Healthcare Contract Configuration Analyst I

Zelis; Plano (TX); Hybrid; USD 54,000 - 68,400; Full time

Benefits offered by this job

401k plan with employer match

Flexible PTO

Health benefits (medical, dental, vis​

Parental leave

Job summary

Zelis is modernizing the healthcare financial experience across payers, providers, and consumers. This role analyzes reimbursement contracts, loads terms between payers and providers, and collaborates with development teams to ensure accurate pricing methods and data loads.

The position reports to the Manager of Contract Configuration and requires timely responses to client issues. Hybrid work with base salary in the mid-market range, plus comprehensive benefits.

Qualifications

• Bachelor’s Degree or equivalent work experience in Healthcare Revenue Cycle Management/Contracting.
• Intermediate to expert Excel skills and Microsoft product proficiency.
• Strong analytical and math abilities; detail oriented and self-motivated.

Responsibilities

• Set up basic contract loads: simple SCAs, basic % of billed charges, basic % of Medicare, general carve-out codes and basic fee schedule set up.
• Interpret complex contract terms, analyze reimbursement methodologies, and rate structures (DRG, APC, CPT/HCPCS, ICD-10).
• Load, maintain, and audit client contracts within the adjudication system.
• Validate and test contract configurations for claims pricing accuracy.
• Maintain fee schedule in contract databases and apply annual escalators for client auto renewals.
• Link contracts to payer products, update and maintain provider groups within client databases to ensure seamless claims routing.
• Handles confidential material on a regular basis and is responsible for protecting the confidentiality of such information within the established guidelines of Company and law. (HIPAA Compliance)

Skills

Excel

Analytics

MS Office

Detail oriented

Education

Bachelor’s Degree or equivalent in Healthcare Revenue Cycle Management/Contracting

Job description

Zelis is modernizing the healthcare financial experience across payers, providers, and consumers. This role analyzes reimbursement contracts, loads terms between payers and providers, and collaborates with development teams to ensure accurate pricing methods and data loads.

The position reports to the Manager of Contract Configuration and requires timely responses to client issues. Hybrid work with base salary in the mid-market range, plus comprehensive benefits.