Claims Settlement Specialist - Network Solutions

Claim Settlement – Financial Settlement - Negotiation

Zelis is a healthcare information technology company and market-leading provider of end-to-end healthcare claims cost management and payments solutions.  As part of our growth, we are seeking a new Claims Settlement Specialist to join our team in Atlanta, GA to support our Network Solutions Division.

The Claims Settlement Specialist is responsible for financial settlement of medical claims/bills on behalf of Zelis payor clients. The Claims Settlement Specialist will be responsible for handling provider telephone calls regarding the payment amount paid to a provider by a payor based on Zelis data points.

During this call, the Claims Settlement Specialist must understand:

• the procedures billed on the claim/bill

• the estimate of the fair value of the payment that was remitted to the provider based on Medicare pricing, location/facility/provider comparisons, and Zelis’ proprietary evaluation software

• how to identify negotiation points for that particular provider if payment is not accepted, as is

• how to negotiate an acceptable payment below the provider’s billed charges.

If you have strong communication skills, are quick thinking and like to take initiative to create resolution, this could be an ideal role for you!

Thank you for your interest in the Zelis team!