to enhance your negotiation skills and deepen your knowledge of healthcare claims, paving the way for future advancement within the organization.
Company Culture And Values
Our team-centric culture at Zelis encourages collaboration and support across departments. We believe in the power of teamwork to achieve shared success and are dedicated to creating an inclusive work environment that values diversity and individual contributions.
Employment Type: Full-Time
We are seeking a detail-oriented Healthcare Claims Negotiator to join our team at Zelis. This role is focused on developing and nurturing strong relationships with medical providers, while strictly adhering to our clients’ policies and regulatory standards. Your primary goal will be to maximize cost savings for clients through strategic negotiation on out-of-network claims.
Key Responsibilities
- Engage with medical providers to negotiate optimal discounts on out-of-network claims submitted to Zelis.
- Establish contracts with medical providers by utilizing current out-of-network claims and conducting outreach, including cold calling to generate bulk contracting opportunities.
- Monitor the In-Process Claims Report to ensure timely response and meet client turnaround expectations.
- Assist providers with any related disputes or issues, ensuring a smooth resolution process.
- Collaborate with Client Service Associates regarding claim inquiries as requested by providers.
- Work in conjunction with various departments within the Zelis Enterprise, including the Claims Integrity Division.
- Maintain a thorough awareness of and adhere to Zelis standards concerning privacy regulations.
- Proficient negotiation skills with a track record of achieving favorable results.
- Exceptional communication and interpersonal skills, with the ability to establish and maintain relationships with medical providers.
- Strong aptitude for managing disputes and resolving issues effectively.
- Familiarity with healthcare regulations and compliance standards.
- Proven experience in healthcare claims negotiation or a related field.
- Comprehensive understanding of out-of-network claims processes.
- Ability to collaborate effectively within a team environment.
At Zelis, we are committed to fostering your professional development. This role presents the opportunity to enhance your negotiation skills and deepen your knowledge of healthcare claims, paving the way for future advancement within the organization.
Company Culture And Values
Our team-centric culture at Zelis encourages collaboration and support across departments. We believe in the power of teamwork to achieve shared success and are dedicated to creating an inclusive work environment that values diversity and individual contributions.
Employment Type: Full-Time
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