Contract Analyst I
ZelisAbout the role
At Zelis, we Get Stuff Done. So, let’s get to it!
A Little About Us
Zelis is modernizing the healthcare financial experience across payers, providers, and healthcare consumers. We serve more than 750 payers, including the top five national health plans, regional health plans, TPAs and millions of healthcare providers and consumers across our platform of solutions. Zelis sees across the system to identify, optimize, and solve problems holistically with technology built by healthcare experts – driving real, measurable results for clients.
At Zelis, AI is woven into the fabric of how we work. Every associate is expected - and empowered - to partner with AI to challenge the status quo, accelerate innovation, and amplify their impact. This is a place for builders with a growth mindset who act with agility, embrace change, and use modern technology to shape smarter solutions, exceptional experiences, and the future of our industry for our clients, customers, and our culture.
A Little About You
You bring a unique blend of personality and professional expertise to your work, inspiring others with your passion and dedication. Your career is a testament to your diverse experiences, community involvement, and the valuable lessons you've learned along the way. You are more than just your resume; you are a reflection of your achievements, the knowledge you've gained, and the personal interests that shape who you are.
Position Overview
This position requires an incumbent to analyze healthcare reimbursement contracts and load contract terms between payers and providers in an accurate and timely manner using proprietary software. This position reports to the Manager of Contract Configuration and will collaborate with the programming and development teams in the creation and vetting of calculation methods, database loads, or changes. This position is an internal resource to staff and clients and as such is expected to respond to client issues and cases in a timely manner.What You’ll Do:
Set up basic contract loads: simple single case agreements (SCAs), basic % of billed charges (BCs), basic % of Medicare, general carve-out codes and basic fee schedule set up.
Interpret complex contract terms, analyze reimbursement methodologies, and rate structures (e.g., 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)
What You’ll Bring to Zelis:
- Bachelor’s Degree or equivalent work experience in Healthcare Revenue Cycle Management/Contracting field
- Microsoft product proficiency. Must be an intermediate to expert user of Excel
- Possess solid analytical and math skills; self-motivated and detail oriented.
Please note at this time we are unable to proceed with candidates who require visa sponsorship now or in the future.
Location and Workplace Flexibility
Zelis is headquartered in the U.S., with multiple locations across the country and in Hyderabad, India. Check out our locations to learn more about our offices. All employee work locations are b
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