Supervisor, Independent Dispute Resolution at Zelis NA in Austin, Texas

Job Description:

Position Overview:



The Supervisor, Independent Dispute Review (IDR) supports the IDR Manager by leading their team that responds to disputed claims submitted through state and federal arbitration processes. This is inclusive of monitoring inventory, daily production, ensuring attendance and scheduling needs are met, documenting and reinforcing departmental policy/procedure to exceed both client and Zelis expectations for dispute resolution. Will interact with internal and external clients to aid in retaining maximum savings, building relationships and supporting the team in achieving all relevant goals and KPI's.



Key Responsibilities:

• Supervise Regulated Claims Settlement Coordinators as it relates to daily responsibilities.
  
  


• Oversee the prompt handling and efficient turnaround of IDR disputes submitted for arbitration to ensure compliance standards are met.
  
  


• Manages daily inventory of IDR disputes.
  
  


• Ensure the team is meeting all production and quality goals.
  
  


• Specialize and provide guidance on complex issues.
  
  


• Participate in the hiring, training, and mentoring of new hires and existing team members with continued support and development.
  
  


• Assist Manager and Director with operation requests and implementation of new or modified standard operating procedures
  
  


• Communicate directly with Clients to provide pending issue status updates and notifications of resolved issues.
  
  


• Provide coverage and support for the department manager when needed.
  
  


• Performs other related responsibilities as assigned.
  
  


• Confirms that all documentation adheres to Zelis standards regarding privacy, compliance, legal aspects, and HIPAA standards.
  
  

Qualifications:

• Prior supervisory experience required
  
  


• Five years or more experience in healthcare, health insurance, or healthcare compliance
  
  


• Five years or more experience working with arbitration, appeals or disputes
  
  


• 2-4 years of medical claims, coding and/or revenue cycle experience
  
  


• Five years or more of customer or client services experience
  
  


• A background in healthcare collections, provider billing, negotiations or compliance is beneficial.
  
  


• Demonstrated aptitude towards problem solving and analysis
  
  


• Outstanding written and verbal skills
  
  


• Exceptional prioritization and organizational skills
  
  


• Knowledge of MS Excel, Outlook, Word and browser technology
  
  

Location and Workplace Flexibility: We have offices in Atlanta GA, Boston MA, Morristown NJ, Plano TX, St. Louis MO, St. Petersburg FL, and Hyderabad, India. We foster a hybrid and remote friendly culture and all of our employee's work locations are based on the needs of the position and determined by the Leadership team. In-office work and activities, if applicable, vary based on the work and team objectives in accordance with Company policies.


As a leading payments company in healthcare, we guide, price, explain, and pay for care on behalf of insurers and their members. We're Zelis in our pursuit to align the interests of payers, providers, and consumers to deliver a better financial experience and more affordable, transparent care for all. We partner with more than 700 payers, including the top-5 national health plans, BCBS insurers, regional health plans, TPAs and self-insured employers, over 4 million providers, and 100 million members, enabling the healthcare industry to pay for care, with care. Zelis brings adaptive technology, a deeply ingrained service culture, and a comprehensive navigation through adjudication and payment platform to manage the complete payment process.


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 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


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