Hybrid Client Inquiry Analyst

at Zelis

• Job title: Client Inquiry Analyst
• Job type: Full Time
• Experience level: Mid level, Senior
• Salary: $65,000 - $87,000 per year
• Degree requirement: Bachelor's Degree
• Tech skills: SQL, Tableau
• Location requirements: Hybrid, Atlanta, United States

About the role

• Client Inquiry Analyst resolving inquiries for healthcare financial solutions across multiple states. Collaborating with teams to enhance client experience and satisfaction in healthcare industry.

Responsibilities

• Perform as subject matter expert (SME) to provide coding and claim adjudication guidance for all assigned clients.
• Demonstrate an expert level of understanding of the Zelis editing products with an ability to clearly articulate correct coding and claim adjudication guidelines.
• Demonstrate the ability to provide written responses that provides clarity and guidance to all internal and external client inquiries.
• Effectively utilize all tools and applications for the resolution and escalation of all internal/external edit/claim inquiries.
• Manage day-to-day activities to ensure all inquiries received are responded to and resolved within appropriate timeframes per specified Service Level Agreements (SLAs)
• Actively participate in all external/internal client meetings by providing an overview of identified inquiry or edit trends for assigned clients
• Proactively identify, resolve and escalate client issues while effectively partnering with assigned business partners to maintain strong internal and external relationships
• Effectively analyze data to ensure proactive identification, escalation and resolution of client issues
• Effectively prioritize to deliver on-time completion of all tasks assigned
• Ensure compliance with HIPAA regulations and requirements.
• Build and maintain strong, long-lasting relationships with other teams through regular communication and proactive engagement.
• Analyze client data to identify trends, patterns, and areas for improvement.
• Develop and deliver insightful reports and presentations to clients, highlighting key findings and recommendations.
• Monitor client performance metrics and provide actionable insights to drive client success.
• Collaborate with cross-functional teams to identify and implement process improvements that enhance the client experience.
• Gather and analyze client feedback to inform product development and service enhancements.
• Stay up-to-date with industry trends and best practices to ensure our client success strategies remain competitive and effective.

Requirements

• Bachelor’s degree in Business, Healthcare, Data Analytics, or a related field
• 3+ years of relevant education and work experience with healthcare payers
• Current certified coder (AAPC or AHIMA), Registered Health Information (RHIA/RHIT) certifications, or RN/LPN with coding knowledge required.
• Extensive knowledge of correct coding, industry standard claim adjudication guidelines and policies
• Extensive knowledge and ability to translate coding and adjudication guidelines, policies, and references into edit policies and rules
• Excellent verbal & written communication skills
• Strong analytical skills with the ability to interpret complex data and provide actionable insights
• Proficiency in data analysis tools and software (e.g., Excel, SQL, Tableau)
• Strong problem-solving skills and the ability to think critically and strategically
• Ability to work independently and as part of a team in a fast-paced, dynamic environment

Benefits

• 401k plan with employer match
• flexible paid time off
• holidays
• parental leaves
• life and disability insurance
• health benefits including medical, dental, vision, and prescription drug coverage