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Senior Carrier Relations Specialist-1

Sapphire Digital

Sapphire Digital

Hyderabad, Telangana, India
Posted on Tuesday, June 11, 2024

Summary of Responsibilities

New Source Data Collection Efforts

  • Work with internal team to understand project requirements
  • Initiate and continue outreach with health plans until data is collected to the client’s specifications
  • Work with health plan to obtain the appropriate files and business rules to support client requirements
  • Maintain and provide frequent data collection updates to Operations team
  • Log and validate health plan data business rules
  • Facilitate communications with health plan regarding new data files
  • Work with internal and external teams regarding escalated data collection efforts

Documentation

  • Document and maintain procedures related the data collection process
  • Ensure health plan business rules are accurately documented and maintained

Collaboration

  • Provide escalation for Data Collection Efforts
  • Drive requests outside of standard data needs
  • Work closely with client-facing teams
  • Support FTP client/health plan accounts
  • Act as a mentor to team members

Summary of Qualifications

Technical Skills:

  • Ability to read, interpret, and verify data from multiple formats.
  • In-depth knowledge of data retrieval and storage systems.
  • Experience with JIRA, Confluence, data management systems, MS Office Suite

Soft Skills:

  • Excellent communication and report-writing skills.
  • Strong analytical and problem-solving abilities.
  • Experience with end-user training and support

EDUCATION / EXPERIENCE

  • Associate or bachelor’ degree in information management, data analytics, computer science, or a related field.
  • 3+ years of experience in healthcare industry or data analytics industry preferred.

work environment

  • 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 integration, where deadlines exist and when necessary due to the needs of the integration team.
  • A standard business environment exists with moderate noise levels.
  • Ability to lift and move approximately thirty (30) pounds on a non-routine basis.
  • Ability to sit for extended periods of time.

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.