Contract Analyst I
$54k - $68.4kTyler Kosmas - State Farm Agent
Job Title
This position requires an incumbent to analyze healthcare reimbursement contracts and load contract terms between payers and providers in an accurate and timely manner using proprietary software.
What You'll Do:
- Set up basic contract loads: simple single case agreements (SCAs), basic % of billed charges (BCs), basic % of Medicare, general carve-out codes and basic fee schedule set up.
- Interpret complex contract terms, analyze reimbursement methodologies, and rate structures (e.g., DRG, APC, CPT/HCPCS, ICD-10).
- Load, maintain, and audit client contracts within the adjudication system.
- Validate and test contract configurations for claims pricing accuracy.
- Maintain fee schedule in contract databases and apply annual escalators for client auto renewals.
- Link contracts to payer products, update and maintain provider groups within client databases to ensure seamless claims routing.
- Handles confidential material on a regular basis and is responsible for protecting the confidentiality of such information within the established guidelines of Company and law. (HIPAA Compliance)
What You'll Bring to Zelis:
- Bachelor's Degree or equivalent work experience in Healthcare Revenue Cycle Management/Contracting field.
- Microsoft product proficiency. Must be an intermediate to expert user of Excel
- Posses strong analytical and math skills.
Location and Workplace Flexibility
Zelis is headquartered in the U.S., with multiple locations across the country and in Hyderabad, India. 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.
Base Salary Range
$54,000.00 - $68,400.00
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.
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 View email address on click.appcast.io.
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