Data Driven Analyst
Zelis (company site, opens in a new tab)5+ yrsHyderabadOn-siteDirect career pageEst. 10–18 LPA
Posted 2d ago
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Job description
Structured overview of role & requirements
About This Role
- Develop and deliver claims edit initiatives focusing on building and testing edits for physician and facility claims using industry standards and proprietary sources.
- Collaborate with Operations, Sales, and IT departments to ensure scalability, functionality, and growth of the claims edit platform.
- Provide subject matter expertise on coding, ensure compliance with HIPAA and quality assurance guidelines, and support client inquiries with documentation and rationale.
Minimum Requirements
- 5+ years experience in healthcare or related industry.
- Current certified coder credential required (CCS, CCS-P, CPC), or registered health information technician (RHIA/RHIT), or nurse (RN, LPN) with coding knowledge.
- Proficient in Microsoft Word and PowerPoint; intermediate to advanced Excel skills preferred.
- Bachelor’s degree preferred in business, healthcare, or technology.
Ideal Candidate Profile
- Strong coding expertise with ability to translate regulatory and coding standards into actionable edits for claims processing.
- Experience working cross-functionally with operations, sales, and IT to drive scalable healthcare technology solutions.
- Analytical thinker with solid project and process management skills, capable of managing multiple projects and adapting to continuous changes.