Zelis

Data Analyst

• Analyze and manage healthcare repricing claim data with focus on Medicare, Medicaid, and commercial reimbursements
• Analyze and interact with data in SQL tables; utilize Excel for manipulation, analysis, and reporting
• Create visualizations and dashboards to present data findings (Tableau experience is a plus)
• Communicate results to internal and external stakeholders including sales and client-facing teams and clients
• Actively contribute innovative ideas and support ad hoc and time-sensitive projects
• Maintain awareness of and ensure adherence to ZELIS standards regarding privacy
• Identify enhancements and process improvement opportunities

Healthcare Data Analyst

Compliance

• Research and decipher regulatory sources regarding payment rules for State Medicaid programs and commercial payment arrangements
• Draft concise documentation for payment procedures and collaborate with development to create user stories and test cases
• Perform analysis of data sources including fee schedules and provider files using tools like Excel
• Interact with regulators and clients to determine and document business requirements
• Lead pricer maintenance, QA activities, audits, troubleshooting, and defect corrections
• Educate internal and client staff regarding payment systems and procedures
• Update internal documentation and oversee one or more payment systems
• Identify issues early and communicate to team and leadership
• Manage competing priorities and deliver quality information while adhering to deadlines

Healthcare Data Analyst

Senior Medicaid Regulatory Pricer Analyst