Apply on Employer Site

Zelis · 19 hours ago

Contract Analyst II

Plano, TX

Full-time, Contract

Hybrid

Mid Level

Zelis is modernizing the healthcare financial experience across payers, providers, and healthcare consumers. The Contract Analyst II will analyze healthcare reimbursement contracts, load contract terms accurately, and collaborate with programming and development teams to ensure effective contract management.

FinanceFinTechHealth Care

No H1B

Responsibilities

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)

Qualification

Healthcare Revenue Cycle ManagementContract AnalysisExcel ProficiencyAnalytical SkillsHIPAA ComplianceEffective CommunicationSelf-MotivatedDetail OrientedTime ManagementAdaptability

Required

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

Posses strong analytical and math skills

Self Motivated and Detail Oriented

Effective written and verbal skills, communicate effectively & expresses ideas clearly and succinctly

Develops Self: Seeks opportunities for continuous learning. Modifies behavior in response to feedback. Knows personal strengths and weaknesses and demonstrates ownership for personal development

Drives for Results: Delivers high quality work and attains results. Demonstrates personal drive and pushes self and others for results and quality work. Responds appropriately to urgent situations

Plans and Organizes Effectively: Prioritizes the importance of tasks and goals. Manages time efficiently to accomplish priorities and overcome obstacles

Displays Adaptability: Performs well in high pressure or stressful situations. Works effectively when direction is unclear or rapidly changing. Demonstrates persistence in the face of obstacles

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)

Please note at this time we are unable to proceed with candidates who require visa sponsorship now or in the future