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Business Analyst - Expert Bill Review

Sapphire Digital

Sapphire Digital

Morristown, NJ, USA · Morristown, TN, USA · St. Louis, MO, USA · Texas, USA · Boston, MA, USA · Boston, MA, USA · St. Petersburg, FL, USA · Petersburg, VA, USA · Atlanta, GA, USA · Atlanta, GA, USA
Posted on Wednesday, June 14, 2023

Position Overview

The Business Analyst, Expert Bill Review is responsible for enabling high quality business analytics solutions in an Agile context that deliver valued business outcomes and informed decisions for Zelis’ key stakeholders in the Expert Bill Review department. The Business Analyst works as part of the Product team to facilitate clear and open communication between Business Owners, Scrum/Development, Quality Assurance, and the Product Owner. This role provides a major contribution to enhancing Zelis’ overall capacity to meet the information technology needs of an ever-changing healthcare market.

Key Responsibilities

  • Act as a Subject Matter Expert for teams, including Product Management, Development, Account Management, Solution Advisors and Operations

  • Gather requirements/acceptance criteria for Expert Bill Review initiatives centered around handling of medical claims for accurate claim payment review through our suite of solutions

  • Provide documentation for system/process updates and existing system functionality for reference by operations

  • Work closely with Product Management, Development, QA and UAT to ensure requirements are realized properly upon release to production

  • Assist in providing training to operations on newly released items

  • Recommend process, workflow and efficiency improvements while keeping the team informed on upcoming product development improvements and new product solutions being taken to market

  • Draft and send release notes and organize user requirements by scheduling meetings with appropriate stakeholders to track and manage accordingly

Skills, Knowledge and Abilities

  • Basic or advanced understanding of payment integrity; itemized bill/clinical preferred

  • Understanding of medical coding and medical claims

  • Ability to see the big picture and learn new processes, technologies and envision how they could benefit Zelis

  • Ability to partner with one or more Product Owners on key initiatives and prioritization efforts

  • Project Management experience; ability to drive output from others without direct supervisory responsibility

  • Excellent problem solving and analytical skills

  • Ability to prioritize and manage multiple concurrent projects


As a leading payments company in healthcare, we guide, price, explain, and pay for care on behalf of insurers and their members. We’re Zelis in our pursuit to align the interests of payers, providers, and consumers to deliver a better financial experience and more affordable, transparent care for all. We partner with more than 700 payers, including the top-5 national health plans, BCBS insurers, regional health plans, TPAs and self-insured employers, over 4 million providers, and 100 million members, enabling the healthcare industry to pay for care, with care. Zelis brings adaptive technology, a deeply ingrained service culture, and a comprehensive navigation through adjudication and payment platform to manage the complete payment process.

Commitment to Diversity, Equity, Inclusion, and Belonging
At Zelis, we champion diversity, equity, inclusion, and belonging in all aspects of our operations. We embrace the power of diversity and create an environment where people can bring their authentic and best selves to work. We know that a sense of belonging is key not only to your success at Zelis, but also to your ability to bring your best each day.

Equal Employment Opportunity
Zelis is proud to be an equal opportunity employer. All 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 encourage members of traditionally underrepresented communities to apply, even if you do not believe you 100% fit the qualifications of the position, including women, LGBTQIA people, people of color, and people with disabilities.

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, to request the reasonable accommodation request form, please email TalentAcquisition@zelis.com

SCAM ALERT: There is an active nationwide employment scam which is now using Zelis to garner personal information or financial scams. This site is secure, and any applications made here are with our legitimate partner. If you’re contacted by a Zelis Recruiter, please ensure whomever is contacting you truly represents Zelis Healthcare. We will never asked for the exchange of any money or credit card details during the recruitment process. Please be aware of any suspicious email activity from people who could be pretending to be recruiters or senior professionals at Zelis.