Operations Analyst
Core
Provide daily operational support to the Itemized Bill Review team, managing claims screening, distribution, and audit workflows to identify client savings and ensure compliance.
Role type
Operations Analyst (Healthcare Claims)
Builds
End-to-end workflow audits for Zelis Prepay and Post-pay Programs
Domain
Healthcare / Health Insurance / Claims Processing
Deliverable
production ML models | product features | dashboards & analysis | client delivery | infrastructure
Required skills
Claims management, revenue opportunity identification, training and onboarding, inventory management, financial recovery tracking, dual acceptance claims processing, client documentation creation, resource deployment, workflow audit management
Preferred skills
Healthcare industry experience, health/medical insurance knowledge, Microsoft Office Suite proficiency, Adobe Acrobat knowledge, typing/data entry skills
Technologies
CMS, MS Office Suite, Adobe Acrobat
Responsibilities
Manage screening and distribution of Itemized Bill Review claims; Monitor new client claims post-implementation; Assist with training and onboarding of new team members; Ensure adherence to client contractual parameters and Zelis privacy standards; Create and maintain accurate client-facing documentation; Deploy resources for daily claims screening and referral processes
Seniority
Mid-level, individual contributor
