Document Retrieval Specialist

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 Document Retrieval Specialist is responsible for supporting the medical claim review and audit process by proactively contacting healthcare providers to request, obtain, and manage billing documentation. This role serves as a key liaison between providers and internal teams, ensuring that required records are received in a timely manner to facilitate accurate claim evaluation and processing. The specialist is responsible for maintaining consistent follow-up on outstanding requests, uploading and organizing received documentation, and reviewing records for completeness, accuracy, and compliance with client requirements. Success in this role requires strong organizational skills, attention to detail, effective communication, and the ability to manage multiple priorities while meeting established productivity and quality standards. What You’ll Do Assist the nursing staff in the medical claim audit process by contacting healthcare providers to request and obtain billing documents via fax, mail, and email for claims processing. Receive and upload retrieved documents into designated systems, ensuring documents are properly indexed and associated with the correct claim. Review uploaded documentation for completeness, accuracy, and compliance with client and provider requirements, identifying and escalating discrepancies as appropriate. Organize and prioritize assigned claims daily and conduct timely follow-up on outstanding document requests. Accurately document outreach attempts, provider communications, request statuses, and other relevant information. Utilize document retrieval systems and related tools efficiently. Learn and process requests according to applicable provider and client requirements. Meet or exceed the Document Retrieval Performance Standards established by the Document Retrieval department. Maintain awareness of and adherence to Zelis standards regarding privacy and confidentiality. What You’ll Bring To Zelis Previous healthcare, medical claims, billing, or customer service experience preferred. Knowledge of Microsoft Office Suite and web-based systems. Strong prioritizing & organizational skills. Excellent customer service & telephone skills. Independence/accountability Requires minimal daily supervision on day-to-day tasks but seeks guidance on more complex tasks; Accountable for day-to-day tasks; Able to follow detailed instructions on new assignments; Maintains professionalism and confidentiality of administrative matters and files; Able to manage and prioritize multiple tasks; Able to work under pressure and meet deadlines; Completes work in a timely manner; Attention to detail. Communication Skills Works well and collaborates effectively with others; Communicates effectively by giving and receiving feedback; Demonstrates professional telephone etiquette and customer service skills; Communicates ideas and information clearly and professionally. Education High School Diploma Associate’s degree a plus Visa Sponsorship 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 $15.00 - $19.00 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 View email address on click.appcast.io. 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. #J-18808-Ljbffr