Client Integration Specialist

Position Overview

The Client Integration Specialist is primarily responsible for achieving key performance goals for the Zelis Claims Cost Solutions department. This role involves aligning daily activities with the mission of Zelis Claims Cost Solutions, adhering to best practices, and acting as a liaison between the Implementation and Edit Configuration teams during the onboarding of new editing clients.

What you'll do :

• Work autonomously on long-term activities; may lead or teach others about processes or tasks.
• Identify and correct issues that may not be immediately evident; present unsolicited ideas to leaders.
• Disseminate information with some guidance; interact mainly with internal and external colleagues.
• Lead day-to-day client-facing activities, new initiatives, processes, and system enhancements while supporting pre-production testing processes.
• Demonstrate outstanding presentation and communication skills during new editing client implementations, providing an overview of the Zelis edit suites.
• Partner effectively with Implementation business partners to provide coding guidance and Zelis editing product support during internal and external client meetings.
• Provide coding and claim adjudication guidance while interpreting client pre-production data to ensure alignment with assigned client payment policies.
• Collaborate with configuration business partners to ensure appropriate setup and customization based on client-specific payment policies and lines of business.
• Facilitate debriefing of client decisions and research policy-related issues identified during the editing testing process.
• Support the pre-production testing process for client-selected edit suites and provide ongoing support to Implementation partners.
• Serve as a subject matter expert (SME) to provide coding and client-specific guidance regarding internal policies and various lines of business.
• Utilize reporting tools and metrics to manage deliverables for external and internal client meetings.
• Actively participate in day-to-day client-facing activities, new initiatives, processes, and system enhancements.
• Facilitate internal work, solutions to issues, and communication of status with the Claims Edits ECR and CPS teams.
• Ensure compliance with HIPAA regulations and requirements.
• Adhere to Zelis standards regarding privacy.

What you'll bring to Zelis :

Location and Workplace Flexibility

We have offices in Atlanta GA, Boston MA, Morristown NJ, Plano TX, St. Louis MO, St. Petersburg FL, and Hyderabad, India. We foster a hybrid and remote friendly culture, and all our employee's work locations are based on the needs of the position and determined by the Leadership team. In-office work and activities, if applicable, vary based on the work and team objectives in accordance with Company policies.