Doc Retrieval II

About Us 

Zelis is modernizing the healthcare financial experience in the United States (U.S.) by providing a connected platform that bridges the gaps and aligns interests across payers, providers, and healthcare consumers. This platform serves more than 750 payers, including the top 5 health plans, BCBS insurers, regional health plans, TPAs and self-insured employers, and millions of healthcare providers and consumers in the U.S. Zelis sees across the system to identify, optimize, and solve problems holistically with technology built by healthcare experts—driving real, measurable results for clients.  

Why We Do What We Do 

In the U.S., consumers, payers, and providers face significant challenges throughout the healthcare financial journey. Zelis helps streamline the process by offering solutions that improve transparency, efficiency, and communication among all parties involved. By addressing the obstacles that patients face in accessing care, navigating the intricacies of insurance claims, and the logistical challenges healthcare providers encounter with processing payments, Zelis aims to create a more seamless and effective healthcare financial system.

Zelis India plays a crucial role in this mission by supporting various initiatives that enhance the healthcare financial experience. The local team contributes to the development and implementation of innovative solutions, ensuring that technology and processes are optimized for efficiency and effectiveness. Beyond operational expertise, Zelis India cultivates a collaborative work culture, leadership development, and global exposure, creating a dynamic environment for professional growth. With hybrid work flexibility, comprehensive healthcare benefits, financial wellness programs, and cultural celebrations, we foster a holistic workplace experience. Additionally, the team plays a vital role in maintaining high standards of service delivery and contributes to Zelis’ award-winning culture. 

Position Overview

objECTIVES AND RESPONSIBILITIES:

Successfully manages both medical record claim audit requests and facility itemized bill claim requests.

Manages 2 or more nurse auditor staff in the medical claim audit process by requesting medical records and applicable documents from medical providers nationwide.

Contacts healthcare providers to request and obtain medical and billing documents via phone, fax, mail & e-mail for claims processing.

Organize and prioritize claims daily for follow up of billing documents not received.

Learn and process according to various provider/client stipulations.

Utilize AutoFax – document retrieval platform efficiently.

Performs other related responsibilities as assigned.

Maintain awareness of and ensure adherence to ZELIS standards regarding privacy.

What You Will bring:

Has foundational proficiency in requesting medical records and applicable documents from medical providers.

2+years of medical record experience or 1+year prior DR I experience.

Has a solid understanding of various types of medical documents.

Has a solid understanding of processes and techniques in obtaining documents.

Great verbal communication skills

Knowledge of MS Outlook, MS Word, & Internet Explorer

Strong prioritizing & organizational skills

Excellent customer service & telephone skills

Independence/ Accountability:

Meets or exceeds the Document Retrieval Performance Standards established by the Document Retrieval department.

Requires minimal daily supervision on day to day tasks but seeks guidance on more complex tasks

Accountable for day to day tasks

Ability to follow detailed instructions on new assigments

Must have professional manner and respect the confidentiality of administrative matters and files

Ability to manage and prioritize multiple tasks.

Ability to work under pressure and meet deadlines.

Completes work in a timely fashion

Outstanding ability to multiplex tasks as required

Attention to detail.

Communication Skills:

Must work well with others

Effectively communicates with others by giving and receiving feedback

Call Center Phone edicate

Communicates ideals and information clearly

education:

Graduate