Document Retrieval Specialist

1 month ago


Morristown, United States Zelis Full time

The Document Retrieval Specialist is responsible for contacting healthcare providers to request and obtain billing documents and processes document request cancellations.

Key responsibilities:

  • Successfully manages both medical claim audit requests and facility claim requests known as UB/IB 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. Including request for priority providers.

  • Contacts healthcare providers (30 or more per day) to request and obtain medical and billing documents via phone, fax, mail & e-mail for claims processing.

  • Meets or exceeds Quality Objectives established by the Document Retrieval department

  • Maintains history of daily assignments in tracking data base

  • Performs other related responsibilities as assigned.

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

Technical Skills / Knowledge:

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

  • Has a solid understanding of various types of medical documents

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

  • Computer proficiency and technical aptitude with the ability to utilize CMS, Adobe Acrobat and MS Office applications

  • Thorough knowledge of company and departmental policies and procedures

Independence/ Accountability:

  • 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 assignments

  • 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

Education:

High School Diploma

Associates Degree a plus

Zelis is modernizing the healthcare financial experience 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 national health plans, BCBS insurers, regional health plans, TPAs and self-insured employers, and millions of healthcare providers and consumers. Zelis sees across the system to identify, optimize, and solve problems holistically with technology built by healthcare experts – driving real, measurable results for clients.

Commitment to Diversity, Equity, Inclusion, and Belonging At Zelis, we champion diversity, equity, inclusion, and belonging in all aspects of our operations. We embrace the power of diversity and create an environment where people can bring their authentic and best selves to work. We know that a sense of belonging is key not only to your success at Zelis, but also to your ability to bring your best each day.

Equal Employment Opportunity Zelis is proud to be an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.

We encourage members of traditionally underrepresented communities to apply, even if you do not believe you 100% fit the qualifications of the position, including women, LGBTQIA people, people of color, and people with disabilities.

Accessibility Support

We are dedicated to ensuring our application process is accessible to all candidates. If you are a qualified individual with a disability or a disabled veteran and require a reasonable accommodation with any part of the application and/or interview process, please email TalentAcquisition@zelis.com.

SCAM ALERT: There is an active nationwide employment scam which is now using Zelis to garner personal information or financial scams. This site is secure, and any applications made here are with our legitimate partner. If you’re contacted by a Zelis Recruiter, please ensure whomever is contacting you truly represents Zelis Healthcare. We will never asked for the exchange of any money or credit card details during the recruitment process. Please be aware of any suspicious email activity from people who could be pretending to be recruiters or senior professionals at Zelis.

Zelis is modernizing the healthcare financial experience 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 national health plans, BCBS insurers, regional health plans, TPAs and self-insured employers, and millions of healthcare providers and consumers. Zelis sees across the system to identify, optimize, and solve problems holistically with technology built by healthcare experts – driving real, measurable results for clients.



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