At Zelis, the Client Relationship Manager is a vital role in ensuring service excellence to Payer Compass clients and their members. This client liaison role will interact with providers and members and is a subject matter expert (SME) in supporting clients, their employer groups, and health plan members with inquiries, services, or issues. This position requires the ability to act independently within the scope of assigned duties and responsibilities.

Key Responsibilities

• Handle escalated issues, and contacts as assigned, ensuring timely and thorough research and proper resolution

• Respond to inbound inquiries from TPA clients, their Client Employer Groups as well as from Plan members and providers

• Collaborate and coordinate interdepartmentally to research and solution for client issues, requests, and needs to bring about resolution within a timely manner

• Participate in new client implementations, subsequent group implementations, business requirement sessions, and User Acceptance Testing

• Participate in client conference calls as needed

• Exemplify professionalism, diplomacy, service excellence, and compliance with established polies, procedures, and protocols

• Assist with Memorandums of Understanding and Single Case Agreements, and code pricing within the Visium™ system

• Respond to and assist Patient Advocates and Patient Advocacy Supervisor with their questions/issues

• Assist with client reporting as needed for Patient and Resolution Advocacy

• Identify and recommend opportunities for efficiencies, performance improvement, and system enhancements to ensure service excellence.

• Comply with HIPAA regulations and ensure confidentiality of calls, documents, and other sensitive information

• Back-fill for Patient Advocate role as needed

• Properly document activity and calls in the appropriate system

Skills, Knowledge and Abilities:

• High school diploma or equivalent required, Bachelor’s degree preferred

• A minimum of 5 years within the Health Insurance industry, patient advocacy, customer service, provider relations, or claims administration

• Excellent attention to detail, time management and decision-making skills

• Excellent customer service skills

• Ability to maintain professionalism, decorum, tact, and diplomacy even during tense situations

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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, 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.