Healthcare Claims Documentation Specialist

Zelis Healthcare, LLC; Morris Township (NJ); Hybrid; USD 21,000 - 26,000; Full time

Benefits offered by this job

401k with employer match

Flexible paid time off

Holidays

Parental leave

Life and disability insurance

Health benefits

Job summary

Zelis Healthcare, LLC is hiring a Document Retrieval Specialist to support medical claim review and audits by proactively contacting providers to request, obtain, and manage billing documentation. You will upload, organize, and review records for completeness and accuracy, ensuring compliance with client requirements and maintaining timely follow-up.

This hybrid role emphasizes strong organizational skills, meticulous attention to detail, and effective communication to meet productivity and

Qualifications

• Previous healthcare, medical claims, billing, or customer service experience preferred.
• Knowledge of Microsoft Office Suite and web-based systems.
• Strong prioritizing & organizational skills.
• Excellent customer service & telephone skills.

Responsibilities

• Assist the nursing staff in the medical claim audit process by contacting healthcare providers to request and obtain billing documents via fax, mail, and email for claims processing.
• Receive and upload retrieved documents into designated systems, ensuring documents are properly indexed and associated with the correct claim.
• Review uploaded documentation for completeness, accuracy, and compliance with client and provider requirements, identifying and escalating discrepancies as appropriate.
• Organize and prioritize assigned claims daily and conduct timely follow-up on outstanding document requests.
• Accurately document outreach attempts, provider communications, request statuses, and other relevant information.
• Utilize document retrieval systems and related tools efficiently.
• Learn and process requests according to applicable provider and client requirements.
• Meet or exceed the Document Retrieval Performance Standards established by the Document Retrieval department.
• Maintain awareness of and adherence to Zelis standards regarding privacy and confidentiality.

Skills

Healthcare claims

Microsoft Office

Prioritization

Customer service

Telephone skills

Education

High school diploma

Associate's degree a plus

Tools

Web-based systems

Job description

Zelis Healthcare, LLC is hiring a Document Retrieval Specialist to support medical claim review and audits by proactively contacting providers to request, obtain, and manage billing documentation. You will upload, organize, and review records for completeness and accuracy, ensuring compliance with client requirements and maintaining timely follow-up.

This hybrid role emphasizes strong organizational skills, meticulous attention to detail, and effective communication to meet productivity and