Zelis Healthcare

About Us

Zelis is modernizing the healthcare financial experience in the United States (U.S.) by providing a connected platform that bridges the gaps and aligns interests across payers, providers, and healthcare consumers. This platform serves more than 750 payers, including the top 5 health plans, BCBS insurers, regional health plans, TPAs and self-insured employers, and millions of healthcare providers and consumers in the U.S. Zelis sees across the system to identify, optimize, and solve problems holistically with technology built by healthcare experts—driving real, measurable results for clients.

Why We Do What We Do

In the U.S., consumers, payers, and providers face significant challenges throughout the healthcare financial journey. Zelis helps streamline the process by offering solutions that improve transparency, efficiency, and communication among all parties involved. By addressing the obstacles that patients face in accessing care, navigating the intricacies of insurance claims, and the logistical challenges healthcare providers encounter with processing payments, Zelis aims to create a more seamless and effective healthcare financial system.

Zelis India plays a crucial role in this mission by supporting various initiatives that enhance the healthcare financial experience. The local team contributes to the development and implementation of innovative solutions, ensuring that technology and processes are optimized for efficiency and effectiveness. Beyond operational expertise, Zelis India cultivates a collaborative work culture, leadership development, and global exposure, creating a dynamic environment for professional growth. With hybrid work flexibility, comprehensive healthcare benefits, financial wellness programs, and cultural celebrations, we foster a holistic workplace experience. Additionally, the team plays a vital role in maintaining high standards of service delivery and contributes to Zelis’ award-winning culture.

Position Overview

The Visium Systems Analyst (VSA) is responsible for analyzing, designing, and implementing information systems that optimize claims editing efficiency and effectiveness. The role requires a deep understanding of technical and business needs, and the ability to bridge the gap between technology and business processes as it relates to claims editing. This role will partner with the claims editing team and the Visium development team with a primary focus on the following: claims editing analysis and research, table builds and data loading preparation, defect research and resolution, and enhancement requests and support.

The Visium Systems Analyst role will partner closely with the team around projects for the build out of the claims edit platform for physician and facility claims including support for communication and documentation. Will work closely with Data Driven Edits (DDE) team and the development teams in the development of edits as it relates to scalability, functionality, and initiatives imperative to growth.

KEY RESPONSIBILITIES:

• Requirements Gathering: Collaborate with stakeholders to identify and document business requirements for the Claims Editing team and translate them into technical specifications for the Visium Development team.
• System Design: Develop detailed system designs, workflow diagrams, and user interfaces, ensuring alignment with business objectives. Test and validate Visium enhancements and development efforts as it relates to Claims Editing.
• Implementation Support: Assist in the installation, configuration, testing, and maintenance of Visium Claims Editing requests.
• Problem Solving: Diagnose and resolve system issues, providing technical support and troubleshooting guidance to end-users. Provide written response, documentation and rationale for inquiries as needed.
• Documentation: Create and maintain comprehensive documentation, including system specifications, user manuals, and training materials. Serve as a Visium subject matter expert and provide support where needed.
• Continuous Improvement: Identify opportunities for system enhancements and process improvements, recommending innovative solutions to drive efficiency. Performs other related responsibilities and special projects as assigned.
• Compliance: Ensure that systems comply with industry standards, regulatory requirements, and organizational policies. Ensure adherence to quality assurance guidelines. Maintains awareness of and ensure adherence to ZELIS standards regarding privacy.

PROFESSIONAL EXPERIENCE:

Skills Experience: Proven experience (5+ years) as a Systems Analyst in healthcare or in a similar role, with a strong understanding of software development and claims editing systems.

• Technical Skills: basic knowledge of programming languages, database management, and system integration techniques preferred; advanced skills in Excel required. Experience with Jira and Confluence preferred.
• Analytical Skills: Strong problem-solving abilities, with the capacity to analyze complex systems and identify root causes. Consistently demonstrate ability to act and react swiftly to continuous challenges and changes.
• Communication Skills: Excellent written and verbal communication skills, with the ability to convey technical concepts to non-technical stakeholders.
• Project Management: Experience managing projects, with a focus on meeting deadlines and delivering quality outcomes. Creative problem-solving skills, leveraging insights and input from other parts of an organization while remaining curious.
• Attention to Detail: High level of accuracy and attention to detail, ensuring the integrity of system data and processes.
• Team Collaboration: Ability to work effectively as part of a team, collaborating with diverse groups to achieve common goals.

EDUCATION:

• Current certified coder (CCS, CCS-P or CPC) preferred

WORK ENVIRONMENT:

• Travel, work-from-home, and in-office requirements should adhere to the standards set by the India office and reporting managers. Travel requirements to (primarily) domestic destinations should not exceed 10%.
• A standard work week exists but with the understanding that additional time/effort outside of the usual parameters can/will occur based upon the overall needs of the claims editing team, where deadlines exist and when necessary due to the needs of the team.
• Ability to sit for extended periods of time.

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 required of personnel so classified. All personnel may be required to perform duties outside of their normal responsibilities from time to time, as needed.