Client Policy Specialist

Position Overview: The Client Policy Specialist is a client facing role that is responsible for interpreting and assessing client payment policy data, as well as being able to document the configuration required for the application of payment policy of Zelis edits. This is a remote role Key responsibilities: Present Zelis edit opportunities during new client implementations and upsell new edit opportunities to assigned production clients. Review client and payment policy documents. Interpret and document the configurations to be applied to Zelis edits. Conduct research and analysis for payment policy items for configuration of Zelis edits; advise how they can be configured to comply with client specific payment policies. Translate client payment policy to Zelis edit configurations. Understand and articulate payment policies; present the policies and associated edit configuration for review and acceptance by the client. Provide direction to internal team based on understanding of client payment policies. Proactively lend expertise to implementation team. Communicate effectively with various members of the client team (internal as well as external) to share client opportunity and limitations. Work with Healthcare Economics team to understand data and report impact and opportunity to client. Apply project management principles in initiating, creating and managing projects. Review and analyze client inquiries for clarity of intent; apply decisions for affected policies while maintaining information and communicating effectively with the client. Monitor, research, and summarize changes as client payment policy changes. Ensure compliance with HIPAA regulations and requirements. Participate in any staff training as necessary. Maintain awareness of and ensure adherence to Zelis standards regarding privacy

Created: 2021-11-29