Zelis

• Partner with Digital Experience leadership to manage and execute the digital experience roadmap. • Serve as the primary liaison between Marketing and the Zelis.com IT development team, helping prioritize work, manage capacity, refine backlog items, and ensure successful delivery of initiatives. • Own and maintain the Digital Marketing Design System in partnership with Creative Design, including design documentation, web templates, components, and design tokens. • Facilitate sprint planning, backlog grooming, requirements gathering, prioritization, and stakeholder alignment activities. • Lead project management activities for digital experience initiatives, ensuring projects remain on schedule, within scope, and aligned to business objectives. • Coordinate cross-functional teams including Marketing, Creative, Product, Analytics, IT, and external vendors. • Support planning and execution of large-scale digital transformation initiatives, including future CMS/DXP platform migrations. • Manage vendor relationships and serve as a key point of contact for project meetings, deliverables, timelines, status reporting, and issue resolution. • Develop project plans, maintain project documentation, track dependencies, and proactively identify risks and mitigation strategies. • Collaborate with UX, Creative, and Development teams to ensure digital experiences align with user needs, business goals, and best practices. • Support testing, quality assurance, and release coordination activities. • Provide regular updates and executive-ready reporting on project status, roadmap progress, and key performance indicators. • Assist with ad hoc digital experience initiatives and operational support as needed.

• Foster a collaborative, inclusive engineering culture that values diverse perspectives and continuous learning • Provide coaching and mentorship to managers and senior engineers, strengthening leadership depth and team effectiveness • Support organizational priorities through thoughtful talent planning, development, and retention strategies • Partner with leadership to reinforce a culture of accountability, transparency, and engagement • Translate enterprise and product strategy into clear engineering priorities, roadmaps, and deliverables • Partner closely with Product and Architecture to deliver scalable, customer-centric solutions • Drive adoption of modern engineering practices and technologies to improve speed, quality, and reliability • Establish and maintain engineering standards, processes, and metrics to drive consistent, high-quality delivery • Optimize team performance through data-driven insights, continuous improvement, and effective resource allocation • Promote cross-functional collaboration to ensure seamless execution across Technology, Product, and business partners • Support operational rigor across global teams, ensuring effective delivery across time zones

• Design, develop, test, and maintain enterprise-grade software applications and services using C#, Rust, and related technologies • Develop and optimize complex SQL queries, stored procedures, and database solutions to support high-volume transaction processing • Design and implement APIs, data integrations, and services utilizing JSON and modern integration patterns • Analyze, develop, and support EDI transaction processing, including troubleshooting and enhancement of inbound and outbound data exchanges • Collaborate with product owners, business analysts, and stakeholders to translate business requirements into technical solutions • Participate in architecture discussions and contribute to long-term technical strategy and platform modernization efforts • Ensure application performance, scalability, security, and reliability through best engineering practices • Conduct code reviews and provide technical mentorship to software engineers and developers • Support production environments by investigating issues, identifying root causes, and implementing corrective actions that improve system stability, reliability, and performance • Create and maintain technical documentation, design specifications, and operational procedures • Work closely with healthcare and benefits subject matter experts to ensure solutions align with industry standards and business requirements

Title: IBR Senior Analyst Location: United States locations US FL Remote US MO Remote US NJ Remote US MA Remote US TX Remote time type Full time Job Description: 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 750 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 Itemized Bill Review Senior Analyst will be responsible for analyzing hospital claims for adherence to proper billing guidelines and will work closely with Expert Claims Review staff to efficiently adhere to policies and procedures for claims processing. This position will also be responsible for training and developing new team associates, report management, and acceptance of claims above the team members' threshold once analysis is complete. Assisting the manager and the team in areas of need will be required. What you'll do: - - Responsible for conducting detailed review of hospital itemized bills for identification of billing and coding opportunities for all payor's claims. - Prepare and upload documentation clearly identifying findings. - Accurately calculate/verify the value of compliance edits and documentation for claim processing. - Monitor multiple reports to track client specific requirements, turnaround time and overall claims progression. - Complete claims processing after the Clinical Bill Review and Audit analysis is completed. Savings acceptance threshold not to exceed $50,000.00 - Adhere to department billing guidelines and documentation. - Maintain audit accuracy and productivity standards per the latest requirements. - Perform regular audits of lower-level team members for quality assurance, providing detailed feedback and education. - Train/Develop new team members utilizing the standard operating procedures and training manual. - Assist team members with daily claim inquiries and difficult claim processing. - Respond to inquiries from Client Services and Provider Services in a timely manner regarding the reacceptance/revision/reprocessing of claims, claim inquiries, and appeal reviews when necessary. - Coordinate/Manage the set up and processing of dual acceptance claims, as well as the creation and accuracy of client facing documentation. - Maintain awareness of and ensure adherence to Zelis standards regarding privacy. - Assist other Zelis staff members as needed, and as requested. What you'll bring to Zelis: - - CPC, or other coding certification, strongly preferred. - 2-4+ years of experience within healthcare industry, - Experienced with health/medical insurance and processing of claims. - Expert knowledge of facility claims, billing, and reimbursement. - Knowledge of ICD-10 and CPT coding guidelines. - Proficient in Microsoft Office, including Outlook, Excel, and Word. - Business writing and oral communications proficiency. - Ability to multitask and strong attention to detail. - Diligent research and organizational skills. - Demonstrates solid understanding of audit techniques, identification of revenue opportunities and financial negotiation with providers. - Proficiency in training techniques aimed at conveying subject matter expertise and scaling staff to maximize savings and revenue. - Computer proficiency and technical aptitude with the ability to utilize CMS, EncoderPro, other audit software and tools, MS Office Suite. - Thorough knowledge of company and departmental policies and procedures. 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.

• Support and maintain the mission-critical Cost Roll process by ensuring accurate aggregation of healthcare claims data and precise matching of claims to provider demographic data. • Maintain and monitor data workflows that aggregate healthcare claims data for the Cost Roll process. • Validate and reconcile claims and provider demographic data to ensure accurate provider matching and data quality. • Investigate, troubleshoot, and resolve data issues that could impact financial, clinical, and provider management systems. • Perform data validation, quality checks, and operational support activities to ensure clean and reliable datasets. • Collaborate with stakeholders to support ongoing data processing, reporting, and operational reliability initiatives.

• Handle moderately complex customer issues that require deeper product knowledge, multi-step troubleshooting, or coordination with other departments. • Serve as a resource for other representatives, providing guidance, informal coaching, and support in resolving customer inquiries. • Analyze customer interactions to identify patterns or recurring issues, and proactively suggest improvements to scripts, workflows, or FAQs. • Ensure accurate and complete documentation of customer cases, including resolution steps, follow-up actions, and feedback for quality assurance. • Collaborate with internal teams such as billing, technical support, or fulfillment to resolve cross-functional issues impacting customer experience. • Contribute to process improvement initiatives, including pilot testing new tools or procedures and providing feedback to supervisors.

• Own and define the Solution Advisor function across Pricing Solutions, including strategy, operating model, and execution priorities • Establish and evolve the SA engagement framework, ensuring consistent deployment of resources against high-impact opportunities • Drive transformation of the SA function from generalist support to strategic solution authority • Oversee and guide solution design for complex, multi-product, and high-value deals across Pricing Solutions • Partner with Sales and Client Management leadership to shape deal strategy, validate feasibility, and align solutions with business capabilities • Ensure consistency in solution architecture, pricing models, and regulatory considerations across all offerings • Identify and drive expansion opportunities within existing clients, including upsell and cross-sell initiatives • Partner with Sales and Client Management to optimize client outcomes and revenue growth • Provide strategic insights into client performance, utilization, and optimization opportunities • Partner with executive leadership across Product, Sales, Client Management, Legal, Marketing, and Operations

• Design and implement enterprise-grade automation frameworks integrating RPA, AI/ML, and cloud-native services (Azure Logic Apps, AWS Step Functions). • Establish standards for bot orchestration, error handling, and scalability. • Implement complex integrations across ERP, CRM, and custom applications using APIs and middleware. • Ensure compliance with Security, privacy, regulatory requirements and cybersecurity standards in automation solutions. • Conduct capacity planning and load testing for automation infrastructure. • Optimize bot utilization and resource allocation across environments. • Lead small project teams and provide technical guidance throughout the project lifecycle. • Identify and mitigate technical risks and dependencies across systems. • Lead design sessions and ensure alignment with business and technical goals. • Guide and mentor engineering teams in solving complex technical challenges. • Evaluate emerging technologies and recommend adoption strategies for long-term innovation. • Collaborate with stakeholders to define technical roadmaps and project milestones. • Lead incident response and post-mortem analysis for critical production issues.

• Maximize the breadth and depth of relationships by working closely with clients • Manage and oversee revenue targets, including budgets, forecasts, and product utilization review for the assigned book of business • Responsible for client renewals and retention • Successfully lead contract negotiations and manage the complete life cycle to renew client agreements • Proactively identify and mitigate risks such as volume decreases, service gaps, and changes in client relationships • Drive revenue growth through existing product optimization • Successfully uncover and qualify opportunities for growth • Conduct and lead all client business reviews and account plans • Ensure industry leading quality service delivery and client satisfaction;

• Maximize the breadth and depth of relationships by working closely with clients to intimately understand their business strategies, needs, and challenges as well as how Zelis supports the achievement of those goals. • Manage and oversee revenue targets, including budgets, forecasts, and product utilization review for the assigned book of business. • Responsible for client renewals and retention. • Successfully lead contract negotiations and manage the complete life cycle to renew client agreements while looking for ways to expand the partnership. • Proactively identify and mitigate risks such as volume decreases, service gaps, and changes in client relationships. • Drive revenue growth through existing product optimization, understand and communicate key differentiators, product strategy, features, and functionality. • Successfully uncover and qualify opportunities for growth to deliver great client value. • Collaborate with sales to present innovative solutions and grow existing client base. • Effectively illustrate and validate client outcomes consistently, leveraging client reporting and knowledge of client’s business goals and measures Conduct Client Business Reviews. • Conduct and lead all client business reviews and account plans to optimize value with the client's book of business. • Ensure industry leading quality service delivery and client satisfaction; measurements include proactive client management, timely escalation and resolution of issues, and nurture clients into loyal promoters. • Secure client references and permission in support of key Zelis initiatives and case studies as needed.