Client Integration Specialist

At Zelis, we Get Stuff Done. So, let’s get to it!

A Little About Us
Zelis is modernizing the healthcare financial experience across payers, providers, and healthcare consumers. We serve more than 725 payers, including the top five national health plans, regional health plans, TPAs and millions of healthcare providers and consumers across our platform of solutions. Zelis sees across the system to identify, optimize, and solve problems holistically with technology built by healthcare experts – driving real, measurable results for clients.

At Zelis, AI is woven into the fabric of how we work. Every associate is expected - and empowered - to partner with AI to challenge the status quo, accelerate innovation, and amplify their impact. This is a place for builders with a growth mindset who act with agility, embrace change, and use modern technology to shape smarter solutions, exceptional experiences, and the future of our industry for our clients, customers, and our culture.

A Little About You
You bring a unique blend of personality and professional expertise to your work, inspiring others with your passion and dedication. Your career is a testament to your diverse experiences, community involvement, and the valuable lessons you've learned along the way. You are more than just your resume; you are a reflection of your achievements, the knowledge you've gained, and the personal interests that shape who you are.

Position Overview
The Client Integration Specialist will have primary responsibility for delivering on the key performance components to achieve goals and results for the Zelis Claims Cost Solutions department. The day-to-day activities of the Client Integration Specialist will align with the overall mission of Zelis Claims Cost Solutions with adherence to best practice policies while serving as a liaison between the Implementation and Edit Configuration team when onboarding new editing clients.

What You’ll Do:

- Work with greater autonomy for longer term activities independently; May lead or teach others regarding process or tasks

- Correct issues that may not immediately be evident; Present unsolicited ideas to leaders

- Disseminate information with some guidance, Majority of interaction with internal and external colleagues

- Leads day-to-day client-facing activities, new initiatives, processes, and system enhancements while supporting pre-production testing processes.

- Demonstrate outstanding presentation and communication skills while providing an overview of the Zelis edit suites during new editing client implementations

- 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

- Partner with configuration business partners to ensure appropriate set up and configuration of customization based on client specific payment policies and lines of business

- Facilitate debriefing of client decisions and research policy related issues identified during editing testing process

- Collaborate with business partners to effectively support the pre-production testing process for client selected edit suites while providing on-going support to Implementation partners

- Perform as subject matter expert (SME) to provide coding and client specific guidance regarding internal policies and various lines of business

- Utilize reporting tools and metrices to manage deliverables for external and internal client meetings

- Participate actively in day-to-day client facing activities, new initiatives, processes, and system enhancements

- Facilitate all internal work, solutions to issues and communication of status with the Claims Edits ECR and CPS teams

- Outstanding presentation and communication skills

- Ensure compliance with HIPAA regulations and requirements.

- Adhere to Zelis standards regarding privacy.

- The position responsibilities outlined above are in no way to be construed as all encompassing. Other duties, responsibilities, and qualifications may be required and/or assigned as necessary. ​

- 70% Transactional, 30% Tactical

What You’ll Bring to Zelis:

- Typically has Bach. +4 yrs;  Masters +2 yrs Attends company training and regional training in area of expertise. Presents own work to members of department and external consultants and external professional meetings

- Extensive knowledge of reimbursement methodologies and acceptable billing practices

- Knowledge of payer reimbursement policies, state and federal regulations and applicable industry standards

- Certified Professional Coder (CPC) Required

- Must possess outstanding presentation and communication skills with proven ability to deliver client presentations

- Project management

- Experience managing internal and external relationships

- Excellent verbal & written communication skills

- Proficient in Microsoft Office, Word, Ex cel

Please note at this time we are unable to proceed with candidates who require visa sponsorship now or in the future.

Location and Workplace Flexibility
Zelis is headquartered in the U.S., with multiple locations across the country and in Hyderabad, India. Check out our locations to learn more about our offices. All employee work locations are based on the needs of the position and are determined by the Leadership team. In-office work and activities vary based on work and team objectives in accordance with Company policies.

While location expectations vary by role, candidates within approximately 50 miles of a U.S. office are generally preferred to support collaboration when needed. Our hybrid approach is flexible, and in-office presence is guided by team and business needs rather than a fixed weekly schedule.

Base Salary Range
$79,000.00 - $99,750.00
At Zelis we are committed to providing fair and equitable compensation packages. The base salary range allows us to make an offer that considers multiple individualized factors, including experience, education, qualifications, as well as job-related and industry-related knowledge and skills, etc. Base pay is just one part of our Total Rewards package, which may also include discretionary bonus plans, commissions, or other incentives depending on the role.

Zelis’ full-time associates are eligible for a highly competitive benefits package as well, which demonstrates our commitment to our employees’ health, well-being, and financial protection. The US-based benefits include a 401k plan with employer match, flexible paid time off, holidays, parental leaves, life and disability insurance, and health benefits including medical, dental, vision, and prescription drug coverage.

Equal Employment Opportunity
Zelis is proud to be an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.

We welcome applicants from all backgrounds and encourage you to apply even if you don’t meet 100% of the qualifications for the role. We believe in the value of diverse perspectives and experiences and are committed to building an inclusive workplace for all.

Accessibility Support
We are dedicated to ensuring our application process is accessible to all candidates. If you are a qualified individual with a disability or a disabled veteran and require a reasonable accommodation with any part of the application and/or interview process, please email TalentAcquisition@zelis.com .

Disclaimer
The above statements are intended to describe the general nature and level of work being performed by people assigned to this classification. They are not to be construed as an exhaustive list of all responsibilities, duties, and skills required of personnel so classified. All personnel may be required to perform duties outside of their normal responsibilities, duties, and skills from time to time.