Responsible for building and running a fully functional application security and testing with teams in North America and overseas. Ensure security is baked into the application development lifecycle using Waterfall and Agile methodologies. Establish security architecture practices to assess the security risk and develop security patterns. Build an application security fun

Job Responsibilities Responsible for building and running a fully functional global security operation center with teams in North America and overseas. Ensure coverage, completeness, and accuracy of tolls deployed and monitored across the enterprise Ensures that the SOC team has proper processes, resources, and tools to timely detect, analyze and respond to security incid

The Claims Settlement Specialist supports claim settlement with providers through post payment negotiation. The Claims Settlement Specialist will be responsible for handling provider telephone calls regarding the payment amount paid to a provider by a payor based on Zelis data points. During this call, the Claims Settlement Specialist must understand (1) the procedures bi

The DRG Validation Nurse Reviewer will be primarily responsible for conducting post service, pre payment and post pay comprehensive inpatient DRG reviews based on industry standard inpatient coding guidelines and rules, evidence based clinical criteria plan, and policy exclusions. Conduct reviews on inpatient DRG claims as they compare with medical records ICD 10 Official

The Certified Edit Dispute Resolution Analyst will be responsible for researching and auditing medical records for complex, diverse, multi specialty provider claims to identify and determine appropriately coded billed services when compared to the Zelis Claim Edits Product. The Certified Edit Dispute Resolution Analyst demonstrates an understanding of Zelis edits as an in

The Senior Member Advocate is a vital role in ensuring service excellence to Zelis clients and their members. The Senior Member Advocate is proficient in and supports all Preservice Outreach, Balance Bill Resolution, and No Surprises Act assignment categories. This position requires the ability to act independently within the scope of assigned duties and responsibilities

We're seeking an Analytics Manager for PINS (Payee Identification and Network Security) to join our team, reporting to the Senior Director. In this role, you'll lead the PINS analytics team and drive the development of a structured analytics program. Your focus will be on managing ongoing and ad hoc reporting, automation, and operational enhancements for the PINS team, en

The Project Manager, PINS (Payee Identification and Network Security) will report to the Sr Director overseeing Zelis Payments' Fraud, Risk Management, and Identity Verification organization (PINS). The PINS team centrally manages Fraud, Onboarding/Verifications, and Account Servicing for Zelis clients, addressing issues related to account takeover, business identificatio