Manager, Client Integration

Zelis

Bedminster, NJ, US
  • Job Type: Full-Time
  • Function: Engineering Software
  • Post Date: 04/28/2021
  • Website: zelis.com
  • Company Address: 2 Crossroads Drive, Bedminster, NJ, 07921

About Zelis

Zelis is a healthcare and financial technology growth company and market-leading provider of claims cost management and payments optimization solutions to price, pay and explain healthcare claims.

Job Description

Description & Requirements

POSITION OVERVIEW:
 
The Manager of Client Integration will have primary responsibility for leading a team of Client Integration Specialist to deliver on the key performance components to achieve goals and results for the Zelis Claims Cost Solutions department.  The Client  Integration Manager will ensure the day to day activities of assigned team aligns with the overall mission with adherence to best practice policies while serving as a liaison between the Implementation and Edit Configuration team when onboarding new editing clients.  
 
KEY RESPONSIBILITIES:
  • Consistently demonstrate outstanding presentation and communication skills while providing an overview of the Zelis edit suites during new editing client implementations
  • Effectively partner with Implementation business partners to ensure coverage and attendance for internal and external client meetings
  • Manage a team of Client Integration Specialist responsible for providing coding and claim adjudication guidance while interpreting client pre-production data to ensure alignment with payment policies
  • Partner with configuration business partners to ensure appropriate set up and configuration of customization based on client specific payment policies and lines of business 
  • Ensure assigned team effectively facilitates debriefing of client decisions and researches policy related issues identified during pre-production testing
  • Collaborate with business partners to effective support the pre-production testing process for client selected edit suites while providing on-going support to Implementation partners
  • Work closely with project stakeholders and cross-functional team to manage product knowledge transfer to assigned team to ensure                                                                                                                                                                                        
  • Perform as subject matter expert (SME) to provide coding and client specific guidance regarding internal policies and various lines of business
  • Manage assigned team to obtain pre-sales data to while partnering Sales Solutions Advisors
  • Manage day to day activities of assigned team to identify patterns in client’s pre-sales data to identify potential savings and provide guidance on new edit opportunities while identifying and documenting client sensitivities
  • Manage assigned team utilizing defined reporting tools and metrices to manage deliverables for external and internal client meetings 
  • Perform day to day coaching of assigned team on client facing activities, new initiatives, processes, and systems. 
  • Ensure compliance with HIPAA regulations and requirements.
  • Conduct staff training and coaching as necessary.
  • Ensure assigned team is aware and adheres to Zelis standards regarding privacy.  
  • The position responsibilities outlined above are in no way to be construed as all encompassing. Other duties, responsibilities, and qualifications may be required and/or assigned as necessary.
 
PROFESSIONAL EXPERIENCE:
  • 10-12+ years of relevant experience or equivalent combination of education & work within healthcare payers
  • Extensive knowledge of reimbursement methodologies and acceptable billing practices
  • Knowledge of payer reimbursement policies, state and federal regulations and applicable industry standards 
  • Current certified coder (CCS, CCS-P or CPC), or registered health information technician (RHIA/RHIT), or RN, LPN with coding knowledge required
  • Must possess outstanding presentation and communication skills with proven ability to deliver client presentations 
  • Project management
  • Experience managing internal and external relationships
  • Excellent verbal & written communication skills
  • Proficient in Microsoft Office, Word, Excel
 
DIRECT REPORTS:
  • Client Integration Specialist
EDUCATION:
  • Bachelor’s degree preferred but not required
WORK ENVIRONMENT:
  • Travel requirements to (primarily) domestic destinations should not exceed 10%.  
  • 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. 

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Disclaimer: Local Candidates Only
This company does NOT accept candidates from outside recruiting firms. Agency contacts are not welcome.