What are the responsibilities and job description for the Resolution Analyst for Provider Dispute Management position at Zelis Payments, part of Zelis?
Job Overview
We are seeking a dedicated and detail-oriented Provider Dispute Resolution Analyst to join our team. This role is pivotal in managing and resolving provider disputes associated with Fee Negotiation, Network, Multi-Service, and Bill Review & Audit claims. Successful candidates will exhibit exceptional customer service capabilities, characterized by articulate verbal and written communication skills. The Analyst will be accountable for key performance metrics including average dispute resolution time, savings retention, and accurate documentation, all aimed at optimizing service delivery to our valued clients and providers.
Key Responsibilities
This position offers significant professional development potential, enabling individuals to build expertise in complex claims resolution and enhance their problem-solving skills, thereby paving the way for future career advancement within our organization.
Employment Type: Full-Time
We are seeking a dedicated and detail-oriented Provider Dispute Resolution Analyst to join our team. This role is pivotal in managing and resolving provider disputes associated with Fee Negotiation, Network, Multi-Service, and Bill Review & Audit claims. Successful candidates will exhibit exceptional customer service capabilities, characterized by articulate verbal and written communication skills. The Analyst will be accountable for key performance metrics including average dispute resolution time, savings retention, and accurate documentation, all aimed at optimizing service delivery to our valued clients and providers.
Key Responsibilities
- Conduct thorough research and resolve provider and client billing inquiries, renegotiating claims as needed to ensure optimal savings while consistently achieving departmental KPI goals.
- Maintain comprehensive tracking of all relevant information related to assigned disputes and resolutions.
- Collaborate extensively with internal teams, including Client Services, Network and Vendor Management, and Bill Review & Audit, to facilitate prompt issue resolution.
- Support team members in navigating complex claims or escalated provider issues.
- Provide direct communication with clients to update them on the status of their concerns and notify them of resolved issues.
- Uphold compliance with HIPAA regulations and adhere to company standards regarding privacy.
- Offer assistance to the Customer Care Team as necessary.
- Undertake additional responsibilities as assigned to support team objectives.
- Exemplary verbal and written communication skills.
- Strong analytical and problem-solving abilities.
- Knowledgeable in HIPAA standards and privacy regulations.
- Capable of tracking and analyzing information related to claim disputes.
- Collaborative approach to working with diverse internal teams.
- Diplomacy and precision in resolving issues.
- Proven experience in customer service or a dispute resolution role.
- Strong attention to detail and analytical capabilities.
- Ability to effectively manage multiple priorities in a dynamic environment.
- Experience in healthcare billing and claims processes is preferred.
This position offers significant professional development potential, enabling individuals to build expertise in complex claims resolution and enhance their problem-solving skills, thereby paving the way for future career advancement within our organization.
Employment Type: Full-Time
