The Coding Validation Analyst manages the Coding Validation queues and is responsible for documenting results of claims performance for new/updated edits through claims review based on new or updated edit logic. This will include analysis/reporting of edit performance and root-cause research of edits that may not perform as intended. The Claims Validation Analyst supports the Claims Editing department with ad-hoc requests from other departments that involve claim validations and all tasks associated with the support of claim workflows relating to Claims Editing.
Zelis is a healthcare and financial technology growth company and market-leading provider of claims cost management and payments optimization solutions to price, pay and explain healthcare claims. Zelis delivers integrated network analytics, network solutions, payment integrity, electronic payments and claims communications for payers, healthcare providers and consumers in the medical, dental and workers’ compensation markets nationwide. Zelis is backed by Parthenon Capital Partners and Bain Capital.
“We are an equal opportunity employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability status, protected veteran status, or any other characteristic protected by law.”