Senior Manager, Specialty Support and Clearinghouse Operations

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.

  

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

The Senior Manager of Specialty Support & Clearinghouse Operations is a leadership position responsible for overseeing niche operational support functions and managing strategic clearinghouse relationships. This role ensures the effective execution of specialized services while serving as the primary operational point of contact for clearinghouse partners, facilitating issue resolution and continuous improvement.

What you'll do:

 

Specialty Services Management  

• Lead and manage a focused teams responsible for:  

• Lockbox Reconciliation Operations: Oversee daily reconciliation activities, ensuring accuracy and timeliness in financial postings.  

• Sworn Statement Support: Coordinate the preparation and validation of sworn statements in compliance with regulatory and client requirements.  

• 1099 Tax Services Support: Supervise the processing and support of Tax-related transactions and inquiries.  

• EDI Support: Provide operational oversight for electronic remittance advice (ERA) processing and troubleshooting.  

• Monitor performance metrics, identify process improvement opportunities, and implement best practices across specialty service areas.  

• Ensure compliance with internal controls, Standard Operating Procedures (SOP) regulatory standards, and client expectations. 

• Owns and manages the Purchase-to-Pay (P2P) process for the team, ensuring efficient and compliant purchasing, invoicing, and payment operations aligned with departmental goals. 

 

Clearinghouse Operations Management 

 

• Act as the primary operational liaison for clearinghouse partners, managing escalations, inquiries, and relationship health.  

• Facilitate cross-functional collaboration to resolve clearinghouse-related issues impacting transaction flow, data integrity, or service delivery.  

• Maintain documentation of clearinghouse processes, escalation protocols, and service-level agreements (SLAs).  

• Partner with internal stakeholders to ensure alignment and responsiveness to clearinghouse needs. 

 

What you'll bring to Zelis:  

• Proven experience in healthcare payment operations, revenue management, or financial services. 

• Minimum of 8 years' experience in a customer management role required.

• 5 + years' experience in a people leadership role.

• Strong understanding of EDI transactions, particularly Electronic Remittance Advice (ERA) files. 

• Demonstrated ability to lead specialized support teams and manage cross-functional relationships. 

• Excellent communication, problem-solving, and organizational skills.