Data Driven Edit

4 weeks ago

Hyderabad Telangana, India Zelis Full time

KEY RESPONSIBILITIES:
Primary focus on Data Driven Edit (DDE) development-
- Research, build and test edits to be used in the Claims Editing library of edits.-
- Use of strong coding and industry knowledge to build edits and editing content (data used by the edits).-
- Ensure compliance with HIPAA regulations and requirements.-
- Ensure adherence to quality assurance guidelines.Work closely with client teams to provide coding expertise for customer and provider inquiries-
- Provide written response, documentation and rationale for inquiries as needed.-
- Utilize the most up-to-date approved Zelis medical coding sources for edit development while also advising appropriate personnel of important changes, issues, and trends.-
- Test and validate changes made to the edit(s).-
- Monitor, research, and summarize trends, coding practices, and regulatory changes.-
- Performs other related responsibilities and special projects as assigned.-
- Maintains awareness of and ensure adherence to ZELIS standards regarding privacy.-
- Partner with other areas to assess and communicate impact to the business for additions, changes, or updates as it relates to edit updates.PROFESSIONAL EXPERIENCE:
5+ years’ experience healthcare or related industry.-
- Current certified coder (CCS, CCS-P or CPC), or registered health information technician (RHIA/RHIT), or RN, LPN with coding knowledge.-
- Proficient in Microsoft Word and PowerPoint.-
- Intermediate to Advanced Excel skills preferred.-
- Creative problem-solving skills, leveraging insights and input from other parts of an organization while remaining curious-
- Consistently demonstrate ability to act and react swiftly to continuous challenges and changes.-
- Excellent analytical skills with data and analytics related solutions.-
- Excellent communication skills.-
- Strong organization and project / process management skills.-
- Strong initiative, self-directed and self-motivation.-
- Good negotiation, problem solving, planning and decision-making skills.-
- Ability to manage projects simultaneously and achieve goals.-
- Excellent follow through, attention to detail, and time management skills.EDUCATION:
Graduation or equivalent is mandatory-
- Current, active CPC or equivalent credentialing required.-
- Bachelor’s Degree Preferred in business, healthcare, or technology preferred.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

  • Data Driven Edit

    2 weeks ago

    Hyderabad, Telangana, India Zelis Full time

    KEY RESPONSIBILITIES:Primary focus on Data Driven Edit (DDE) development Research, build and test edits to be used in the Claims Editing library of edits. Use of strong coding and industry knowledge to build edits and editing content (data used by the edits). Ensure compliance with HIPAA regulations and requirements. Ensure adherence to quality assurance...

  • Data Driven Edit

    4 weeks ago

    Hyderabad, India Zelis Full time

    KEY RESPONSIBILITIES: Primary focus onData Driven Edit (DDE)development Research, build and test edits to be used in the Claims Editing library of edits. Use of strong coding and industry knowledge to build edits and editing content (data used by the edits). Ensure compliance with HIPAA regulations and requirements. Ensure adherence to quality...

  • Data Driven Edit

    4 weeks ago

    Hyderabad, India Zelis Full time

    KEY RESPONSIBILITIES: Primary focus onData Driven Edit (DDE)development Research, build and test edits to be used in the Claims Editing library of edits. Use of strong coding and industry knowledge to build edits and editing content (data used by the edits). Ensure compliance with HIPAA regulations and requirements. Ensure adherence to quality...

  • Edit and Content Analyst-2

    1 week ago

    Hyderabad, Telangana, India Zelis Full time

    Perform end to end testing to ensure appropriate functionality, product integrity, accuracy, and quality of all changes and enhancements of the edit platform, Data Driven Edits PriZem (in-house system), Visium through the Payment Integrity (Claims Editing) process. - Analyze clinical and technical requirements and define the scope of UAT testing. Setup,...

  • Video Editing/Making Internship

    4 weeks ago

    Hyderabad, Telangana, India Hamsi Marketing Private Limited Full time

    About the internship:Looking to kickstart your career in video editing and making? Join our team at Hamsi Marketing Private Limited as a Video Editing/Making intern We are seeking a talented individual who has a passion for creating engaging and visually appealing videos. As an intern, you will have the opportunity to work alongside experienced professionals...

  • Systems Integration Advisor

    4 weeks ago

    Hyderabad, Telangana, India NTT DATA Full time

    NTT DATA Services currently seeks Java Developer to join our team in Bangalore/Hyderabad - About the Role **Responsibilities**: - Perform build & implementation, functional, integration and unit/performance testing, test automation - Assures quality, security and compliance requirements are met as part of projects delivery - Adhere to Agile development...

  • Big Data Engineer, Data Modeling

    2 weeks ago

    Hyderabad, Telangana, India data Full time

    What can you tell your friends when they ask you what you do? We're looking for an experienced Big Data Engineer who can create innovative new products in the analytics and data space. You will participate in the development that creates the world's #1 mobile app analytics service. Together with the team, you will build out new product features and...

  • Big Data Engineer, Data Modeling

    2 weeks ago

    Hyderabad, Telangana, India data Full time

    What can you tell your friendswhen they ask you what you do?We're looking for an experienced Big Data Engineer who can create innovative new products in the analytics and data space. You will participate in the development that creates the world's #1 mobile app analytics service. Together with the team, you will build out new product features and...

  • Big Data Engineer, Data Analysis

    2 weeks ago

    Hyderabad, Telangana, India data Full time

    What can you tell your friends when they ask you what you do? "As a Data Analyst at , I help analyze, monitor, and deliver comprehensive and high-quality app market data to app professionals. I am empowered to work independently with the support of team members spread across APAC, AMER, and EMEA. I am the key contributor to the new and existing product...

  • Sfdc Admin

    3 weeks ago

    Hyderabad, Telangana, India NTT DATA Full time

    **Req ID**: 268394 We are currently seeking a SFDC Admin to join our team in Hyderabad, Telangana (IN-TG), India (IN). Why the Role Is Important: Our Salesforce Administrators are fundamental to ensuring the digital technology and related services that NTT DATA builds for our clients are valuable, intuitive, and impactful. The work of Salesforce...

  • Sfdc Admin

    2 weeks ago

    Hyderabad, Telangana, India NTT DATA Full time

    **Req ID**: 285916 We are currently seeking a SFDC Admin to join our team in Hyderabad, Telangana (IN-TG), India (IN). Our Salesforce Administrators are fundamental to ensuring the digital technology and related services that NTT DATA builds for our clients are valuable, intuitive, and impactful. The work of Salesforce Administrators provides our clients...

  • Video Editing/Making Internship

    4 weeks ago

    Hyderabad, Telangana, India XtraLiving Private Limited Full time

    About the internship:As a Video Editing/Making intern at XtraLiving Private Limited, you will have the exciting opportunity to showcase your skills in Adobe Premiere Pro, Video Editing, Video Making, Adobe Illustrator, and Adobe Photoshop. This internship will provide you with hands-on experience in creating engaging and innovative video content for our...

  • Digital Content Associate

    2 months ago

    Hyderabad, Telangana, India ADCI HYD 16 SEZ - H83 Full time

    Graduate - Good Aptitude - Knowledge of Excel - Ability to communicate effectively The Primary responsibility of the role is to perform Data operations in Digital Platform. Need to continuously adapt and learn new features on the Editors and improve on his/her acumen to quickly edit and fix up contents. He/she has to follow editing SOP to spot/catch errors...

  • Data Analyst

    2 weeks ago

    Hyderabad, Telangana, India Data Unveil Full time

    About us: At Data Unveil, we believe in delivering the best for our clients (Pharma Companies). We use the latest technology and tools to aggregate and analyze specialty healthcare data received from various data partners. We provide clear and hassle-free business insights to enhance the client's vision and drive business success.Position Title:Data Analyst...

  • Data Driven Marketing Manager

    4 weeks ago

    Hyderabad, India Mars Full time

    JOB DESCRIPTION Job Description: Role: Data-Driven Marketing Manager (Media) Location: Hyderabad Job Purpose: The Media Manager role is centralized role will be responsible for building superior performance media capabilities for multiple brands in the Mars Petcare portfolio. As the Media Manager you lead national media strategy and execution...

  • Data Driven Marketing Manager

    4 weeks ago

    Hyderabad, India Mars Full time

    Job Description:Role: Data-Driven Marketing Manager (Media)Location: HyderabadJob Purpose:The Media Manager role is centralized role will be responsible for building superior performance media capabilities for multiple brands in the Mars Petcare portfolio. As the Media Manager you lead national media strategy and execution across a variety of programmatic...

  • Video Editing/Making Internship

    4 weeks ago

    Hyderabad, Telangana, India Blackbuck Engineers Private Limited Full time

    About the internship:Selected intern's day-to-day responsibilities include: 1. Capture high-quality photographs and videos of company events, team activities, and product features.2. Edit and produce engaging video content for our website, social media platforms, and marketing campaigns3. Collaborate with the marketing team to develop creative concepts and...

  • Data Analyst

    4 weeks ago

    hyderabad, India Data Unveil Full time

    About us: At Data Unveil, we believe in delivering the best for our clients (Pharma Companies). We use the latest technology and tools to aggregate and analyze specialty healthcare data received from various data partners. We provide clear and hassle-free business insights to enhance the client’s vision and drive business success.Position Title: Data...

  • Tableau Data Engineer

    3 weeks ago

    Hyderabad, India NTT DATA Full time

    Job DescriptionReq ID:284210NTT DATA Services strives to hire exceptional, innovative and passionate individuals who want to grow with us. If you want to be part of an inclusive, adaptable, and forward-thinking organization, apply now.We are currently seeking a Tableau Data Engineer to join our team in Hyderabad, Telangana (IN-TG), India (IN).Data Engineer...

  • Tableau Data Engineer

    4 weeks ago

    Hyderabad, India NTT DATA Full time

    Job DescriptionReq ID:284210NTT DATA Services strives to hire exceptional, innovative and passionate individuals who want to grow with us. If you want to be part of an inclusive, adaptable, and forward-thinking organization, apply now.We are currently seeking a Tableau Data Engineer to join our team in Hyderabad, Telangana (IN-TG), India (IN).Data Engineer...